[thaw13579]

Yes, that is a economic & public health policy problem that really needs to be solved. We can look to Japan as example of what's possible, they have invested in nearly twice the number of scanners per capita of Canada, and they can get same-day MRIs for $50, roughly speaking.

[lostlogin]

> they can get same-day MRIs for $50

I’d like to see a breakdown on how they do that. Staffing alone is a multiple of that.

[vixen99]

Romania: for a head MRI on demand - not more than a few days and less than 400 Euros.

[lostlogin]

That’s more believable than $50, and isn’t out of whack with what’s achievable where I am (New Zealand).

[thaw13579]

From what I know, seems like a mix of medical price fixing by the gov't, adoption of lower cost hardware, and universal healthcare. There's apparently less bureaucracy, perhaps because there is no need for negotiation at every step of the process?

[lostlogin]

There are big costs. The hardware, the facility (RF cage and chillers), power, water, staff, RIS/PACS etc etc.

I can’t see how you can do it for $50. Does the ‘universal healthcare’ bit mean that the government is paying most the bill and it’s $50 out of pocket?

[thaw13579]

Yes, $50 was a rough out-of-pocket estimate, the amortized cost per scan for operation alone is probably on the order of hundreds of dollars per scan, assuming high utilization.

One funny thing about MRIs is the magnet is always on, so there could be some clever ways to reduce costs running them after hours.

[fc417fc802]

> there could be some clever ways to reduce costs running them after hours.

It seems like a dedicated round the clock facility housing at least dozens of MRI machines ought to offer significant economies of scale. I wonder if I'm wrong about that or if there's some other reason we don't see this approach taken by governments.

[lostlogin]

The staffing costs then skyrocket. 1.5x or double time. However, the main obstacle is a lack of staff. Good staff are hard to find and worth what they cost. And they usually don't want to work out of hours. The economies of scale are interesting. Eg PACS/RIS cost very little more when you increase scans done, and rent is a fixed cost. The best thing that happens are you increase scanners at a the management of no-shows. Patients fail to turn up regularly (a 'did not arrive', DNA). With more imaging going on, you just grab the next available patient, the gap ends up later on, then you make a new booking. The record at my site is 6 DNAs and no slots missed. I run a small MRI service.