Profit shouldn't drive health care

Say What wrote:

Brad II wrote:
"The NCPA did not do the research; they compiled the data and listed their sources. Facts are not partisan."
Say what??? Facts are not partisan??? And fish don't swim???
Brad, of all the posts on these forums, you are the biggest user of "facts" to try to make your partisan points.

Sad thing is, most of these forums, as they relate to healthcare are made up of political groupies who have no clue about the issue, just what they've been told. HC is a serious issue that needs attention, but so far, few have proposed a workable solution.

Chris wrote:

<quoted text> Sad thing is, most of these forums, as they relate to healthcare are made up of political groupies who have no clue about the issue, just what they've been told. HC is a serious issue that needs attention, but so far, few have proposed a workable solution.

So true! I, for one, haven't the foggiest notion of what should be done but I have been satisfied with Medicare and I do not have supplimentary insurance because I can pay the 20% not covered. One key factor is that Medicare has limits on the amounts they pay for everything and so even though doctors and hospitals send in bills for six times the amount, they only get paid according to the schedule. I Have had two major operations and the cost was reasonable. I chose my own doctors.(One bad doctor and one good one!) My good doctor told me he liked having Medicare patients because he knew he would always be paid where some HMOs would not allow some proedures.

But I think what is needed for the overall health plan is some very original ideas, not copies of failed or poor plans of other countries. If we could apply the smarts of all the people who invent these far-out electronic devices to a health plan, we might come up with something good.

Say What wrote:

<quoted text>
So true! I, for one, haven't the foggiest notion of what should be done but I have been satisfied with Medicare and I do not have supplimentary insurance because I can pay the 20% not covered. One key factor is that Medicare has limits on the amounts they pay for everything and so even though doctors and hospitals send in bills for six times the amount, they only get paid according to the schedule. I Have had two major operations and the cost was reasonable. I chose my own doctors.(One bad doctor and one good one!) My good doctor told me he liked having Medicare patients because he knew he would always be paid where some HMOs would not allow some proedures.
But I think what is needed for the overall health plan is some very original ideas, not copies of failed or poor plans of other countries. If we could apply the smarts of all the people who invent these far-out electronic devices to a health plan, we might come up with something good.

"original", yes.. Now for someone with the fortitude and intelligence to make it happen. I'm no expert on HC, sure don't proclaim to be, I know the heat/cool business or Hvac. I know how to take care of my employees, and my customers and certainly how to make a reasonable profit. I can't imagine getting my competitors to go along with me on raising emergency service fees 500% or more in the winter time for broken furnaces. Assuming I did accomplish the above, it would be just as outrageous if someone, let alone a politician, tried to find a method for my customers to "pay" the exhorbitant fees that I charge by creating a "heating insurance program". Here again, my ethics would prevent me from doing this in business, but it sure hasn't prevented the HC industry from doing exactly that...

Chris wrote:

<quoted text> HC is a serious issue that needs attention, but so far, few have proposed a workable solution.

Health care is very serious and a very complicated issue. There are workable solutions that have been proposed.

There is some good info on the current bill here:

http://edlabor.house.gov/documents/111/pdf/te...

Brad II wrote:

<quoted text>
Health care is very serious and a very complicated issue. There are workable solutions that have been proposed.
There is some good info on the current bill here:
http://edlabor.house.gov/documents/111/pdf/te...

Brad this is similiar to other proposals I've read. It addresses insurance and options for employer/nonemployer purchasers. Getting more people insured will immitate a "fleet discount" type plan, which will lower costs minimally. The issue is costs are astronomically out of line. Even for the insurance companies who charge higher premiums to cover those costs. It's really not so much "how do we pay for it?", but "how do we make it affordable?" A good start might be addressing Tort reform, along with immigration reform and a host of other points would help, but at the end of the day, costs would still be too high for the avg american health consumer.

Chris wrote:

<quoted text> The issue is costs are astronomically out of line. Even for the insurance companies who charge higher premiums to cover those costs. It's really not so much "how do we pay for it?", but "how do we make it affordable?" A good start might be addressing Tort reform, along with immigration reform and a host of other points would help, but at the end of the day, costs would still be too high for the avg american health consumer.

Costs are high but then so is the quality of our health care. As George Will stated in a recent column,“we want 2009 health care at 1960s prices”. Our health care is vastly better than it was 40 years ago and some, not all, of the pricing reflects the cost of equipment, innovations etc. We do spend an enormous amount on health care because we can, we have better access so we consume more. I agree Tort reform is needed, that would help cut down on the endless tests doctors send their patients for so that their butts are covered in case someone decides to sue.

Some are suggesting plans for catastrophic coverage combined with an HSA, this is what I currently have. Why should someone have every single doctors visit paid for? I pay for all my doctors visits but if something serious happens I have coverage for that. I am happy with that type of service. I know that our current system does need reform but the single payer government plan is not sustainable, Medicare and Medicaid are both going broke.

Some doctors are suggesting that a lot of the testing and screening being done is not necessary. Cutting back on testing a screening could save a lot of money.
“Today, however, there's a small but growing band of researchers, clinicians, and expert panels who are speaking out against the unbridled use of these tests. One of them, H. Gilbert Welch, MD, a professor at Dartmouth Medical School, has laid out very persuasive arguments in an aptly titled book, Should I Be Tested for Cancer? Maybe Not and Here's Why. In this straightforward and well-referenced book, Dr. Welch raises several concerns about cancer screening.

1. Few People Benefit From Screening
For starters, the majority of folks who are screened receive no benefit. That's because, despite scary statistics, most people will not get cancer. Let's look at breast cancer as an example.

According to government statistics, the absolute risk of a 60-year-old woman dying from breast cancer in the next 10 years is 9 in 1,000. If regular mammograms reduce this risk by one-third-a widely cited but by no means universally accepted claim-her odds fall to 6 in 1,000. Therefore, for every 1,000 women screened, three of them avoid death from breast cancer, six die regardless, and the rest? They can't possibly benefit because they weren't going to die from the disease in the first place.”
http://www.naturalnews.com/z026558_cancer_can...

Profit may drive health care and any other business in the US but taxes will drive it now. The money will get funneled from the private sector to the government. And name me a business that does work for profit. Unless people expect every business in the USA to become charities. I doubt if they are thinking of prospering themselves. Its sick to expect people to not make money from their line of work.

This past weekend, lost in the wall-to-wall Michael Jackson coverage and Sarah Palin goodbye-cruel-world nincompoopery, there was a second round of tea party protests.

They were easy to miss because nobody showed up. But if you happened to have been driving in the vicinity of an evil publicly-funded park, you might've seen two or three Republicans loitering around -- sitting there in the socialized grass, believing that a vigorous protest involves napping in lawn chairs.

While I spent a few moments of my holiday weekend revisiting the irony of anti-socialism protests taking place on socialized park land, it occurred to me that the proposed government-run public health insurance option probably won't cost nearly as much as the CBO is suggesting.

Because clearly there won't be any Republicans signing up for it.

I mean, no Republican would dare sign up for inexpensive, easily portable health insurance. Not when red, white and blue All American for-profit health insurance is available. After all, free market private health insurance will probably continue to be the more expensive option, so that must mean it's the finest insurance, right? Expensive equals good, no?(No. More on that presently.)

And of course none of the Republicans or Blue Dogs in Congress are covered by a government health insurance plan. Except for all of them.

Please explain, conservatives and wingnuts, why you wouldn't seriously consider switching to the public option if it turned out to be more affordable and portable from job to job -- not to mention the fact that you wouldn't be turned down for a preexisting condition; you wouldn't be randomly booted from the plan as soon as you needed it most; and you would never have to worry about health insurance coverage ever again. Employed or unemployed. Sick or healthy.

I find it hard to believe that you, Mr. and Mrs. Wingnut, would defiantly pay more for less reliable insurance if offered a better deal. To pay more for less would be outstandingly backwards. Palin backwards. "Quitter" equals "fighter" backwards.

The fact remains that the only downside to the public option is that it's just too awesome. We don't deserve anything that good. Simply put: it's Medicare, but for anyone who wants it. And this is somehow a nightmare scenario -- one that we must never be allowed to experience even though it would cost much less than our current system, it would cover everyone who wants it, and it would be accountable to the American people. This is somehow a terrible idea. Terrible to the private health insurance mafia, that is. They simply can't allow you to have an affordable public option because they need your financial support. Face it,$1.4 million a day to lobby members of Congress isn't cheap.

Brad II wrote:

<quoted text>
Costs are high but then so is the quality of our health care. As George Will stated in a recent column,“we want 2009 health care at 1960s prices”. Our health care is vastly better than it was 40 years ago and some, not all, of the pricing reflects the cost of equipment, innovations etc. We do spend an enormous amount on health care because we can, we have better access so we consume more. I agree Tort reform is needed, that would help cut down on the endless tests doctors send their patients for so that their butts are covered in case someone decides to sue.
Some are suggesting plans for catastrophic coverage combined with an HSA, this is what I currently have. Why should someone have every single doctors visit paid for? I pay for all my doctors visits but if something serious happens I have coverage for that. I am happy with that type of service. I know that our current system does need reform but the single payer government plan is not sustainable, Medicare and Medicaid are both going broke.
Some doctors are suggesting that a lot of the testing and screening being done is not necessary. Cutting back on testing a screening could save a lot of money.
“Today, however, there's a small but growing band of researchers, clinicians, and expert panels who are speaking out against the unbridled use of these tests. One of them, H. Gilbert Welch, MD, a professor at Dartmouth Medical School, has laid out very persuasive arguments in an aptly titled book, Should I Be Tested for Cancer? Maybe Not and Here's Why. In this straightforward and well-referenced book, Dr. Welch raises several concerns about cancer screening.
1. Few People Benefit From Screening
For starters, the majority of folks who are screened receive no benefit. That's because, despite scary statistics, most people will not get cancer. Let's look at breast cancer as an example.
According to government statistics, the absolute risk of a 60-year-old woman dying from breast cancer in the next 10 years is 9 in 1,000. If regular mammograms reduce this risk by one-third-a widely cited but by no means universally accepted claim-her odds fall to 6 in 1,000. Therefore, for every 1,000 women screened, three of them avoid death from breast cancer, six die regardless, and the rest? They can't possibly benefit because they weren't going to die from the disease in the first place.”
http://www.naturalnews.com/z026558_cancer_can...

My wife is a career health professional. She corrected me on the "testing" issue. Yes, doctors do order an inordinate amount of tests due to tort claims, so that is an issue. Most Xrays take approx 5mins or less to complete. Technician time is 20mins with machine setup. Radiologist analysis is another 20mins. Materials and labor usually averages $75... Patient receives bill for $850.and up.. Emergency room: Avg visit time( not incl waiting) is 1hr. Materials/Labor is usually in the $200 range, not including tests. Patient receives bill for $3500 and up.. My wife will agree that we have quality healthcare, but it's quickly becoming an out of control money vacuum that dwarfs the oil industry. Somebody in the oil industry said years ago that "we can raise prices to over $5.gal and people will accept it as normal, just be patient" And we are quick to yell for price caps or regulations on "big oil".

Chris wrote:

<quoted text>My wife is a career health professional. She corrected me on the "testing" issue. Yes, doctors do order an inordinate amount of tests due to tort claims, so that is an issue. Most Xrays take approx 5mins or less to complete. Technician time is 20mins with machine setup. Radiologist analysis is another 20mins. Materials and labor usually averages $75... Patient receives bill for $850.and up.. Emergency room: Avg visit time( not incl waiting) is 1hr. Materials/Labor is usually in the $200 range, not including tests. Patient receives bill for $3500 and up.. My wife will agree that we have quality healthcare, but it's quickly becoming an out of control money vacuum that dwarfs the oil industry. Somebody in the oil industry said years ago that "we can raise prices to over $5.gal and people will accept it as normal, just be patient" And we are quick to yell for price caps or regulations on "big oil".

The prices you share need to be put in perspective. I'm not defending what the providers charge, but instead giving what I see as the reason the charges are so out of whack.

A relative of mine moved back up here in 2005 and brought health insurance with her. At the time she was pregnant. She went in the hospital here in Paradise, had a tough delivery and was released after several days. The total bill was close to $20,000.00. Her health insurance had the “reasonable charge” clause most health insurances have, and paid about $11,000.00. Since the health insurance she brought with her was not one of the benefit providers the local hospital accepted assignments on they did not discount the bill one cent. My relative paid the difference out of pocket.

When I say “accept assignment” I’m speaking of the relationship between the provider (hospital) and the benefit provider (insurance). Some hospitals have relationships with certain insurance companies in which they agree to accept the insurance’s “reasonable charge” schedule as their full payment.

Fast forward to this year. The same relative now had new insurance (Blue Cross) which is a benefit provider the local hospital accepts assignments on. She is pregnant again and again enters the same hospital. This time the delivery is much, much easier (thank goodness), and she goes home the next day. The total bill is $7,000.00 to which Blue Cross says $1,500.00 is reasonable and pays 80% of that. The hospital in this case willingly accepts the $1,500.00 as her full charge and she pays the 20% balance.

If you compare these two examples you can see how convoluted health care can be. If this person had had the same insurance she brought with her in 2005 she would have been expected to pay $7,000.00, but because of the relationship the hospital had with the new insurance company $1,500.00 was “reasonable.”

brad jenks wrote:

<quoted text>
The prices you share need to be put in perspective. I'm not defending what the providers charge, but instead giving what I see as the reason the charges are so out of whack.
A relative of mine moved back up here in 2005 and brought health insurance with her. At the time she was pregnant. She went in the hospital here in Paradise, had a tough delivery and was released after several days. The total bill was close to $20,000.00. Her health insurance had the “reasonable charge” clause most health insurances have, and paid about $11,000.00. Since the health insurance she brought with her was not one of the benefit providers the local hospital accepted assignments on they did not discount the bill one cent. My relative paid the difference out of pocket.
When I say “accept assignment” I’m speaking of the relationship between the provider (hospital) and the benefit provider (insurance). Some hospitals have relationships with certain insurance companies in which they agree to accept the insurance’s “reasonable charge” schedule as their full payment.
Fast forward to this year. The same relative now had new insurance (Blue Cross) which is a benefit provider the local hospital accepts assignments on. She is pregnant again and again enters the same hospital. This time the delivery is much, much easier (thank goodness), and she goes home the next day. The total bill is $7,000.00 to which Blue Cross says $1,500.00 is reasonable and pays 80% of that. The hospital in this case willingly accepts the $1,500.00 as her full charge and she pays the 20% balance.
If you compare these two examples you can see how convoluted health care can be. If this person had had the same insurance she brought with her in 2005 she would have been expected to pay $7,000.00, but because of the relationship the hospital had with the new insurance company $1,500.00 was “reasonable.”

This sounds like an argument for a public health care option for those who don't like unpleasant insurance company surprises.

Frank wrote:

<quoted text>
This sounds like an argument for a public health care option for those who don't like unpleasant insurance company surprises.

Perhaps Frank...

Then the government would be the provider saying what is "reasonable" as they do with Medicare today.

These models I cite are part and parcel and the direct result of the model established under Medicare.

brad jenks wrote:

<quoted text>
The prices you share need to be put in perspective. I'm not defending what the providers charge, but instead giving what I see as the reason the charges are so out of whack.
A relative of mine moved back up here in 2005 and brought health insurance with her. At the time she was pregnant. She went in the hospital here in Paradise, had a tough delivery and was released after several days. The total bill was close to $20,000.00. Her health insurance had the “reasonable charge” clause most health insurances have, and paid about $11,000.00. Since the health insurance she brought with her was not one of the benefit providers the local hospital accepted assignments on they did not discount the bill one cent. My relative paid the difference out of pocket.
When I say “accept assignment” I’m speaking of the relationship between the provider (hospital) and the benefit provider (insurance). Some hospitals have relationships with certain insurance companies in which they agree to accept the insurance’s “reasonable charge” schedule as their full payment.
Fast forward to this year. The same relative now had new insurance (Blue Cross) which is a benefit provider the local hospital accepts assignments on. She is pregnant again and again enters the same hospital. This time the delivery is much, much easier (thank goodness), and she goes home the next day. The total bill is $7,000.00 to which Blue Cross says $1,500.00 is reasonable and pays 80% of that. The hospital in this case willingly accepts the $1,500.00 as her full charge and she pays the 20% balance.
If you compare these two examples you can see how convoluted health care can be. If this person had had the same insurance she brought with her in 2005 she would have been expected to pay $7,000.00, but because of the relationship the hospital had with the new insurance company $1,500.00 was “reasonable.”

I absolutely agree on the insurance contract rates. "reasonable and customary" is the usual phrase. Most often, they take an nationwide avg and then create a figure that is "reasonable", which also affects the premiums. The insurance companies still have strict constraints though, as the hc providers always have their limits on what they think is a reasonable profit margin. The insurance companies then have 2 options, take it or be dropped by the provider. Being dropped is an everyday occurrence, leading to the insurance companies usually caving into demands in order to keep their customers. The latest craze is cutting hospital staffing to increase profit. RN's kept at minimum, while LPN's or even CNA's are used regularly to cut hourly costs. And of course, more PA's to replace doctors. There is no country that even comes close in medical research and technology. But the actual quality of care is dropping as the prices increase.

Chris wrote:

<quoted text>I absolutely agree on the insurance contract rates. "reasonable and customary" is the usual phrase. Most often, they take an nationwide avg and then create a figure that is "reasonable", which also affects the premiums. The insurance companies still have strict constraints though, as the hc providers always have their limits on what they think is a reasonable profit margin. The insurance companies then have 2 options, take it or be dropped by the provider. Being dropped is an everyday occurrence, leading to the insurance companies usually caving into demands in order to keep their customers. The latest craze is cutting hospital staffing to increase profit. RN's kept at minimum, while LPN's or even CNA's are used regularly to cut hourly costs. And of course, more PA's to replace doctors. There is no country that even comes close in medical research and technology. But the actual quality of care is dropping as the prices increase.

It's a mess with many warts. Still, anyone who thinks the government will do a better job is nuts.

The government has been part of the problem since Medicare was established. Back then they said very few will live to use these benefits and as a result were less concerned with "certain" costs.

Take for example medical "supplies" and medical supply companies. When Medicare was established they assigned "schedules" for how much they would pay for supplies. In effect they said a band aid was worth “this amount” and oxygen was worth “that amount” instead of allowing the free market to bid for the business.

If you look at the two government health care providers (Veterans’ Hospitals and Medicare) you find one who allows competitive bidding (Veterans’) and the other (Medicare) paying based on schedules for supplies. You end up paying under Medicare MUCH more for a band aid or oxygen than you do at the Veterans’ Hospitals. Then politics steps in, lobbyists for medical supply companies line the pockets of those nice folks who represent the “people” and the system remains the same.

A few years ago I read the savings to the tax payer for oxygen alone would be in excess of 5 billion annually if Medicare went competitive as compared to what the Veterans’ Administration pays. But what the heck….what’s a billion here or a billion there when we’re talking about our government?

A few legislators get their pockets lined and we pay billions upon billions of dollars extra as the medical supply lobby inserts their influence. Government does things best don’t cha know?

brad jenks wrote:

<quoted text>
It's a mess with many warts. Still, anyone who thinks the government will do a better job is nuts.
The government has been part of the problem since Medicare was established. Back then they said very few will live to use these benefits and as a result were less concerned with "certain" costs.
Take for example medical "supplies" and medical supply companies. When Medicare was established they assigned "schedules" for how much they would pay for supplies. In effect they said a band aid was worth “this amount” and oxygen was worth “that amount” instead of allowing the free market to bid for the business.
If you look at the two government health care providers (Veterans’ Hospitals and Medicare) you find one who allows competitive bidding (Veterans’) and the other (Medicare) paying based on schedules for supplies. You end up paying under Medicare MUCH more for a band aid or oxygen than you do at the Veterans’ Hospitals. Then politics steps in, lobbyists for medical supply companies line the pockets of those nice folks who represent the “people” and the system remains the same.
A few years ago I read the savings to the tax payer for oxygen alone would be in excess of 5 billion annually if Medicare went competitive as compared to what the Veterans’ Administration pays. But what the heck….what’s a billion here or a billion there when we’re talking about our government?
A few legislators get their pockets lined and we pay billions upon billions of dollars extra as the medical supply lobby inserts their influence. Government does things best don’t cha know?

It sounds as if Medicare went competitive that 5 billion annually could be put towards expanding it to cover more people, like say 55 and up. Many people who retire at 55 have a real problem with coverage between then, and when Medicare kicks in at 65. Did they raise it to 67?
What would you suggest for those leaving employer based private health ins at 55 for the years before eligible for Medicare?

Chris wrote:

<quoted text> Patient receives bill for $3500 and up.. My wife will agree that we have quality healthcare, but it's quickly becoming an out of control money vacuum that dwarfs the oil industry. Somebody in the oil industry said years ago that "we can raise prices to over $5.gal and people will accept it as normal, just be patient" And we are quick to yell for price caps or regulations on "big oil".

The hospitals and clinics do have to pay for the equipment that they purchase. I would not hazard a guess as to what one MRI machine would cost but I know that it would very expensive. Throw all the other expenses on top of that and I am sure that that makes up a big part of the cost. A friend works at a local hospital doing maintenance, they needed to put some new cabinets in the ER,$5000 worth of cabinets took $12,000 worth of engineering that is due to the strict regulations from the state.

Frank wrote:

<quoted text>
It sounds as if Medicare went competitive that 5 billion annually could be put towards expanding it to cover more people, like say 55 and up. Many people who retire at 55 have a real problem with coverage between then, and when Medicare kicks in at 65. Did they raise it to 67?
What would you suggest for those leaving employer based private health ins at 55 for the years before eligible for Medicare?

I suggest they be responsible and buy their own health insurance, and once they become eligible for Medicare, research it to see if they should or should not buy a Medicare supplement.

Expanding Medicare to younger people when Medicare is going broke does sound like a typical solution to the problem (at least in the last few years), but I somehow doubt that will "solve" the problem.

Thanks Brad,
Heres a report from England;

Last Friday I learned what it was like to be part of a civilized, first world health system.

I was in England, staying at my godmother's house, when I got slammed by one of my chronic migraines. When I get migraines I usually resign myself to a dark room, take my medication and wait for the nauseating pain and blurry vision in my left eye to dissipate.

As I rummaged around my suitcase to find my salvation, high doses of Trexamet and Naprosyn, I discovered that I had forgot to pack them in my rush to the airport. Not having my medication doesn't mean enduring one bad headache. It means enduring about three days of completely crippling head pain. Instead of panicking over my fate, I picked up the phone and called my doctor in NY. I thought she'd be able to call in a prescription. No dice. She actually didn't even call me back. Plus, as my godmother reminded me, she wouldn't be able to call in a prescription because she's not part of the British health system.

So I resigned myself back to my dark room, put a cloth over my head and tried to do what my mother always tells me: "go to another place." Well, my godmother came upstairs shortly afterward and suggested that she could take me to that other place... a National Health office.
Since I thought getting an appointment there would require a referral, at least a day's wait and an exorbitant amount of money, I told her not to bother. She called anyways, got me an appointment for the next hour and we were off to the neighborhood clinic.

It was amazing. I filled out paperwork with my New York address, waited five minutes, met with the doctor, got a prescription, walked downstairs to the pharmacy under the clinic and was back at my godmother's house an hour later. Believe it or not, I didn't have to pay a cent for the visit. I did, however, pay a "private" prescription price for the medication that added up to about $30 dollars.

I'm not denying that there are problems with the British system. My problem wasn't life threatening, but it was temporarily crippling. For people with deadly diseases like cancer there are documented frustrations over access to certain treatment. My great-uncle actually got sent home from a British hospital because there weren't enough beds that day. He was scheduled for open heart surgery... an operation he endured the following week.

There will always be problems in a system that takes care of millions, but that shouldn't preclude us from not giving millions their rights to proper health care. What Obama said about energy applies to health care: "Don't let the perfect be the enemy of the good." From my experience the British system was good. It was also good to my great-uncle. Even though he was sent home, he was treated. His immediate family didn't have to haggle with insurers or cut costs. His country took care of him. America should be able to do the same.

And Here's the latest insane rhetoric from the US;

Rep. Paul Broun, a Georgia Republican, upped the rhetoric against public health care Friday, saying that giving people the option of a public plan "is gonna kill people."

Broun is a doctor. "A lot of people are going to die," he diagnosed from the House floor.

He criticized the British and Canadian systems of universal health care and said those nations, "don't have the appreciation of life as we do in our society, evidently."

Brad II wrote:

<quoted text>
The hospitals and clinics do have to pay for the equipment that they purchase. I would not hazard a guess as to what one MRI machine would cost but I know that it would very expensive. Throw all the other expenses on top of that and I am sure that that makes up a big part of the cost. A friend works at a local hospital doing maintenance, they needed to put some new cabinets in the ER,$5000 worth of cabinets took $12,000 worth of engineering that is due to the strict regulations from the state.

Depending on the type of MRI, ie; number of magnets/speed,$600k-$2mil.. Avg cost to patient is $500 p/use. 3 uses p/hr, 12hrs p/day is a standard avg use. The return on investment is around $18k p/day. It's "normal" use is based on a 5 day week, with exceptions for weekend ER usage. The return on the machine is approx $4,320,000 p/yr. So it's a good investment for any hospital. You are correct on the engineering issue, even here in Indiana, hospitals spend an inordinate amount of their budgets on EG, but the overall costs are dwarfed by the tremendous profit realities. If I would have had more capital, I would have invested in a local hospital partnership. The 3 year return was over 25%. They speculate the 5yr return will climb much higher.