My MRI and Medical Savings Accounts thoughts

I hate arguments made with anecdotal evidence.  But since everyone likes their own anecdotes, why should I be any different?

I don’t have a Medical Savings Account, but I do have catastrophic health insurance.  It’s just like regular health insurance except I have to pay the first $5,000 of medical expenses per year out of pocket.  That makes me sensitive to medical pricing.  Indeed, it makes me a bit too reluctant to get medical treatment sometimes, I admit it.  I’m tight.

However, I’m a 46 year old man with 66 year old knees that could not be neglected any longer.  Today I bit the bullet and, with the help of a Doctor friend who gave me a ‘scrip, I went shopping for two MRI’s.  I called 12 radiology clinics. The price for an MRI for a “regular” patient, that is, one with insurance, averages $1,183 per knee.  The best price for a cash patient like me is $375. 

That’s a savings of $808 or 68%.

Not all medical procedures are as competitive as MRI’s, but still… 68%?  I’m more firmly convinced than ever that Medical Savings Accounts are the way to go. 

Over to you, Democrats!

Comments

[Frank Borger]

Since I recently retired my wife and I are on high deductable with no drug payment. The plan did provide a drug card that offered "group prices" I didn't think much of the card, but had to order Albuterol Inhalers for my asthma.

Under our high cost, fancy Blue Cross Blue Shield plan, (about $1200/month for the wife and I, with me paying half,) the inhalers were a $10 copay.

With the new cheap plan, ($365/month for the wife and I,) the inhalers are 6 for $56 or $9 and change each.

It's not the industry's fault, but well meaning laws have pushed medicine into a situation where you lose money on many patients and have to make it up on the fancy procedures where it's all the market will bear.

[pedro]

You're right about how it's all messed up. The only thing stranger than the medical situation is how college football bowls and championships came about. Not that anyone, not even a Seminole or a 'Cane or a Blue, could deny that the University of Florida Gators were the best team this year. But don't you with UF and Boise State could play just one more game? That would be great.

What were we talking about?

Oh yeah, medical insurance. Well, maybe MSA's could be a good way to start draining the swamp while we bring more trophies back to THE SWAMP.

[MikeInSeattle]

The 68% discount is called charity. (It's what you get when you remove the profit element - you know, stuff you Republicans defend over all else like corporate profits, profit for the owners, etc.)

One nice thing of a good negotiated plan (like, say, the military's or medicare now that the Democrats have put negotiation for prices back in) is that for a group of, say, 300,000,000, you can get a pretty good price for everybody and not just those relying on charity.

[pedro]

Ah yes, "We're from the government and we're here to help you."

I can hardly wait.

[MikeInSeattle]

Ah yes, answering with a bumper sticker. Care to compare insurance company results vs public funded health plan results in either the US or any other western country?

How about, "We from your insurance company and we're here to deny your claim and cancel you"?

[pedro]

No, Michael, I don't. I want us to be better than France, better than Canada, AND better than we are now. I think the best way to do it would be with more liberty, not with more government.

And I have absolutely zero hope of any of that happening, so it really doesn't interest me all that much. I just thought it was illuminating that the insured rate for an MRI was almost three times the self-pay rate, that's all.

[MikeInSeattle]

Good that you don't want to compare since we have both the worst cost/benefit ratio in the industrial world and close to the worst health care. Much worse than say, France or Canada or the UK.

So, we're paying the most and we're getting the least. But our insurance company executives ARE the best paid in the world. And, after all, isn't that what our family's health is all about?

[pedro]

The cost/benefit ration is not that easy to compute. How does one factor in long waiting periods for treatments? If you have to wait so long your condition gets worse or kills you, how valuable was that free health care? And what about the cost side? Have indirect economic consequences, of any system, been factored in? By the time an analyst is finished getting to a cost/benefit ratio on something with so many personally variable issues, I doubt he'd have anything much more valuable than an informed opinion.

But that's not what I want to talk about. I'm not interested in defending our status quo, which is all screwed up and in some respects worse than others'. I'm much more interested in how to improve it incrementally now and how to revamp it as close to ideal as possible long-term.

Having the patient insulated from costs, which both the American and European systems do, seems disastrous for any cost containment effort. On the other hand, as I said in my original post, we don't want people passing up necessary treatment for financial reasons - a mistake I candidly admit I've made myself. MSA's solve the problem in a nice right-now incremental way, provided the individual has some good luck in the first year or two. Getting people MSA's while they're still young and healthy looks like a can't-lose win-win idea to me. Socialized medicine looks like the opposite.

We can do better, but only if we work together. So let's.

[MikeInSeattle]

Well, cost per person is easy. I think we all agree that the average person in the US pays one of the highest costs for medical care in the world. (If not, those numbers are easy to get)

Benefit is fairly easy. There are two numbers that are typically used; Average Lifespan and Infant Mortality.

Average Lifespan has the advantage of showing the effect of a whole life of medical factors but has the downside of also showing the health costs of poverty and war. (but less than you'd think since Israel which hasn't had a lot of years without war has an average lifespan about a year and a half longer than the US). Still, it's a good measure even with those factors when you're comparing countries inside similar groups of countries (say, Western Industrials with each other or Sub-Saharan African with each other)

So where is the US? This bastion of "We've got the best healthcare system in the world"?

Number 1 is Andorra. (Yes, Andorra) with a lifespan of 83.51 years.
Japan is 6th
Sweden is 7th
Canada (those evil socialize medicine types 100 miles away from us here in Seattle) are 12th and average just over 80.
Evil France? - 16th best
Those Brits? - The UK is 38th.

How about us? We're number 47. (Let's hear that cheer. We're number 47. We're number 47. We're umber 47.) Bosnia is actually higher than we are...

OK. There are admitted flaws in using life expectancy. (I admitted them myself) Let's look at infant mortality. This is considered THE default number for measuring health since most societies provide good health care to pregnant women and newborn infants no matter what.

The best place to be born is Singapore. They have only 2.29 deaths per 1000 births.
Those Volvo-driving Socialists in Sweden come in 2nd at 2.76.
Japan is 4th. (Another top 10 for the Japanese!)
Germany is 11th. (Guess you have a better chance of being born if your grandparents were in the Axis than the US)
France? #12
Canada is 23rd.
The UK is down at 28th. Not great...

Where are we?

Why, we're 42nd best. Below Cuba. Below Italy. Below Slovenia.

We have an infant mortality of 6.43. That's two and a half times as many dead babies as Sweden.

Now. If you think a fabulously wealthy nation with the best medical technology in history should be content paying the most of any nation and having the 42nd (or 47th) best healthcare then we disagree on the point of a society...

But, hey, while our health care system is laughed at, our health insurance company executive compensation packages are the envy of the world.

(Oh, and in case you think I used some evil, leftist, doctored, socialist numbers - All of these are from the CIA's annual World Fact Book. Feel free to look it up at www.cia.gov)