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View Diary: I feel sorry for health insurance companies. Yes, I said that. Why? This Time report must be read. (228 comments)

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  •  Competition (14+ / 0-)

    Every hospital has to have all the latest equipment, even if its available at another hospital 10 miles away. They all need to do everything, regardless of the duplication and cost.

    Example - there are at least 6 hospitals in Delaware that I can think of offhand. That's full hospitals, not just clinics. Those hospitals all have extensive imaging units, and there are separate facilities for that scattered through the state. They all do every kind of major surgery.

    Remember, this is DELAWARE. All the major hospitals in philly and s. jersey, as well as those in Baltimore and DC, including major research hospitals and world class facilities, are no more than 3 hrs from anywhere in the state.

    I can understand some duplication, but really, that much? Most places where there is universal care of any type will have way more primary care facilities and way less of these expensive, super full service facilities.

    Which is what we need. More primary care, which is what everybody needs, and more geriatric and long term care, which we will need soon, and less of the 'we can do everything kinda ok' facilities.

    •  this is a big part of the cost of healthcare, (5+ / 0-)

      although it is invisible to nearly everyone who doesn't understand medical diagnostic tools and their value/cost.

      Most of the modern imaging devices cost upwards of 7 figures each.

      Most of these devices are not in use for a majority of the day.

      Nearly every single clinic and multiple physician group and hospital has all of these devices, no matter how big the population in the area is.

      Remember, each device must be paid for through patient billings before it can start to make a profit for the providing physician, clinic or hospital (be assured that the sales force for the company which manufactures the device pushes this information when urging another provider in a community full of the devices to buy one for his/her medical office/clinic).

      Simply mathematics could show that the biggest cost to Americans for healthcare today is hidden in the over-supply of diagnostic devices in every single area of the nation. The more of these devices in any area, the higher the cost for the diagnostic use of each one (because not enough patients use each one, so they charge more per use to pay off the cost of them sooner and to start seeing a profit off of them).

      If the hospitals would schedule the use of the these devices around the clock, and the company who manufactures them are only allowed to sell a specific number of such devices in any geographical area (based on population and access to the various units situated in their location)...

      the costs of healthcare would start declining in real time.

      Look, if there are 2,000 MRI devices in a population pool of 240,000 people and the percentage of time during the past ten years that the devices have been used is available (and it is), then a mathematical evaluation will tell if there are enough or too many of them in that community.

      It's a big money pit that most people just aren't aware of when it comes to the cost of healthcare.


      "I like paying taxes...with them, I buy Civilization" -- me

      by Angie in WA State on Thu Feb 21, 2013 at 12:17:24 PM PST

      [ Parent ]

      •  I question whether the imaging devices are not... (0+ / 0-)

        in use the majority of the day.  When I've had to make an appointment for a CT or MRI it's usually a week out.  Sometimes it's less than that, maybe a day or two in the future, but still these devices get a lot of use.  

        I mean, technically they may not be scanning literally nonstop with a conveyor belt dropping patients into place, but at the same time they certainly aren't collecting dust.  

        Also, the article linked in the diary indicated that an MRI or CT machine was paid off in like the first year.  Their initial cost doesn't explain the absurd rip-off prices we're charged for their use.  

        The fact is, when you enter the medical world it's like entering the Twilight Zone.  All of a sudden walking on a treadmill for 20 minutes with an attached heart monitor costs a thousand dollars.  It's fucking ridiculous!  

        •  Since hospitals operate on a 24 hour basis, I (0+ / 0-)

          note that the devices are not operating for a majority of the day, but what I meant was they are not in use for over 12 or 16 hours of each day.

          In addition to there being far too many of them in most geographical areas for the cost of each diagnostic test to be reasonable for patients and their insurers.

          In addition to Healthcare services being one of only two industries in These United States which are specifically exempted from the Anti-trust laws of the early 20th century. Thus clinics and hospitals and doctors can collude to fix prices as high as the market will bear - and then some. And they can do it all as often as they like, legally.

          So whenever one place in an area raises the cost of a test, you can bet your bottom dollar that every other clinic and practice and hospital in the serving area will do the same.

          I used to work for sole practitioner. He asked me to use my own cell phone and pretend to be a patient and call around to see how much the other doctors in his specialty were charging by the hour. He was a European immigrant. I explained to him he could just have me write a letter to the clinics and ask them, and why.

          In any other industry it would be a federal crime, with jail time, to collude and price fix - because it is not in the best interests of the consumer patient to do so.


          "I like paying taxes...with them, I buy Civilization" -- me

          by Angie in WA State on Fri Feb 22, 2013 at 11:03:36 PM PST

          [ Parent ]

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