The Machine That's Bankrupting American - The $2 million MRI

The Machine That's Bankrupting America
The $2 million MRI scanner and what's wrong with U.S. health care.

By Mark Gimein
Posted Monday, September 21, 2009 - 7:10am

The main question of the national debate on health care has been who should pay for it, but lurking behind it is another one: Why does American health care cost so much in the first place? If you want an answer to that question, there's no better place to start than the proliferation of the gleaming new magnetic resonance imaging machines filling U.S. hospitals.

According to the latest data, the United States has just over one MRI scanner for every 40,000 people. That number that may not sound high, but it means that we have more than three times as many devices per person as you will find in the United Kingdom or France, and almost four times as many as in Canada. Only Japan, an MRI-happy outlier, has more.

-------------------

One of the main reasons we now have a crisis in health insurance is that we have a crisis in health care costs that has been (as the Times' Rampell beautifully charts) 30-plus years in the making. The proliferation of MRI scanners is an easy-to-quantify and telling example of the bigger trend. Doctors and hospitals turn ever more readily to the latest equipment and technology, performing more procedures at greater cost without a corresponding improvement in care. Patients come to expect to be subjected to a growing battery of tests and operations. And instead of welcoming ideas about how to reverse this cycle, Americans worry about rationing.

http://www.thebigmoney.com/articles/money-trail/2009/09/21/machine-thats-bankrupting-america

involved around having surgery. It's non-invasive and much much safer.

And costs a hell of a lot more. Maybe non-invasive, and safer is relative.

Exploratory surgery is probably only marginally less safe.

Are you trying to be for real here?

Whether that's true or not, I'm not going to say, but I can say from my own experience I was sent for an MRI on my ankle by a doctor that also proposed a very invasive surgery. I decided to get a 2nd opinion and the 2nd doctor ignored my MRI and said he could see everything he needed with the x-ray. He preformed an orthoscopic surgery on my ankle which lasted 30 minutes and fixed my problem.

I took it for a test once. It's loud as fucking hell, but for some odd reason, it was painful. There was a burning sensation somewhere and I kept tasting metal.

so I can't speak to the medical end, but I do work with expensive machines.

The key to owning an expensive machine is to get a lot of use of of it.


Instead of charging $1000 each to 2,000 patients to pay for the machine, why not charge $250 or $300 each to 10,000 patients.

Run the machine 24/7. The additional revenue will more than cover the cost of overtime or additional staff.

Plus, 8,000 more patients get the benefits of an MRI.

Everytime I've had one there has been one malfunction or another. I was left in a machine once for an hour, thats enough to drive one crazy. My one Dr. switched my test to a different medium because it was easier & faster.

The quality guru of the 20th century used the example of MRI's in his discussion of cooperation vs. competition.

If there's three hospitals serving one community, to compete they all go out and buy MRI machines. They all have to charge a lot to pay for the big investment and the three machines all spend a lot of time idle. Better for them to share in the purchase of one machine and have all three hospitals use it cooperatively. Now each hospital has the use of an MRI at 1/3 the cost, and savings can be passed on to the consumer.

Cooperation vs. competition.

-90% Jimmy

30 years in manufacturing as a CNC Applications Engr, laid off last February

is that one of the MDs buys the equipment, opens up an MRI-only outpatient service, and takes patients from all three hospitals.

So the MRI machines are costing $50 per American..

I think you'll need to find something else that is driving the cost of medical care into the stratosphere.

of the 40k people will get a MRI...not true...

I never claimed each person would get an MRI, although since a lot of people will get more than one MRI (my daughter has had at least six) the numbers might be higher than you would imagine.

But $50 for each American to pay for MRI machines clearly is but a drop in the bucket when it comes to what we spend each year on health care in this country.

and then have to make a return on their investment. Why that little bit of ethical cross purposes was EVER allowed, I have no idea. It's a clear conflict of interest.

On a 50K car is quite expensive. I imagine maintenance on a 2M MRI is quite a bit more so.

A car is a highly stressed piece of equipment that is in many ways even more complex than an MRI. An MRI has very few moving parts which are the things that tend to need maintenance most on a car.

I had a Q45 some years back, it was $30k when it was new in '92, I bought it with 100k miles on it and drove it for 70k and spent very little on maintenance, oil changes, brakes once and tires once. My ex totaled it and we still got about 75% of what we originally spent on the car because it was in such great shape still.

Come on, that argument is being disingenuous at best. Now I love cars moe than most guys, but you're talking about comparing an 1800's invention with something that was developed in the 1970's. The technology and complexity of an MRI dwarfs that of the basic car. (were not talking things like formula 1 here either.)

Serious question: How would you compare the modern automobile to a modern Hard Disk Drive (as found in your computer)?

High end cars these days don't just have one computer, some of them have dozens.

And far more moving parts in a car than an HDD, I've had both apart, most HDDs have two moving parts, the disk itself and the head assembly, cars have thousands of moving parts working in an extremely severe environment.

One of the claimed advantages of electric cars is that they'll have a lot fewer moving parts and far less maintenance than ICE cars.

Consider the mechanics of the modern HDD. One of the several read/write heads has a width of less than 100 nanometers and a thickness of about 10, it flies above the platter at a speed of up to 15,000 RPM, at a height that’s the equivalent of 40 atoms. If you start multiplying these infinitesimally small numbers, you begin to get an idea of their significance and sheer impressiveness in comparison to larger everyday machines.

Consider this little comparison - if the read/write head were the size of a Boeing 747, and the hard-disk platter were the surface of the Earth:

The head would fly at Mach 800
At less than one centimeter from the ground
And count every blade of grass
Making fewer than 10 unrecoverable counting errors in an area equivalent to all of Ireland.

Unequivocably... a Hard Drive is VASTLY superior (technologically) than a automobile. Sure it's just a hard drive... a component. But the base technology is phenominal. A car is car. High school kids can build/fix them in garage with little more than a torque wrench and socket set. IMO, when something mechanical breaks it's usually not a big deal to fix... because mechanics are generally simpler than newer forms of technology.

Squeezing out a great deal of horsepower from a fairly small engine while simultaneously meeting stringent emission regulations is a remarkably difficult technical accomplishment.

Turbochargers turn 150,00 rpm in an environment that would melt quite a few metals and must do so for 100k miles or more with little to no maintenance.

Fuel injectors and the various sensors on a modern engine also work to exacting tolerances in an environment that would reduce a HDD to something suitable for recycling in mere moments, these parts also must be trouble free for long periods of time.

Sure a modern HDD is a technological wonder, but so is a modern automobile.

It was on the news last night. Local man went to the hospital to get an MRI for back pain and went home with a diagnosis of cancer of the spine. If you get too restrictive, people like him will die because they won't find it till its too late to do anything about it.

You guys need to get a grip.

let`s junk technology and go back to laying on hands....

It was a slew of expensive newer technology that has sent health care costs spiraling up and outpacing the rate of inflation as doctors and hospitals invested in this new expensive technology.

I also read that the cost has also slowed back down to the rate of inflation now, as the technology has been now been purchased, the investment made, and health care costs are now following the rate of inflation more closely for a while, until the next expensive leaps in technology come around.

No idea how true it is though.

I've had three MRIs - left shoulder and both knees. Not one of the MRIs showed the extent of the damage in any of the joints so the surgeons underestimated the work and time needed for the operations and vastly underestimated the recovery time. The worst was the shoulder - the MRI showed only a little tearing of the cartilege. I had three completely detached tendons (ligaments, never can remember), the cartelege was badly shredded. Just evaluating the damage took as much time as the entire operation was supposed to take. The operation to actually repair the joint took over four hours.

I went in expecting a sling and a few inconvenient weeks of recovery before starting two months rehab. I spent six weeks with an immobilized arm and another six months of rehab. Without the deceptive MRI results, the surgeon would have gone over all the possibilities and not be so sure it was a minor patch job with a short recovery.

For my recent shoulder operation on the other side, the surgeon and I agreed, no MRI. He just left a little more time than he would normally allow, given my history. The X-rays showed him enough to get started and the additional damage not shown used up the rest of the time. He said an MRI would not have shown that additional damage also.

I will have to be dragged kicking and screaming to any future MRIs. I think they are a waste of money and will never willingly allow another one. By the way, the first shoulder was without insurance, the rest were (or would have been) covered by our insurance.