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by nradov
630 days ago
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Patients have time to shop for most healthcare services. Only a small fraction of healthcare spending is for emergencies. The highest cost stuff is mostly elective procedures. If you need a colonoscopy or hip replacement then you have time to shop around. Socialized healthcare has its advantages and is probably more cost effective on average. But we also see affluent Canadians coming to the USA as medical tourists and paying cash for MRI scans in order to avoid the queues back home. |
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Patients have the time but rarely have the actual ability to shop around outside asking "is this provider in my coverage plan?" They demand me to sign a document stating I'm willing and able to pay while often never being able to actually tell me what the procedure will actually cost. Often, they won't even know that same day the procedure is done, it'll be weeks before I'm actually invoiced. And don't even get me started when you've chosen the surgeon in your plan, the facility in your plan but it turns out the anesthesiologist they scheduled wasn't in your plan. Oops. That's an expensive mistake you made, should have shopped around!
My knee kept locking up and I'd experience tremendous pain. Only once every few weeks though, so I had time to "shop around". I called up several places and tried to get an estimate of what it would cost ahead of actually seeing the doctor. Nobody would actually offer that, they could only make an appointment to see the doctor. No idea what the doctor would actually want to do during that appointment, so who knows what things will cost. Will they want x-rays? Will they want an MRI? Can they do the MRI there? Won't know until you commit to paying!
And out of the few dozen choices of kinesiologists around me which were covered by my insurance few had any appointments available within the next several weeks. Many weren't seeing new patients. So really it was deal with my knee randomly causing me immense pain for several more months or take whoever had the first appointment. And this is in one of the top five largest metro areas in the country, not some small town in the middle of nowhere.
Shopping for which hospital to do the delivery of my children, the estimates for our costs after insurance had a massive amount of uncertainty to the point of being useless. Could be $4k, could be $20k, who knows. Imagine going to a burger joint and the menu says a burger could be anywhere from $1 to $50, we'll invoice you in a month. Go down the street, menu says it could be $3 to $48, we'll invoice you in a few weeks. What an ability to shop around! Free market at work!
> avoid the queues back home.
I already mentioned, most kinesiologists around me were fully booked for months. Very few had anything within several weeks. That's queueing.
I tried to book an appointment with a new dermatologist a few months ago. Once again, in this very large metro area. For dermatologists in my area covered by my insurance, the earliest appointment was six months out. It took several months to get a family member's hip replacement scheduled. We have queues in this country as well.
Getting medical imaging is generally pretty quick and easy though, and places like MRI imaging centers just want to keep moving people through so if they have an empty spot in an afternoon having someone in the machine constantly is important. It's also generally the easiest thing to automate in healthcare; mostly just a matter of getting enough machines and lightly trained techs to rotate people through. Radiologists are often off-site contractors getting paid for every scan they review.