[SketchySeaBeast]

Firstly, I'll caveat with this that I'm Canadian - I see different issues in my system than the for profit model. Regarding the cost - I guess that depends on the tests themselves - MRI's and CAT scans are costly machines, especially compared to 15 minutes of a doctors time. Also, how does that affect availability of that equipment for higher priority patients?

There's also the question of ethics - how invasive of a procedure does one do as an extra test before it's an issue? My wife is a sonographer - ultrasounds aren't completely diagnostic, only indicative, and a lot of the time the patient will have to go to a more extreme diagnostic to confirm. Should we be skipping the ultrasound and going straight to the biopsy every time?

[PhasmaFelis]

> MRI's and CAT scans are costly machines, especially compared to 15 minutes of a doctors time.

I know the machines themselves are very expensive, but what are the costs to run a test? Does it draw ruinous amounts of power when running, or are there expendable materials involved?

[SketchySeaBeast]

No, but the initial investment does need to be recouped. The machines can cost into the millions.

[LeifCarrotson]

It's true that the investment does need to be recouped for purchasing future machines, but once you have one, it's a sunk cost.

And even then, if it's a big $5M machine [0] that lasts 10 years [1], and we generously assume it takes 1 hour per patient [2] and runs 12 hours a day, 300 days a year [3], the cost can be recouped if each test costs $140.

But an MRI bill easily costs 20 times the cost to recoup the investment.

[0]: They're usually $1-3M, and extremity scanners (hands, feet etc.) can be under $500k. [1]: The average age of an MRI machine is ~11 years, i.e. they typically last 22 years [2]: Most procedures take less than half an hour of scan time, but there's some shuffle and overhead [3]: Medicine does not run on banker's hours

[FireBeyond]

Or more... $2800 would be a cheap MRI in some places... $4K+ I've seen quoted.

It's also no coincidence that companies target physicians to form "imaging cooperatives" where they finance MRI/CT/PET offering recoupment times of a year or less...

and completely by chance have higher by a Std Dev or more ordering of imaging in their private practice...

It's hard, however ethical you are, to not err on the side of sending someone to imaging when you profit linearly off of said imaging.

[darkerside]

FWIW I'm guessing these are often purchased on borrowed money, so there may be interest to account for

[BoiledCabbage]

Yes but once you have the machine, 2 people using it today or 20 makes very marginal difference.

[SketchySeaBeast]

Yup. Then it comes down to capacity - how many scans you can do a day vs. how many people need the diagnostic vs. how many people could use the diagnostic.