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I've been hearing a lot from the rich about how the poor "will overuse medical services" if they aren't charged a percentage of their costs, preferably a high one, but nobody ever mentions how impossible it is finding out what those costs are. This is a ridiculous argument, given that truth, and a dangerous situation for the working class because for example, people often are told a procedure will be covered when it is not. This must be made illegal for the current monstrosity to work. Also, with the cost of travel falling, people need to be able to know the price, so they can decide if medical travel is a better idea. I know that the cost of an MRI that costs $3000 here is $98 in Japan, the government price list is online. So, anyone who is getting an MRI can get a free trip to Japan, and save thousands of dollars too. So what the hell is going on that the hospitals and doctors don't publish the prices for MRIs, CAT scans, all medical tests, etc. so people can negotiate prices. Thats what the hospitals elsewhere do. This would save lives!

Last night I watched Sick Around the World, and it had me really angry about the incredible arrogance and indeed, malevolence of our leaders here for deigning themselves so empowered as to block the nation's upgent demand for passage of affordable health care in the US and replace it with an unaffordable abomination. Both parties are doing this hijacking. Affordable health care starts with an idea, universality. It requires that other alien concept to the robot like politicians, transparency. It includes another idea, managers put the peple of this nation ahead of profits. In other words, they must be mentally healthy, sane individuals. Any politician who lacks that certain amount of sanity, enough to see that the system we have right now not only isn't working, its murdering huge numbers of people every day, should be removed from the position of responsibility, Any politician who fails to respect the need of America for change in the immediate time context, needs to immediately be led away and replaced.

MRIs are a powerful diagnostic tool.

Lives are lost, diagnoses are missed, when people can't afford to get one. And thanks to companies like Tosiba, almost any hospital, or even small medical groups, can afford an MRI machine now.

The Obama administration plans to make healthcare "more efficient" and slow the rate prices are increasing by curtailing the use of important diagnostic procedures and tests. Even though the rate of medical errors is at all time highs.

As part of their PR campaign, they are asking people call it "defensive medicine" as if knowing more about patients health status was a bad thing. Why are they ramping up the PR to attack something that helps people get better and sometimes, prevents really terrible outcomes? What about the wisdom of common sense, and being responsible, You know that old saying "measure twice, cut once"? Or "first, do no harm"?

Also, wait a minute. If MRIs often cost so little elsewhere, whats really going on?

"MRI prices fall sharply in markets outside U.S. - Diagnostic Imaging
"Japan has the most competitive prices," said Ralph Andreas, vice president of international for Toshiba America MRI in South San Francisco. But MRI prices ..."

How can an MRI of the neck and lower head that costs more than $3000 in the US cost $98 in Japan?
Read this interview with Naoki Ikegami chair of the Department of Health Policy and Management at the Keio University School of Medicine, is widely regarded as Japan's top health economist.

I can't imagine what would threaten anybody about requiring that all prices, the real prices, for medical services be published. And that quality levels for hospitals and doctors also be published. That way, people could make realistic determinations of which doctor or which hospital to use. They might be able also to find cheaper services elsewhere.

What is so threatening about the free market to America's corporatocracy?

Originally posted to Andiamo on Thu Nov 12, 2009 at 07:35 AM PST.


Should alll prices for medical fees, procedures, materials, etc, be published and available on the providers web sites?

98%54 votes
1%1 votes

| 55 votes | Vote | Results

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Comment Preferences

  •  Tip Jar (8+ / 0-)


    by Andiamo on Thu Nov 12, 2009 at 07:35:44 AM PST

  •  I see from the body of your diary... (2+ / 0-)
    Recommended by:
    Leo in NJ, RLMiller

    ... that your CAPS LOCK is not stuck.  Nothing you can do about the tip jar, but I do suggest editing your title to normal upper and lower case practices.

    Grab all the joy you can. (exmearden, 8/30/09)

    by Land of Enchantment on Thu Nov 12, 2009 at 07:37:24 AM PST

    •  Ever hear the story of Kitty Genovese? (0+ / 0-)

      "Catherine Susan Genovese (July 7, 1935[1] – March 13, 1964), commonly known as Kitty Genovese, was a New York City woman who was stabbed to death near her home in the Kew Gardens section of Queens, New York on March 13, 1964.[3] Genovese was buried in a family grave at Lakeview Cemetery in New Canaan, Connecticut.

      The circumstances of her murder and the lack of reaction of numerous neighbors were reported by a newspaper article published two weeks later; the common portrayal of neighbors being fully aware but completely nonresponsive has later been criticized as inaccurate. Nonetheless, it prompted investigation into the social psychological phenomenon that has become known as the bystander effect (seldom: "Genovese syndrome")[4] and especially diffusion of responsibility."


      by Andiamo on Thu Nov 12, 2009 at 08:03:58 AM PST

      [ Parent ]

  •  While (2+ / 0-)
    Recommended by:
    celdd, ItsSimpleSimon

    I have no issue with publishing costs. I don't see it as much of a game changer.

    While it may make people pause for elective medical care. It is difficult to comparison shop or negotiate a better price when  are having a heart attack.

    In the choice between changing ones mind and proving there's no need to do so, most people get busy on the proof.

    by jsfox on Thu Nov 12, 2009 at 07:39:37 AM PST

    •  It's a big game changer for non-emergency care: (2+ / 0-)
      Recommended by:
      gogol, icemilkcoffee

      For example, I'd like to be able to compare the costs of a routine urgent care visit with a routine pediatrician's visit.  And I'd like to be able to compare Dr X's cost with Dr Y's.  Thanks to my high-deductible junk insurance, all doctor visits are paid out of pocket for me, and I've found through bitter experience that I'm better off not taking the kid to the doctor at all.

      •  Thats what HCR is all about keeping (1+ / 0-)
        Recommended by:

        God forbid that people be able to go to the doctor without fear. That's Un-American.


        by Andiamo on Thu Nov 12, 2009 at 08:05:51 AM PST

        [ Parent ]

  •  I don't always agree with you, Andiamo, (0+ / 0-)

    but on this point I do.  Of course, if everyone paid the same for procedures, that would eliminate the bargaining that insurance companies engage in, and that large corporations ("groups") engage in, all of which is a good thing as far as I am concerned.

    A society grows great when old men plant trees in whose shade they know they shall never sit. -Greek proverb

    by marleycat on Thu Nov 12, 2009 at 07:40:36 AM PST

  •  Yeah, I want to see the Republicans (0+ / 0-)

    fight this one.   lol

    "A man of true science uses but few hard words, and those only when none other will answer his purpose..." - Melville

    by ZedMont on Thu Nov 12, 2009 at 07:45:36 AM PST

  •  Price posting would be nice for the... (2+ / 0-)
    Recommended by:
    otto, marleycat

    "shopping around" part. I have insurance thru a local county govt job (damned socialists) and we have Well Baby visits covered 100% up to $500.

    Now, if you have children, you know the first year there are a few of these.

    After our 3rd visit, the billing kicked in and we found the very first well baby visit sucked out the funds provided to me.

    I was shocked. The pediatrician charges around $800 a piece for these visits.

    Being that my coverage amounts had to come from SOMEWHERE, I assume I could have found a pediatrician that charged much lower so I would not be "shell-shocked" when my bills came back to me.

    Price posting would have been nice.

    •  But some deliveries here cost $287,000 (0+ / 0-)

      so even a $500 discount on the post natal visits isn't going to help much.

      Thats a good example where it may make sense to travel somewhere nearby, say, Costa Rica, to have a baby. Even if you have to stay there a while, its still much cheaper. And you could probably find a specialist who was very good. I'm sure that Americans get treated very well.


      by Andiamo on Thu Nov 12, 2009 at 07:56:16 AM PST

      [ Parent ]

  •  I think the issue is competition. (1+ / 0-)
    Recommended by:

    If you can see what hospitals, doctors charge and what insurance companies pay, you can "shop.'

    "A man of true science uses but few hard words, and those only when none other will answer his purpose..." - Melville

    by ZedMont on Thu Nov 12, 2009 at 07:47:14 AM PST

  •  Excellent point (0+ / 0-)

    When I was pregnant, I had to pay my doctor and hospital bills ahead of my son's birth covering "normal" pregnancy and delivery fees. I could NEVER get either to tell me what was included in the "normal". Did that include epidural? Did that include a five hour labor or a 25 hour labor? Did that include stitches for tearing or not? No one could tell me.

    I ended up being induced because of high BP and then ended up with a C-Section when my son was flipped and couldn't get out. Naturally, I got an additional bill. But again, I had to fight like mad to get a breakdown of what was additional. Everything from post-surgery gas meds, ibuprofen and padding for my incision were extra. But, still, I NEVER got a list of "normal" charges.

    My friend got her Ph D last year in women's studies and wrote her doctorate thesis on the "normalcy" of pregnancy and concluded that the word is used in abundance without a clear definition of what it is.


    •  Pregnancy (0+ / 0-)

      There is no clear definition of normal pregnancy as many problems can arise. The problem with what doctors/hospitals charge is rampant. Even as a physician I had fallen victim for it when I had to take an insured relative to the ED.

      I agree with the diarist  that the doctors should post their rates for non-emergency visits, and give patients a breakdown of potential costs. The problem is that if something goes wrong in an elective procedure or even a pregnancy the costs could quickly escalate. That is why there is insurance in the first place, to spread the risk of that around.

      The doctor can charge the insurance what they want, but in the end the amount the ins pays is agreed upon and is much less. It is those without insurance that end up bearing the brunt of this especially with ER visits.

      As I follow this debate closely, more doctors are thinking about charging patients directly and not going through Medicare or other insurers. It may save them money as they will not worry about paying coders, insurance approval etc... Especially if medicare cuts go through that is what many will do. Insurance will then remain for inpatient procedures and emergencies.

      •  Understandably, (0+ / 0-)

        charges will accrue in unexpected or emergency treatment. That's a given. And I did get a list of the non-normal charges. But never got a break-down of the initial "normal" charges. I have no clue what the room cost, the nursing charges, the sonograms, etc. My point is that if doctors and hospitals are going to charge a standard rate for pregnancy and labor, then shouldn't they know what makes up that standard charge? And shouldn't they be able to break it down? Since they couldn't or wouldn't do that, it seems arbitrary.


  •  Gee, I wish Dr. Steve would weigh in on this... (0+ / 0-)

    Mass general was caught screwing people on procedure costs by the Boston PCP says everybody in the industry was aware that this was going on.

    •  People advise bringing a notebook and tying it (1+ / 0-)
      Recommended by:

      to yourself. Perhaps chaining it to yourself might be better. That way, when you are conscious, you can keep notes on what they use. Each napkin, each bowl of applesauce. Many people have their families bring in food.

      It would actually be cheaper to have a first class restaurant deliver.


      by Andiamo on Thu Nov 12, 2009 at 08:10:10 AM PST

      [ Parent ]

  •  I believe that this is in the Senate bill... (0+ / 0-)

    It certainly was presented in Baucus' chairman's mark...  I think it is still there...

    DARTH SPECTER: I am altering the deal! Pray I don't alter it any further!
    LANDO REID: This deal keeps getting worse all the time!

    by LordMike on Thu Nov 12, 2009 at 08:43:09 AM PST

  •  List price vs. actual price (0+ / 0-)

    A friend who is a doctor had a couple of stents placed in his heart. He was curious about the costs for the procedure. He managed to get copies of the paperwork through his contats.

    The hospital billed the insurance company $45,000, the "list price." The insurance company paid the "negotiated" price of less than $5000 for the entire procedure.

    You can bet that if he did not have insurance he would have been billed the full $45,000, and the collection agents would have gone after his assets if he was not able to pay.

    "In a time of universal deceit -- telling the truth is a revolutionary act."

    by fixxit on Thu Nov 12, 2009 at 08:45:24 AM PST

    •  If they had to publish their prices (0+ / 0-)

      I imagine the 'MSRP' and the 'going rate' would become closer over time. No cash customer would come to their hospital if they saw the 'MSRP', and through competition, eventually they will have to drop their MSRP to something close to their 'going rate'.

  •  While there are emergencies (0+ / 0-)

    when we don't care about price, a very large percentage of our medical care money is spent in areas where we do have some control over where we go.

    And even when we we're sick and don't want to be shopping if we, in general, knew where the prices were lower we could go there.

    Of course, with insurance, it doesn't matter.  Once you stay 'within system', every provider gets paid the same, and really, you don't even care about that because you get charged the same co-pay no matter which one you go to.  If we bought cars this way, I'd drive a porche.  With the same 'co-pay' as a volkswagon, why not?

    Perhaps if a doctor charges less than the 'in system' price, the discount should come off of the co-pay first and then the insurance company's part.

  •  Superbly good idea (0+ / 0-)

    Rarely have I seen an idea that is so simple, so easily implementable, and makes so damn much sense!
    Who the hell voted 'no' on your poll? You need a kick in the nuts.

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