About 80% of hospitals in the US are owned by a government or a non-profit (cite).
Just over 40 now, married, 2 kids. My wife and I both have some not uncommon pre-existing conditions. We just moved to TN from MI several months ago, and in Michigan, BCBS was a small fortune and I’ve been avoiding the Urologist and hospitals as mush as possible until I had to have a 6mm stone removed under general anesthesia. This was just before I had to drop BCBS, and now, apparently, kidney stones are looked upon as “kidney disease” by a lot of insurers. I’ve passed 9 as well. Some just slipped on through with hardly a pang, but the majority of them were atomic bombs of pain. The 6mm one lasted for 3 months, and was practically debilitating and agonizing. I guess I just really got gun shy after that last one. But hell, I’m not gonna let these ridiculous costs keep me from seeking medical attention as soon as I feel a real sign something’s wrong.
Anyhow, We’re finally getting around to choosing a best-of-all-evils plan.
Besides, I don’t mind paying what it’s worth, but these costs are just so convoluted, outrageously bureaucratic, if not ethically despicable. Perhaps I’ll be one of the 25%* and help burst that bubble the medical field and insurance companies are puffing up on the backs of the very people the former supposedly wants to help; and on great cost and effort on their parts.
Everybody who lives, will at some point need medical attention, and ERs can’t turn people away by law. So here’s, arguably, two rhetorical questions: What exactly are insurance companies providing here, other than creating a middle-man? What’s a society for if we can’t pool together on civil, moral, ethical and practical grounds?
I know this isn’t really news here in America, but that bill is laughable, if it wasn’t just pathetic and sad.
I do feel better, and it was over before I knew it, but now I’ve got a bigger pain in my wallet. That said, thanks all for the all the advise and information!
*Just ranting. I’ll pay something, but within reason. Okay, rant over. For now.
Agree on all counts.
But just to add to that, there are inefficiencies in the medical industry that affect every country. Americans just have the double whammy of paying for those inefficiencies as well as the unique costs of their health insurance industry.
For example, when it comes to scanning devices, there are virtually no pressures pulling down prices.
It’s very hard for new companies to enter the market. The R&D costs are prohibitive if you’re just starting out, and the regulatory / legal complications mean the only really feasible way of getting a foot in the door within 15 years is to buy out an existing company.
Meanwhile the big boys compete more on client/customer relationships than price. Or add features of limited real value so they can keep inflating prices. And I’m saying that as someone who works for such a company.
Part of the reason for high medical costs may be that medical professionals don’t have price competition so it’s not really a free market.
In the UK it’s not uncommon for CT scanners or other high tech equipment to be paid for by local subscription.
My wife and I were friendly with the chair of our local hospital’s league of friends. They raised many £thousands each year through various events to buy equipment. Donations are not tax deductible here either.
I had an ER visit which included a CT scan of my head and neck back in 2010. I saw the bill for that one since I had to pay $150 of it as my ER copay. I was in there for close to 8 hours, was in a bed in a private room, and the whole visit billed to my insurance was about $5,000. I think I remember the CT portion being $3,000. Still expensive, but not as nuts as the OP.
In contrast, I had an MRI done last August on my sprained knee. Because that was not an emergency and could be scheduled at a place that just does MRI’s and not a hospital, I think that was just $350 billed to my insurance and no copay for me.
No idea what either of those might have cost if I didn’t have insurance. I thought it was less expensive for individuals if they had to pay out of pocket.
Planet Money had a podcast on MRI scans and prices in the US vs the rest of the world. The main takeaway is that, while better equipment plays a factor, the main factor is that people don’t comparison shop medical care since insurance takes care of it all anyway. That means there’s no incentive for scan centers to compete on price.
According to a somewhat recent Time magazine article called “Bitter Pill” by Brill, there is no actual reasoning behind hospital prices. He claims that hospitals use a price list called a ‘charge master’ that lists prices for various hospital services that have no relationship to the actual cost or value of the service provided- that the charge master is basically just made up numbers.
Brill reports that the most accurate medical service pricing is Medicare pricing which takes into account the cost of the equipment, its parts, maintenance and repair, the cost of the employees that run and interpret the results, etc., and that Medicare pricing is actually quite reasonable and fair.
Brill also states that hospitals are happy to provide steep discounts to cash-paying customers (discounts based on ridiculous charge master prices), but that those discounts also have little or no relationship to the actual cost or value of the service and that ultimately cash-paying customers actually pay more for services in order to subsidize the discounts offered to insurance companies and to cover the very, very little charitable service hospitals do provide. Cash paying customers are not aware of this and are just happy to get a 50% (or whatever amount) discount. He also claims that charitable care provided is listed at the inflated charge master prices to make hospitals look good (more giving than they really are) and to pad appeals for donations.
That was a difficult read if what Brill claims is true.
“Bitter Pill” in PDF: Welcome to livingwithmcl.com
I know this thread is a bit old, but i thought folks might be interested in an article from today’s New York Times, about the overuse, and widely varying costs, of echocardiograms.
The variations are even higher than that in some areas. For example:
All of this, according to the article, at a time when the equipment for performing these tests is getting cheaper and cheaper. Medicine, it seems, is one area where advances in technology and the reduced cost of equipment don’t actually lead to downward pressure on prices. Of course, those evil countries with their socialist medicine don’t know how to do things properly:
But US hospitals do procedures whether they need to or not, because the procedures make money, and there’s no point having a machine that goes PING if you can’t use it as often as possible. I really like this comment on the situation from a doctor in San Diego:
Emphasis mine. 
The $8,000 is the charge master price. This is, as far as I can determine, a totally made up price. Almost no one pays it. Ask the hospital for a real price, and you will probably get one. No one is sure how the charge master prices are generated, and no one will talk about them, but they are totally made up, not based on anything, and always appear ludicrous when quoted.
When I had my cataract surgery, I got statements from the surgeon, anesthesiologist, assorted nurses, and other staff. Everything was itemized, and the insurance company paid for everything, but a small copay. A couple of months later I received another statement for use of the little building the surgery was done in: $8,500, which the insurance company had paid in full.
I sent the hospital a note, saying that when I need cataract surgery in the other eye, I want to have it done here in my home, after which I’ll bill them for $8500.
Not as cheap as Thailand but prices for non-NHS scans in the UK start at around $500:
Say, that’s a nice kidney stone you got there. Be a shame if it just stuck around hmmmmm?
Oh, you want to get rid of it? Intense pain? That’ll be $8,000. Better hurry though. That’s a special sale. In the next 10 minutes, the price is gonna go up to $10K. Or you could head over to another hospital across town if you like.
Oh, and about your car in the parking lot .. Nice car. Be a shame if it got smashed. For $500, Vinnie here will guard it for you.
Private CT scans in Vancouver - $600 - $1100 depending on whether contrast is needed. Of course this is only if you can’t wait and want to jump the queue.
My wife has had MRI’s and we have not had to wait long at all. No reason to go private. But I have known people who did - mainly because they had tons of money and just wanted to get it done on their schedule.
When the hospital found out that the insurance WASN’T going to pay the $2800 (ever have an MD demonstrate an inhaler for you?) bill, and it would come out of my pocket, it became a $600 bill.
It is much better to ask for a lot and settle for less than to ask for less - every once in a while, someone will pay the asked price.
My first encounter with UCSF ER was when I hemorrhaged and was written off for dead (yes, the “Is there anyone you would like to have present”? Q) - I went in Sun evening and checked myself out the next morning.
I had just purchased health insurance - my insurance company loves me - and the bill came to $54K - almost $5K/hr - ER, ICU, EKG, 2 units of reds, saline and blood draws every hour.
I wonder how much they charged for the toe tag they had to discard…
Here in Trinidad I could go to the premiere private hospital and get a damn MRI for about 500 USD, not sure about CAT scan.
Dental work is shockingly, shockingly cheap.
Those albuterol asthma inhalers asthmatics in the USA now have to pay 60 USD a piece for cost 2.50 USD here and they are OTC. Pretty much all meds except hardcore narcotics or other abuse prone stuff are OTC and the price differential is SHOCKING.
Someone is making bank off USA consumers.
I have had 2 CAT scans in the last 10 years here in Australia. I have had to sign my name for both of them.