Doctor suing to reverse law raising health care costs

ludin · Aug 2, 2018

jaeger19 said:
One.. its not a hypothetical situation.

The studies show that it happens and is a significant problem.

And it does not give hospitals an exclusive right to operate those machines. YOU sir could decide that you want to own a bunch of MRI and imaging centers or any other businessman and start your own imaging center business. In fact.. there are lots of free standing imaging centers not hospital owned.

Yes.. the very laws you say we don't need.

By the way.. the more facilities.. the price an MRI tends to go up.. not down. Its the nature of the healthcare business that when access is high (lots of places to go).. prices go up because with fewer people paying per machine.. the cost per person has to go up.

laws of supply and demand say otherwise.

ludin · Aug 2, 2018

Mycroft said:
You don't need a law forbidding a particular provider from being able to provide a service to deal with a provider who orders unnecessary services.

You have to realize that he is supposedly in the medical insurance field.

He doesn't like lower cost procedures because it takes away from his bottom line.
if procedures cost the cash price then insurance companies couldn't justify their 20-40% premium hikes.

in order to justify their premium increases insurance companies have to have ever exceedingly higher medical costs.

if medical prices go lower then they can no longer justify those premium hikes.

Jaeger cannot justify that a MRI at one place costs 40k and at another 4k. the cost to operate the machine is the same no matter
where it is installed at. if this doctor can do it for 500 then well that is what he can do it at.

if a hospital wants to compete then they will need to do it at 500 as well. that is when we will see medical costs start going down.

jaeger19 · Aug 2, 2018

ludin said:
and leave it to the insurance guy to hate lower medical expenses which should cost as much as he charges anyway.

ll.

what "lower charge".. as studies show.. that insurance guy is likely paying MORE for that MRI.. and for a MRI that isn't needed.

Yep why wouldn't he refer this patients to his own MRI machine?

Absolutely.. the physician makes money when he self refers.

i know i would pay 500 instead of 4k. it is called smart shopping.

I know I would rather pay nothing for an MRI I don't need... than pay 500 for an MRI that was ordered simply to pad the doctors pocket.

I am sure the insurance company would feel the same way.

jaeger19 · Aug 2, 2018

ludin said:
laws of supply and demand say otherwise.

Actually no they don't.

You have demand say for 100 MRI's. in a quarter. .

In one community.. their are 2 MRI.. which means that you have 50 people for each MRI.

What price per patient do you have to get. .to meet your cost for that MRI.

In another community.. they also have 100 patients for MRI per quarter.

That community has 100 MRI's available. so one patient per quarter.

What does the charge per patient have to be.. to meet the cost of that MRI?

Which community has to have a higher cost per patient.. to support that number of MRI's. (that access).

Please answer that question.

ludin · Aug 2, 2018

jaeger19 said:
what "lower charge".. as studies show.. that insurance guy is likely paying MORE for that MRI.. and for a MRI that isn't needed.

LOL if he is charinge 500 how is that lower than 40k at a hospital charges? your math is off.

Absolutely.. the physician makes money when he self refers.

Yes he has to pay to keep the machine maintained etc, but he isn't charging 40k is he?

I know I would rather pay nothing for an MRI I don't need... than pay 500 for an MRI that was ordered simply to pad the doctors pocket.

Prove this doctor is an unethical doctor first.
i have already shown you that doctors already pad themselves with un-needed procedures etc ..
i don't see you ranting on that.

again if he is being unethical in his treatments there is a reason that a medical board will review his practice.

I am sure the insurance company would feel the same way.

Nope they will be glad to get a bill for 500 or less vs 40k.
or they should be.

jaeger19 · Aug 2, 2018

ludin said:
You have to realize that he is supposedly in the medical insurance field.

.

I am in the medical field.. not medical insurance.

He doesn't like lower cost procedures because it takes away from his bottom line.
if procedures cost the cash price then insurance companies couldn't justify their 20-40% premium hikes.

Umm sir.. I just supported laws against self referral that hurt my bottom line... because its the ethical thing.

Jaeger cannot justify that a MRI at one place costs 40k and at another 4k. the cost to operate the machine is the same no matter
where it is installed at. if this doctor can do it for 500 then well that is what he can do it at.

sure I have.. multiple times.. you just refuse to listen or understand the reasons why.

if a hospital wants to compete then they will need to do it at 500 as well. that is when we will see medical costs start going down.

Actually no.. thats not true. in fact.. you already go around pointing out that hospitals can charge 4k and yet you can get one for 500. so the competition already exists.. and yet.. ooops.. still a difference.

Of course.. I explain to you why there is a such a difference... but you refuse to listen..

the fact you want to remain ignorant.. is on you..

jaeger19 · Aug 2, 2018

ludin said:
LOL if he is charinge 500 how is that lower than 40k at a hospital charges? your math is off.

.

Well one.. I pointed out the research.. and linked to it. that often the price of the MRI INCREASED when physician owned their own MRI.

Yes he has to pay to keep the machine maintained etc, but he isn't charging 40k is he?

No.. he is often ordering MRI's that aren;t necessary. And he may actually be charging more than others as studies show.

Prove this doctor is an unethical doctor first.
i have already shown you that doctors already pad themselves with un-needed procedures etc ..
i don't see you ranting on that.

Sir .. I just entered the thread.. stating that physician owned MRI leads to overutilization.. THATS WHAT GOT ME IN THIS CONVERSATION.. was stating that overutilization or "padding" as you call it exists.and is a significant problem with self referral.

So you need to take a deep breath here and think before you post.

again if he is being unethical in his treatments there is a reason that a medical board will review his practice.

Actually its medical boards who have often recommended laws to decrease the chances of self referral for profit.

Nope they will be glad to get a bill for 500 or less vs 40k.

no.. they would wish they didn;t have a bill for an unnecessary service.

ludin · Aug 2, 2018

jaeger19 said:
Actually no they don't.

You have demand say for 100 MRI's. in a quarter. .
In one community.. their are 2 MRI.. which means that you have 50 people for each MRI.

Yep

What price per patient do you have to get. .to meet your cost for that MRI.

So far from the cash prices i have seen it ranges from 300-750.
only hospitals are charging 4k-40k for the same procedure.

In another community.. they also have 100 patients for MRI per quarter.
That community has 100 MRI's available. so one patient per quarter.

What does the charge per patient have to be.. to meet the cost of that MRI?

The same price as it costs the other. the cost to maintain an MRI is the same no matter where you put it.

Which community has to have a higher cost per patient.. to support that number of MRI's. (that access).
Please answer that question.

The cost of the community with 100 would have a lower price as places compete for customers.
the community with 2 would probably have slightly higher prices but shouldn't be abnormal.

in general though the cost is going to be the same.
more competition brings lower prices. this is the law of economics no matter what industry you are in.

before hospitals were the only people that could have MRI machines. they charge a fortune.
not independent imaging centers have popped up and doing it for <80% of the cost.

4k or more at a hospital 300-750 maybe a 1k at an independent image center.

jaeger19 · Aug 2, 2018

ludin said:
Yep

The cost of the community with 100 would have a lower price as places compete for customers.
the community with 2 would probably have slightly higher prices but shouldn't be abnormal.

in general though the cost is going to be the same.
more competition brings lower prices. this is the law of economics no matter what industry you are in.

before hospitals were the only people that could have MRI machines. they charge a fortune.
not independent imaging centers have popped up and doing it for <80% of the cost.

4k or more at a hospital 300-750 maybe a 1k at an independent image center.

Wow.. you have to work hard to be this obtuse.

Obviously.. the community with 100 MRIS.. and 100 patients per quarter..

MUST have a higher price per MRI or they could not meet the cost of the MRI.. (with all MRI costs being equal).

More competition DOES NOT always mean lower prices.. That is an economy fallacy propagated by laypeople.

I just gave you an example of why increased access actual leads to higher prices... Because that cost of the MRI has to be met.. and if there are fewer patients per MRI.. the price of the MRI has to be higher.

Its one of the reasons that American healthcare costs more.. We pay for that increased timeliness of care...

If you have 1 doctor that services a community of 100.. he can accept a lower price per patient.

than if there are 5 doctors available for that community of 100.

thats the economic reality.

ludin · Aug 2, 2018

jaeger19 said:
Wow.. you have to work hard to be this obtuse.

Obviously.. the community with 100 MRIS.. and 100 patients per quarter..

MUST have a higher price per MRI or they could not meet the cost of the MRI.. (with all MRI costs being equal).

More competition DOES NOT always mean lower prices.. That is an economy fallacy propagated by laypeople.

I just gave you an example of why increased access actual leads to higher prices... Because that cost of the MRI has to be met.. and if there are fewer patients per MRI.. the price of the MRI has to be higher.

Its one of the reasons that American healthcare costs more.. We pay for that increased timeliness of care...

If you have 1 doctor that services a community of 100.. he can accept a lower price per patient.

than if there are 5 doctors available for that community of 100.

thats the economic reality.

actually what would happen is that that community would see some centers close until supply met demand.
the centers that would be left would be the ones that offered the better services to their customers.

the prices would then equalize to about where they are at.

yes you are pretty obtuse.

you can't justify a 40k dollar MRI where someone else can charge 500.
there is no difference between the two of them. the costs to operate are the same.

ludin · Aug 2, 2018

jaeger19 said:
Well one.. I pointed out the research.. and linked to it. that often the price of the MRI INCREASED when physician owned their own MRI.

If it increases then people will go elsewhere.

No.. he is often ordering MRI's that aren;t necessary. And he may actually be charging more than others as studies show.

he is charging 500 which is less than the 40k a hospital charges.
Please provide your proof that he is ordering unethical MRI's to people
I will be waiting on your evidence to show that he would be doing that.
If not you are slandering a doctor with no evidence.

Sir .. I just entered the thread.. stating that physician owned MRI leads to overutilization.. THATS WHAT GOT ME IN THIS CONVERSATION.. was stating that overutilization or "padding" as you call it exists.and is a significant problem with self referral.

again that is why we have a state review board. again how is this any different than the link that showed you where doctors order un-needed tests all the time?

So you need to take a deep breath here and think before you post.

Yes you do.

Actually its medical boards who have often recommended laws to decrease the chances of self referral for profit.

charging 40k for a 500 procedure is what they should be going after.

no.. they would wish they didn;t have a bill for an unnecessary service.

they don't mind pay for all the other un-needed services they pay for.
however again charging 500 is less than charging 40k.

which you still can't justify.

Greenbeard · Aug 2, 2018

ludin said:
actually what would happen is that that community would see some centers close until supply met demand.

That assumes providers can’t induce demand. Given the high degree of delegation of decision-making to clinicians inherent in medicine, that’s long been a concern (you can go all the way back to Arrow’s famous 1963 paper for this: “As a second consequence of informational inequality between physician and patient and the lack of insurance of a suitable type, the patient must delegate to the physician much of his freedom of choice.”)

The danger that providers can produce the demand needed to match the supply of health care infrastructure, driving up spending, is one of the primary reasons CON laws were created. I’m sympathetic to the argument that the changing shape of the health care market makes such laws less relevant today, perhaps even counterproductive, but it’s silly to pretend there was never a rationale for them.

ludin · Aug 2, 2018

Greenbeard said:
That assumes providers can’t induce demand. Given the high degree of delegation of decision-making to clinicians inherent in medicine, that’s long been a concern (you can go all the way back to Arrow’s famous 1963 paper for this: “As a second consequence of informational inequality between physician and patient and the lack of insurance of a suitable type, the patient must delegate to the physician much of his freedom of choice.”)

The danger that providers can produce the demand needed to match the supply of health care infrastructure, driving up spending, is one of the primary reasons CON laws were created. I’m sympathetic to the argument that the changing shape of the health care market makes such laws less relevant today, perhaps even counterproductive, but it’s silly to pretend there was never a rationale for them.

The fact is that people need MRI's.
and doctors should only be ordering MRI's if they are needed.

however the fact is this an imaging center can offer an MRI for 500 but
a hospital requires 4k-40k for the same thing is complete bunk.

that is the issue.

jaeger19 · Aug 2, 2018

ludin said:
actually what would happen is that that community would see some centers close until supply met demand.
.

Nope.. not if they could get their price.. they wouldn't.

the only one here being obtuse is you.

I just gave you a perfect example of hour increase in supply can cause an increase in price.

And yes.. I can justify a 40K" MRI where someelse can charge 500.

Actually their MAY be a difference in the MRI.. and their certainly can be a difference in the facilities that they are in.

Now.. I have explained this before.. but I will now do so again.. not in the hopes that you will actually try and learn something.. but to educate anyone else that might be reading this. I know understand that your belief is based on ideology not reality.

So.. for those of you that want to understand what.. can cause a 40k MRI.. and a charge of 500.,

1. First.. the charge means nothing really. Because insurance companies will pay based on what their allowable is.. and the charge itself doesn't matter. That "40k" charge in a hospital.. really might simply be because of bookkeeping and tax purposes.

2. Second.. the charge may be different anyway because the cost of two facilities.. total cost.. is different.

One facility is a hospital.. that has all sorts of costs. Costs that occur.. even when a person is not using that room or equipment. hospitals have overhead because they have to have supplies.. staff.. and equipment to deal with what comes in.. whether it does come in or not.

Another facility.. like an outpatient free standing MRI clinic.. doesn't have these extra costs... it just provides MRI, CT and x ray.. only those services that are needed every day or close.

So.. the hospital.. has a lot of xtra costs... now it can't expect that its going to get that cost reimbursed.. by the one patient that say uses a ventilator.. because that might cost 1 million for that one ventilator... so what the hospital, does.. is cost shift onto other more prevalent services.. like MRI or pharmacy.

So that MRI costs 1800 and that ibuprofen costs 3 dollars a pill. and in that way. the hospital can recoup its costs for all the equipment and staff they have available.. IF they are needed.

The free standing MRI clinic doesn't have those x tra costs.. and they don't have to cost shift as much or at all....And thats in part why they their charge is 500 dollars.

itsforthekids · Aug 2, 2018

FreeWits said:
https://www.vox.com/policy-and-poli...st-certificate-of-need-north-carolina-lawsuit

TL;DR: A surgeon was banned from getting his own MRI machine, so he sued. If he is allowed to get his own MRI machine, he can potentially drop the cost of a scan from thousands to $500.

LOL @vox

FreeWits · Aug 2, 2018

itsforthekids said:
LOL @vox

I have my own issues with Vox, but I found this article to be better than a lot of their other articles. I've skimmed other articles by this author and he seems to be much more honest than Vox author's like Ezra Klein. I like to be open to a wide variety of publishers, and even a wide variety of authors, some of who may come from publishers I usually don't like as much. Do you have an issue with the actual article? If so, I'd like to hear the attack on the substance.

Skeptic Bob · Aug 2, 2018

ludin said:
It isn't the government.

I had to get an MRI. here is the stupid thing right.
So i called the hospital. It was going to cost almost 4k for an MRI an my insurance wouldn't cover it as it fell on my deductible.
I called a local imagining center for the MRI. They billed my insurance i paid the co-pay and insurance covered the entire thing
i didn't get one bill.

the cost though was like 500-1000 bucks.

there is no reason that a hospital charges 4k for something that can cost 500.
that is why our healthcare is so expensive.

now if you got to that same hospital and claim no insurance and want to pay cash they will charge you about the same
500-1000.

it doesn't cost the hospital anymore money than it does an imaging center to have that MRI machine. yet you will pay 3x as much
with insurance as you will without it.

Yeah, I have heard the same. I have also heard hospitals will do this (up charging people with insurance) to offset the money they lose on people coming into the ER who don’t pay. I don’t know how accurate that is, though.

Greenbeard · Aug 2, 2018

ludin said:
The fact is that people need MRI's.
and doctors should only be ordering MRI's if they are needed.

And the question is whether giving them a financial incentive to order superfluous scans is problematic. I would think those who believe physicians provide a huge volume of unnecessary services to mitigate the risk of tort damages would be doubly concerned about the effect of such incentives on physician behavior.

ludin · Aug 2, 2018

Greenbeard said:
And the question is whether giving them a financial incentive to order superfluous scans is problematic. I would think those who believe physicians provide a huge volume of unnecessary services to mitigate the risk of tort damages would be doubly concerned about the effect of such incentives on physician behavior.

That is why they can face ethic boards.
They already do that because of insurance companies.
And malpractice.

In any event. Cash would solve much of the issue.

jaeger19 · Aug 3, 2018

ludin said:
If it increases then people will go elsewhere.
.

no they won't.. Just like as you point out.. people go to MRI's that "cost 40k".

Heck.. I have patients that have had two MRI's one. completely unnecessary because after one MRI.. which showed the issue they had... when they went to a specialilst.. the specialist said "well, I need a better MRI.. this one isn;t good".. of course the new MRI was done... at the specialist office.. and made them money.

Completely unnecessary.

Please provide your proof that he is ordering unethical MRI's to people
I will be waiting on your evidence to show that he would be doing that.
If not you are slandering a doctor with no evidence.

I already provided evidence on the overutilization that happens when physicians own their own MRI.
In fact I provided numerous studies that showed that very thing.

the evidence of what happens in referral for profit is pretty clear.

now.. you answer my question.. based on the research .. a physician before they own an MRI was writing referrals for MRI.

When the OWN their own MRI.. the number of referrals to MRI goes up by 38% (more in some studies). Please explain the reason for the dramatic change in practice pattern.

again that is why we have a state review board. again how is this any different than the link that showed you where doctors order un-needed tests all the time?

Okay.. please explain exactly how the physician gets caught. I want you to explain exactly how.. a "review board" works to discover overutilization.

You should spend some time listening to people like myself that understand medicine.. rather than make claims about things you don't know about.

I'll get you started.. the first thing that has to happen is that a patient.. with no medical knowledge.. has to know that the MRI that was ordered.. was not appropriate.

So how does that happen?

Oh.. and then when they DO know that it might have been inappropriate.. they have to then bring it up to the medical review board (made up of who.. physicians.. many who may own their own MRI's).. and basically alienate the physician that they are going to for surgery or whatever.

Then the review board would have to investigate.. and then issue a warning. Which is all that would happen.

Heck.. dude... you don't even understand overutilization.. it occurs (as I have pointed out).. even when there isn;t a financial incentive for the provider; It happens simply for defensive medicine.

charging 40k for a 500 procedure is what they should be going after.

Why? So you think a state board of physicians should be deciding what providers can charge for procedures? Hmmm thats interesting.. MR "freemarket".

But.. at the end of the day, providers understand the issues when it comes to those charges. I tried to explain to you why the difference.. and at this point.. you are just going on your ideology and not reality.

they don't mind pay for all the other un-needed services they pay for.
however again charging 500 is less than charging 40k.

which you still can't justify.

Yeah.. I already justified it.. and pointed out the economic reasons it occurs. You just choose to avoid the truth.

jaeger19 · Aug 3, 2018

Skeptic Bob said:
Yeah, I have heard the same. I have also heard hospitals will do this (up charging people with insurance) to offset the money they lose on people coming into the ER who don’t pay. I don’t know how accurate that is, though.

there is some of this certainly for non payers. But when you seem claims that there is a lot of cost shifting where a private insurance company is charged more.. than public insurance like Medicaid or medicare.. that effect is probably more limited.

The amount private insurance pays are generally more than what public insurances pay but thats largely due to the volume discount that public plans enjoy. I accept less from Medicare.. because it represents a HUGE patient population. (but there is some truth to the fact that better paying insurance also do help subsidize Medicare/Medicaid as well. I could not survive only on Medicare reimbursement rates. (unless we did things like whats being discussed today.. which is self referral for profit and driving up utilization).

The real reason that you see differences in cost is cost shifting.. in which the hospital shifts costs from less used procedures/equipment.. that they HAVE to have.. whether they use it or not daily. to equipment/procedures that are used more.

Its why when you have surgery in the hospital.. its going to cost you more... because you are paying for the fact that the hospital has the full gamut of services available to you if things go south in surgery. Staff, equipment, technology etc.

When you have surgery in an outpatient surgery center down the road.. its less expensive. BUT.. if you suffer a severe problem on the surgery table? Its a good chance that you are getting transferred to the main hospital that has the ability to save your life.

ludin · Aug 3, 2018

jaeger19 said:
no they won't.. Just like as you point out.. people go to MRI's that "cost 40k".

Heck.. I have patients that have had two MRI's one. completely unnecessary because after one MRI.. which showed the issue they had..

Because they don't know better? They are simply told insurance will pay for it then they are shocked at a bill for 20k bucks for something that costs 500.
Why? because you guys obfuscate the prices so badly that no one knows what anything costs. it should be considered price fraud.

Defensive medicine is the 3rd most expensive thing in our healthcare system. the First 2 are malpractice and administrative costs.

I already provided evidence on the overutilization that happens when physicians own their own MRI.
In fact I provided numerous studies that showed that very thing.

I have shown that people need to start reporting them to the medical ethics board and that will help regulate it.

the evidence of what happens in referral for profit is pretty clear.

Show that this guy is doing referral for profit. so far you haven't.
in fact you have yet to show that anything this guy is doing is unethical.

now.. you answer my question.. based on the research .. a physician before they own an MRI was writing referrals for MRI.

Then they should be reported for unethical medical practices and it would stop or he would lose his medical license.

Okay.. please explain exactly how the physician gets caught. I want you to explain exactly how.. a "review board" works to discover overutilization.

Actually i prefer actual research into actual medical articles and things on the subject vs your protective interests in keeping people paying 40k for a MRI
that costs 500.

I'll get you started.. the first thing that has to happen is that a patient.. with no medical knowledge.. has to know that the MRI that was ordered.. was not appropriate.
So how does that happen?

There is a thing called getting a 2nd opinion. You are free to take your last MRI to another doctor and have them view it. If they say sure that shows what i need then you can confirm
that getting a 2nd one is not needed.

Oh.. and then when they DO know that it might have been inappropriate.. they have to then bring it up to the medical review board (made up of who.. physicians.. many who may own their own MRI's).. and basically alienate the physician that they are going to for surgery or whatever.

The warning is usually the first step in telling someone that they are acting unethically. If the behavior doesn't stop then well further measures can be taken place.

Heck.. dude... you don't even understand overutilization.. it occurs (as I have pointed out).. even when there isn;t a financial incentive for the provider; It happens simply for defensive medicine.

You projecting again. The main topic here is someone offering an MRI to people that need them for 500 instead of your defense of a 40k MRI.
All you do is yell at clouds.

Why? So you think a state board of physicians should be deciding what providers can charge for procedures? Hmmm thats interesting.. MR "freemarket".

No where did i say that why do you have to lie? What i have stated is that there is no excuse to charge 40k for a procedure that costs 500.
that is what we call price gouging.

But.. at the end of the day, providers understand the issues when it comes to those charges. I tried to explain to you why the difference.. and at this point.. you are just going on your ideology and not reality.

No i am going by the reality that it costs the same amount to maintain an MRI no matter what building it sits in. It is a fixed cost to run and operate that machine.
just because it sits in a hospital doesn't mean that it all of a sudden costs more money. You can't justify the cost difference of 500 an 40k.

Yeah.. I already justified it.. and pointed out the economic reasons it occurs. You just choose to avoid the truth.

No i choose to recognize reality that people like you are the issue with out medical system.
price gouging people for pure profit reasons. so you can justify 30% premium increases.

https://www.upi.com/Health_News/201...by-20-times-or-more-study-says/8071473425895/

The jig is up. how about this. YOu guys stop scamming people and then once you do that maybe we will listen to what you have to say.

ludin · Aug 3, 2018

Skeptic Bob said:
Yeah, I have heard the same. I have also heard hospitals will do this (up charging people with insurance) to offset the money they lose on people coming into the ER who don’t pay. I don’t know how accurate that is, though.

The government will cover people that don't pay in most costs. So the hospital doesn't lose money.
https://www.upi.com/Health_News/201...by-20-times-or-more-study-says/8071473425895/

that is the bigger issue right there.

then combine that with this.

https://www.kevinmd.com/blog/2017/03/high-medical-costs-blame-insurance-industry.html

then we wonder why our system is expensive.

throw in defensive medicine costs and it just goes over the top.
of course the government is not the solution either. they are just as bad if not worse.

jaeger19 · Aug 3, 2018

ludin said:
Because they don't know better? They are simply told insurance will pay for it then they are shocked at a bill for 20k bucks for something that costs 500.
Why? because you guys obfuscate the prices so badly that no one knows what anything costs. it should be considered price fraud.

y.

nope..they do it because 2. convenience.

You seem to think that when you come in with a head injury.. you can say.. "hold on.. I want to be transferred out of the hospital to this outpatient clinic to get my MRI.. then bring me back for brain surgery" :doh

I have shown that people need to start reporting them to the medical ethics board and that will help regulate it.

You haven't shown anything. first..you didn;t even know it happens in the first place.. second.. you as a patient wouldn;t know anyway in all likelihood.. THEN you would have to know the financial situation of the physician and then you would have to report it and know it was financial and not defensive medicine...

You have a pipe dream here.

Show that this guy is doing referral for profit. so far you haven't.
in fact you have yet to show that anything this guy is doing is unethical.

WTF? I just showed you a plethora of evidence that shows the referral for profit happens and is an issue.

Then they should be reported for unethical medical practices and it would stop or he would lose his medical license.

Who should report it.. YOU.. who think you just got a great deal because you only paid 500 for an MRI.. that you actually didn;t need?

You don't even know you didn;t need that MRI.

There is a thing called getting a 2nd opinion. You are free to take your last MRI to another doctor and have them view it. If they say sure that shows what i need then you can confirm
that getting a 2nd one is not needed

.

Oh.. so on every MRI you get.. you are now going to go through the expense of seeing another physician simply to confirm that the MRI that you got was sufficient and or necessary? Do you even read what you post? Come on man.

You projecting again. The main topic here is someone offering an MRI to people that need them for 500 instead of your defense of a 40k MRI.
All you do is yell at clouds.

All I do is provide concrete evidence of self referral for profit and overutilization..

No where did i say that why do you have to lie? What i have stated is that there is no excuse to charge 40k for a procedure that costs 500.
that is what we call price gouging.

Which means the if the state board is going to regulate it.. then they ARE setting prices.

No i am going by the reality that it costs the same amount to maintain an MRI no matter what building it sits in. It is a fixed cost to run and operate that machine.

Exactly.. completely ignoring that the building that it sits in DOES MATTER.. and its not a fixed cost to operate that machine anyway.

You can't justify the cost difference of 500 an 40k.

I already did... the charge isn;t just about what the cost of the MRI machine is. .. You completely ignore the economic reality.

No i choose to recognize reality that people like you are the issue with out medical system.
price gouging people for pure profit reasons. so you can justify 30% premium increases

\Ummm WTF are you talking about.. who is justifying a 30% premium increase.? What premium am I charging as a provider?

The jig is up. how about this. YOu guys stop scamming people and then once you do that maybe we will listen to what you have to say.

Wow.. now you see the disconnect you are making? On one hand.. when I tell you that overutilization is real and a problem.. you deny that it happens... and that self referral is an issue.. and then.. you go on to complain that you won't listen to me telling you about the medical system.. because I'm scamming people. :doh

Honestly.. here is the real kicker, you are a perfect example of WHY YOUR OWN PREMISE.. won't work. You think that you as a consumer.. can make great decisions and get the best prices and cheapest healthcare.. and yet then you demonstrate a monumental lack of understanding of the medical system.

ludin · Aug 3, 2018

jaeger19 said:
nope..they do it because 2. convenience.

You seem to think that when you come in with a head injury.. you can say.. "hold on.. I want to be transferred out of the hospital to this outpatient clinic to get my MRI.. then bring me back for brain surgery" :doh

You seem to think that because it sits in a hospital a 500 test should cost 40k. It is what we call unethical price gouging.

You haven't shown anything. first..you didn;t even know it happens in the first place.. second.. you as a patient wouldn;t know anyway in all likelihood.. THEN you would have to know the financial situation of the physician and then you would have to report it and know it was financial and not defensive medicine...

You assume people are stupid. We are not. I have shown plenty. In fact I posted two links that show enough.

You have a pipe dream here.

You just ticked that I want to remove the medical industry ability to scam people.

WTF? I just showed you a plethora of evidence that shows the referral for profit happens and is an issue.

You don't read and shout at clouds. I said show that this doctor the doctor in the article is going to do that.
You can't. Sure there are some bad doctors out there over charging people, however they are not the norm.

Who should report it.. YOU.. who think you just got a great deal because you only paid 500 for an MRI.. that you actually didn;t need?

Some doctors order an MRI to be sure. Even if it shows nothing paying 500 is better than 40k.

Oh.. so on every MRI you get.. you are now going to go through the expense of seeing another physician simply to confirm that the MRI that you got was sufficient and or necessary? Do you even read what you post? Come on man.

If I have a doctor do as you said want another one. Why would I not get a second opinion?

All I do is provide concrete evidence of self referral for profit.

That or they were needed and they got new patients that were looking for mri's.
In order to prove your case you would need to provided that the majority of them were not needed which you can't do.
You cry and whine about profit while defending 40k dollar mris that cost at most 500

Which means the if the state board is going to regulate it.. then they ARE setting prices.

No where did I say set prices stop lying.

Exactly.. completely ignoring that the building that it sits in DOES MATTER.. and its not a fixed cost to operate that machine anyway.

No it doesn't. Yes it is a fixed cost.

I already did... the charge isn;t just about what the cost of the MRI machine is. .. You completely ignore the economic reality.

Yes you do. I have already shown the medical industry is ripping people off.
While there might be a slightly more cost it isn't 39.5k more of a difference.

\Ummm WTF are you talking about.. who is justifying a 30% premium increase.? What premium am I charging as a provider?

You overcharge people for procedures. You rice gouge people high prices on things that do not cost that. The insurance companies then turn around and complain of higher prices and then raise rates.

Wow.. now you see the disconnect you are making? On one hand.. when I tell you that overutilization is real and a problem.. you deny that it happens... and that self referral is an issue.. and then.. you go on to complain that you won't listen to me telling you about the medical system.. because I'm scamming people. :doh

The article I posted is proof enough.

Honestly.. here is the real kicker, you are a perfect example of WHY YOUR OWN PREMISE.. won't work. You think that you as a consumer.. can make great decisions and get the best prices and cheapest healthcare.. and yet then you demonstrate a monumental lack of understanding of the medical system.

No I understand it just fine. You guys stop riding people off and stop marking things up 400% or more above what they should and you might carry some leverage. I noticed you didn't bother to read the article I posted that showed th evidence of what hospitals are doing to people.

Yes we can because when we refuse to pay your 400%+ markups you will lower them.
You will have no choice. Otherwise no one will go to your hospital.

That is what my system does. It puts the power back into the attention doctor hands.
I get the best price possible.