I did have to go to the hospital this week for an MRI, and when signing in I saw a sign saying that people without a Québec Health Card (or various International Student Insurance/etc cards) would be charged $475 a day for Emergency care, with other services charged in addition to that. I had the option of getting the MRI privately, and that would have cost about $700, or so I was told. While I am glad that our health care system pays for all of these services (and yes, I’m aware it’s not free and it comes from our taxes etc), it is interesting to a) see the “true” cost of health care here in Québec, as well as b) get a sense of how that compares to the costs cited in threads like these for US health care services.
Note to self: never go to America. How is it even legal to charge that much?
I can’t even begin to understand the American concept that medical care is an industry which should make a profit, rather than the basic human right which it is in the rest of the civilised world.
Nope, its reasonable for having a facility available 24/7/365 that can deal with damn near anything you can throw at them from stuffy noses to multiple gunshot wounds. There are fixed costs at play for every body that gets checked into the system, medical records, the exam, restocking teams, housekeeping, phamacy, labs, etc. Those things cost money even when they are not in use.
That is what you are paying for.
It pisses me off every time I hear ambulance bills derided based purely on mileage.
You are paying for availability of care. Emergency services are ALWAYS going to be the most expensive and least cost effective.
For a board full of people this fucking smart, some of y’all really don’t think this stuff through.
But is that really the cost of the service, or is it the cost of a hospital/service provider trying to make a profit or even just break even because the system is such that a lot of what they are providing is given out for free to the uninsured?
The first case is fair. The second…not so much.
Someone might pit me for this, but here’s a comparison involving a veterinary clinic (the only experience I have with needing to pay costs): a cat needing x-rays, urinalysis, blood draw and full panel, three nights stay, IV fluids and antibiotics, 24/7 care of a vet, vet techs and the costs involved in a very fancy/fully-equipped emergency vet hospital (electricity, mortgage, receptionists, etc) cost about $1500. That, to me, is a deal, and is the cost of medicine. Most of what is done on humans is done on animals too, when it comes to the technology.
Are the costs that many US hospitals are forced to pass on to their patients fair? The more of these threads I read, the more I feel they aren’t. Our system isn’t perfect - very far from it - but it isn’t bankrupting people for a single ER visit either. These are expensive services…but I don’t think they are that expensive.
Another factor to keep in mind is that cats rarely sue if they aren’t cured at once.
I am only familiar with one state, but at least in that one, the limit on the liability for vets if the “patient” dies is the fair market value of the animal, which is not very high for a used cat. Another factor is that people resist the idea of euthanasia if the cost of treatment is excessive, while this is not unheard of in veterinary care. Another is that people are not shielded from the cost of veterinary care at the point of sale as they are if they have health insurance for themselves.
I suspect that if, for the last fifty years, people had to pay for their own health care, and were willing to accept the same kind of outcomes for themselves and their loved ones as they are for their animals, health care for humans would cost a good deal less.
There’s the joke about the big expensive machine that generated $10,000 of revenue for a business every hour, and broke down. The in-house maintenance staff tried everything they could think of, and nothing worked. So they called in a consulting engineering firm, who sent out the field support guy.
He poked about in the machine for ten minutes, then pulled out a hammer and banged the machine on the side. It started up, and ran perfectly.
The engineer sent a bill for $5,005. He was asked to justify such a large bill for hitting the machine with a hammer. The breakdown was as follows:
Hitting the machine with a hammer…$5
Knowing that the machine needed to be hit with a hammer…$5,000
My friend swallowed a chunk of meat that was too large and it got stuck in her esophagus. She wasn’t choking, but it wouldn’t go down and she couldn’t swallow. The ER doc stuck some forceps down her throat and pulled it out. Her insurance company was billed $20,000.
I chewed my food really carefully for a long time after that.
For no other reason than oh my fucking god horrified proximity commiseration…
My cousin-in-unlawfulness just had what turned out to be unnecessary emergency thoracic surgery going after a torn aorta that showed up in some sort of imaging but wasn’t actually torn. He went in because he had been sick for a few days. He has no insurance. His wife is 4 months preggers and they have a toddler. He’s now recovering flat on his back for at least 6 months.
I mean…holy hell. How are people supposed to deal with shit like this?
Oh no, your country, your system. If it suits you stick with it but on the whole, faults and all, I’d rather pay for the NHS through taxation and have healthcare free at the point of use.
Thanks for considering that reasonable. I had someone yell at me for their $300 bill for care for their pet’s diarrhea. See they worked in human medicine so they know that stuff doesn’t cost that much. It’s okay for human medicine to markup 1000 percent, but in veterinary medicine we are expected to charge cost. It doesn’t matter that we need to pay for other things such as building and equipment costs and of course salaries.
Good points: I didn’t consider the insurance angle and the different choices made when facing disease or injury.
When a US hospital provides a breakdown of costs, though, does it usually separate the procedures from the extra costs? Such as listing X-rays - X$, IV antibiotics - Y$, Administrative fees - Z$? If so…are the costs reasonable for those items? Like I said in my other post: are patients being charged what it cost, or are they being charged what it cost to fill in the gaps in the system?
What’s most frustrating about vet bills is the lack of billing options: paying $1500 for the services we received was one thing, paying it all at once was another. We managed, but it wasn’t easy, and I’m sure a lot of people would have had a lot of trouble paying that all at once (or even be able to put in on a credit card).
That particular vet clinic is expensive: it is the 24/7 emergency vet for the island of Montreal…all the vets in the area pay into having this place open, rather than being on-call themselves. It’s a pretty neat deal, but you start at a $125 consult rather than the more standard $45 or so. Still, in an emergency, they are fantastic. We had to bring the same cat back there last month…unfortunately we had to put her down since she was in massive organ failure (started with the kidneys), but it was better than trying to get her to survive the night and going to the local vet.
Which is a great argument for more urgent care centers which can be staffed with mid-level practitioners (physician assistants & nurse practitioners) to deal with stuff more serious that primary care providers can handle (or are closed), but don’t really require a full ER staff.
Yes indeed, if your kid has an ear infection you should understand underwriting the MRIs and Cat Scanners is part of your fees. You should be glad to kick in for heart surgeons and cancer wards.
Does that really make sense to you?
Given out for free as mandated by law…laws passed by your elected representative. Nobody in the ER holds up treatment on a critically ill or injured patient based on ability to pay, period.
A vet hospital gets to pick and choose, bring in your sick cat and they tell you its gonna be $5,000 to save it, you can say “no thanks, put fluffy to sleep”.
Also since most pets are legally personal property of very limited financial value, lawsuits for malpractice and or negligence are almost a non issue, hospitals get sued on a daily/weekly basis, better yet, sued by people who never paid for those services.
Yes, it does, you are also paying for staff vacation time… When your kid turns out to have a life threatening congenital heart condition that manifests one night at 11pm they have someone available to fix it that night, or at least has the ability to sustain your child until one is called in. EVERY business does this to some degree or another usually lumped into base rates. CT scanners are tools a hospital is expected to have on hand in the event they are needed. They don’t wait for someone to need one to buy one.
You are paying for availability, don’t like emergency prices, don’t use emergency services. Anyone ever try to get a plumber at 3am, invariably there are some available at 2-3 times the normal going rate for such things. You need it now, you pay a premium, because they had to spend extra money to staff and equip the facility you are using at the time of your need.
