Are You Kidding Me?
Tuesday, December 11 2012
How Much For An MRI? $500? $5,000? A reporter Struggles to Find Out
Everyone has a story about an experience with our dysfunctional health care system that would make someone say “are you kidding me?” Once I had to be taken to a hospital by ambulance due to a concussion, and then a few weeks later got a bill from my insurance company because the particular ambulance company I used was not covered under my plan. Yes, that’s right, apparently before dialing 911 I was supposed to call my insurance company to find out which ambulance should pick me up.
The above article highlights an experience by a reporter in Massachusetts who tried to find out the cost of a recent MRI she had to receive. Needless to say it was not very easy to do. This is important because one of the recent trends in health policy is to figure out ways to increase transparency regarding the cost of medical services. The theory goes that if patients have more information regarding the costs of services they will become “smart shoppers” for health care, which combined with a new wave of high deductible plans, could help bring down costs. But if it’s this hard to find out the cost of services in the first place, how can this theory be tested?
If we ever had full transparency as to the cost of medical services, the public would be very surprised. Health care services, such as an MRI, are incredibly expensive, but people are typically insulated from these costs by insurance. Furthermore, as the article points out, many times health professionals charge more for a service that is more “profitable”, such as MRIs, to offset the costs of other services that are less financially viable. And, health professionals often must charge those with private insurance much more to offset the lower reimbursements they receive from Medicare and Medicaid.
We should strive for more transparency in health care if for no other reason than so the public is more aware of the complex underpinning of our dysfunctional system, which hopefully could encourage a movement for real, meaningful health system reform.
Mike Murphy has over 7 years of policy and political analysis across multiple organizations, focusing on many issues including federal fiscal issues, state and local finance, tax policy , health care, and transportation.
Yes. This is exactly why it is so vital to have single-payer healthcare, like the rest of the industrialized world does. The “free market” is ill-suited to the delivery of healthcare to those who need it. It’s ridiculous to have to compare costs of a procedure like you do a TV, and the rich do not deserve to live any more than the poor.
Plus, single-payer is way cheaper and has better outcomes.
I’ve had no insurance since 2001, I pay out of pocket for services. I usually go out to bid for services informing the vendors I am on a fix income and pay out of pocket at the time services are rendered. In states like Michigan I usually saw a 50% break from the originally quote price. In New Hampshire I would usually see a 15% to 25% break. However health cost in New Hampshire are much hire than Michigan. New Hampshire is a closed state so the competition for insurance is limited. My last MRI cost $600 in Michigan with payment in advance.
I both states getting a quote for most procedures in advance is almost impossible from a accuracy stand point. Colonoscopies and supporting services vary widely. There’s the attending Physicians fee, Anesthesiology fee, Facility Fee, and Diagnostics. Diagnostics is where things seem to get complicated and expensive quickly. The best price I found two years ago was in Costa Rica at a US Veterans Administration approved facility. In New Hampshire the price was at minimum $3,500. For the same price in Costa Rica I would get a Colooscopy, Dental work and Eye exam; including a weeks stay for two with airfare. Go Figure!
@Tom If the rich do not deserve to live any better than the poor, we need to revise our foodstamp and welfare system to provide for meals at Four Seasons and nights at the Ritz. We are a wealthy nation that can do anything we want. We just cannot do everything we want. We are the only developed country withbout a medical budget, so its no wonder we have run away Medicare costs. The Medicare liabilities we are leaving behind is going to criple the next generation. Canada has a government run single payer sytem and has also developed an illegal underground medical ssytem that provides medical care for people who cannot get attention in their single payer system. I cannot imagine why anyone would believe that the government (i.e. politicians and bureaucrats)can set up a better medical sytem than what the free market could establish if left alone(i.e. if we eliminated all the tax incentives for companies to provide medical insurance and let individuals make their own decisions – just like auto, home and life insurance.) As Pres. Reagan said “Government is the problem, not the solution”
@John. I did not say the rich deserve to live any better than the poor; I simply said they deserve to live.
You know, of course, that there are more people here who cannot get medical care because they do not have insurance. No, I’m sure you say, they can get whatever care they want when they go to the emergency room; that’s precisely the point–by the time they get to the emergency room, they are sicker, the care costs more, and we all pay anyway because they can’t pay the bills.
As for Reagan–he is the reason we are in this mess. By “mess,” I mean the following–since 1980, real wages for people who work for a living have remained stagnant or even gone down in real terms, while productivity has gone way up. Where has that money gone? Well, income and wealth disparity have increased to Gilded Age levels. So, since the top has taken money they did not really earn, maybe they can give up some of it to support the society that they are all a part of.
As for crippling us–I would rather have every person be covered for healthcare than continue with the bloated Pentagon budget as it is.
There is no other industry that has a system that is so convoluted that you could never identify the cost for a service prior to receiving it. Insurance companies contractually restrict hospitals from releasing their contracted rates with that provider. It could be helpful to patients to knew ths information as they shop around for that lower cost MRI or other test.
Hospital bills are not in a form that individuals can understand – they are in a form that insurance compaies can understand. This is partially the result of the way our healthcare system has developed due to tax incentives (companies get tax break for healthcare costs, but individuals do not unless they have very high medical expenses.) Changing the tax code and mandating that everyone pays the same price for the same medical proceedures would be a great start in fixing the system. But that is probably unattainable since Medicare dictates prices so low that hospitals would go out of business if they had to offer those prices to everyone. And for congress to consider a change to the tax code – with so many vested interests – its not likely to happen. So it appears that we are stuck with a really screwed up medical system until it literally breaks the bank (US Treasury) because Congress does not have the courage or leadership to solve a problem. However, they are great at pointing fingers. The current Medicare healthcare system is well on its way to impoverishing future generations of Americans unelss dramatic changes are made. Obamacare only added to an already incredible financial burden on the US that will be borne by our children and grandchildren.
A major contributing factor to cost obfuscation is that payment is essentially guaranteed the moment the patient walks in the door, regardless of whether a service is rendered. As soon as an insured patient presents his/her insurance card to the receptionist, payment will be rendered regardless of what actually transpires in the exam room. Can you imagine that happening at a grocery store? If your insurance paid the store for a loaf of bread when you walked in the door, how likely is the store to knock itself out making sure you receive your money’s worth of bread? Twice I have worked with my insurance company to take back payment from doctors who literally did nothing, and although I was successful it was an ordeal. We need to broaden the discussion beyond the mere argument over who pays how much, and ask: What are we getting in return for our money?