Why an MRI costs $1,080 in America and $280 in France


On Friday, the International Federation of Health Plans — a global insurance trade association that includes more than 100 insurers in 25 countries — released more direct evidence. It surveyed its members on the prices paid for 23 medical services and products in different countries, asking after everything from a routine doctor’s visit to a dose of Lipitor to coronary bypass surgery. And in 22 of 23 cases, Americans are paying higher prices than residents of other developed countries. Usually, we’re paying quite a bit more. The exception is cataract surgery, which appears to be costlier in Switzerland, though cheaper everywhere else.

Prices don’t explain all of the difference between America and other countries. But they do explain a big chunk of it. The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it.

“Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. They do this in one of two ways. In countries such as Canada and Britain, prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.

In America, Medicare and Medicaid negotiate prices on behalf of their tens of millions of members and, not coincidentally, purchase care at a substantial markdown from the commercial average. But outside that, it’s a free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured.


“In my view, health is a business in the United States in quite a different way than it is elsewhere,” says Tom Sackville, who served in Margaret Thatcher’s government and now directs the IFHP. “It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.”

The result is that, unlike in other countries, sellers of health-care services in America have considerable power to set prices, and so they set them quite high. Two of the five most profitable industries in the United States — the pharmaceuticals industry and the medical device industry — sell health care. With margins of almost 20 percent, they beat out even the financial sector for sheer profitability.

The players sitting across the table from them — the health insurers — are not so profitable. In 2009, their profit margins were a mere 2.2 percent. That’s a signal that the sellers have the upper hand over the buyers.

This is a good deal for residents of other countries, as our high spending makes medical innovations more profitable. “We end up with the benefits of your investment,” Sackville says. “You’re subsidizing the rest of the world by doing the front-end research.”

But many researchers are skeptical that this is an effective way to fund medical innovation. “We pay twice as much for brand-name drugs as most other industrialized countries,” Anderson says. “But the drug companies spend only 12 percent of their revenues on innovation. So yes, some of that money goes to innovation, but only 12 percent of it.”

one thing i liked about this article was that they came right out and said it: the new healthcare laws did nothing about price. it goes on to try and explain that fact away in some form, but the fact remains. your country doesn’t really care about you. sorry, friends. 



If I get a total of 100 tumblr followers by this Friday, I will post something special from my new book, Broxo, which comes out from First Second books this October!

Follow this guy, people!! This is the dude who made our Wet Hot American Summer St. Jude fundraiser happen last year!!

"Best" Scenes from this week’s Conservative PAC conference

At the “Red Carpet Blogger Awards” at CPAC, 2/10/12. Rappers: Steven Crowder and Chris Loesch.

A Conservative’s Tips For Finding The Right Mate

The Regrets of the Dying, Numbers 6 thru 11

A nurse asked her dying patients to look back on their lives and share what they regretted most. The top five most common were:
  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
  2. I wish I didn’t work so hard.
  3. I wish I’d had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish that I had let myself be happier.

The nurse recently released 6 thru 11 on the list. The commonalities shared by humanity never cease to astound me:

  1. I wish I hadn’t been tricked into feeding that chicken to another chicken on a fraternity bet.
  2. I wish I’d rescued my children from that polar bear.
  3. I wish I hadn’t bought a polar bear.
  4. I wish that Doritos came in more flavors, like Ranchier Ranch, Dumpling, and Leonardo DiCaprio.
  5. I wish I had Pedi Egg’d, even once.
  6. I wish I’d thought of Muppets more.

    30 New Things, Day 14. Re-imagining the calendar.

    My friend @katekrontiris blogs about my horrible day planner, and offers some inspirations for how to port over a more personalized and inspirational calendaring system into the digital sphere.



    After moaning to a friend early this morning about how bad I am at managing my own time, I had an interesting conversation this evening about re-imagining the calendar.  

    The photos are of horrible quality, but illustrative nonetheless.
    Below, is the most recent innovation in calendaring — it appears to be the equivalent of a large school binder or karaoke song list.  

    Inside are carefully crafted pages for each day, suited to this particular user’s thoughts about how he wants to spend his time and what he is willing to commit to (he only uses pen; all entries must be serious).

    Clearly, he is doing more during the middle of the day than early (or late) in the day, hence the different time slot sizes.  And he wants to track both his aspirations and his accomplishments — it is purposeful, deliberate, measured.

    This made me wonder if there was a way to re-think our digital calendaring tools to make them inspiring, instead of oppressive.  Why must the thought of looking at my calendar fill me with dread?  Why shouldn’t I look forward to being inspired by what is to come, as opposed to feeling pressured by responsibilities?

    These questions made me wonder whether there was a “design” fix to be had — what would make me excited to look at my calendar?  

    My conclusion was that it would be some combination of visual beauty and sound wisdom: a changing set of images that delight my eyes, attached meaningfully to the events of my day, perhaps with some lightly served suggestions for how to better manage my time.  Perhaps my engagements would not be locked into the standard day-to-day or week-by-week format — perhaps they would be organized chronologically and thematically.  Could I get some analytics?  Could I see how much time I spend in class vs. working vs. procrastinating vs. socializing?  Could I evaluate my happiness alongside the way I’ve chosen to spend my time?

    Essentially, why couldn’t my calendar be both smart and beautiful?