This is what a world without Obamacare or Single Payer looks like

MRI SCANS AT $395.00 - Advanced Patient Imaging offers an affordable solution to medical imaging services that's designed around the patient. We offer a fixed, all inclusive price of $395.00 for all MRI scans. This price includes the scan, contrast (if ordered), a copy of your exam on a CD-ROM and professional interpretation from a board-certified radiologist within 24 hours. Advanced Patient Imaging developed our business model centered on low fixed costs. We do not have excessive operating or overhead costs like most large hospitals or other imaging centers. This allows us to offer individuals who may have no insurance, high deductible or co-insurance plans an affordable medical imaging option without sacrificing quality of service. Advanced Patient Imaging is committed to providing our patients with the best service at the best price. We employ a friendly, professional, caring staff with years of experience and specialty training. Our radiologists are board-certified by the American Board of Radiology. We utilize the same state-of-the-art medical imaging equipment that you will find in hospitals and imaging centers throughout the country.

In Minnesota, a company sold Groupons offering cut-rate prices for MRIs to screen for risk of stroke.

That kind of online deal hasn't made it to Cincinnati, but you can walk in to a storefront medical office and get a magnetic resonance imaging test for $395 – about one-sixth the cost of the test in a hospital.

Low-cost alternatives for big-ticket diagnostic tests are the latest signs of how Greater Cincinnatians are changing the way they buy and use health care. As shifting pressures reshape the medical economy, people are relying more on their shopping skills and less on doctors to reduce expenses that health plans no longer cover.

Advanced Patient Imaging, open just two months in a small office complex near Eastgate Mall, offers MRIs for a flat $395, including the test interpretation by a specialist. MRIs can detect cancer, ligament damage and other problems with soft tissue that escape X-ray.

The company does not take insurance. But a customer will get a receipt for filing with an insurance company to have the cost applied against a plan deductible. Customers don't need a doctor's referral unless they want to file a claim with their insurance.

The point, say the company's founders, is to provide a low-cost alternative that avoids the paperwork hassle of insurance and a hospital's built-in costs that are passed through to consumers. Plus, with coverage deductibles running to $7,500 a year, consumers end up paying out of pocket anyway for MRIs and other medical tests.

"The hardest thing about this," said David Durham, clinical coordinator for Advanced Patient Imaging, "is getting people to embrace the belief that they are their own health-care advocates."

Jaime Conner of Batavia, who recently took her teenaged daughter to the clinic for an MRI, is delighted at the price for such an important diagnostic test.

"I love the choice being given to me," she said. "For years, we just assumed you have to go to the hospital to get things done. I like the idea of choice. It lets me decide how much I'm going to spend."

In the past 30 years, medical science has multiplied the tools that can guide health care decisions. The tried-and-true X-ray test that reveals bones has been joined by the computed tomography or CT test, which uses X-rays to create cross-section images of the body, and the MRI, which uses magnets and radio waves to reveal soft tissue.

With an MRI, a patient dons a hospital gown to lie on a flat surface that is wheeled into a tube encircled by the magnet housing. As a magnetic field is generated, radio-frequency waves are directed at the patient, who must be still for the length of the test, sometimes up to 45 minutes. The procedure generates detailed images of inside the body.

Because the equipment expense is so high – an MRI machine costs about $1 million – only hospitals have had the buying power to purchase them. The federal government has found that the national average price for an MRI is about $2,700, not including the radiologist's reading.

Tack onto that price the separate cost of a radiologist who interprets the findings and writes a report: an extra $150 to $300.

As the cost of the machinery has dropped, some tests have moved out of the hospital setting, particularly ultrasounds and mammography. Durham, an ultrasound technician for more than 20 years, and Driggs, a former executive with Hospital Corp. of America, together have been running a mobile ultrasound unit in Cincinnati for six years.

With the cost changes driven by the Affordable Care Act, the two men realized that medical testing was becoming an entrepreneurial opportunity. Fliers inserted into print editions of The Enquirer, for example, advertise services of Life Line Screening of Independence, Ohio, which puts ultrasound testing in mobile units. Consumers can get ultrasound screenings for five conditions for $149.

In Plymouth, Minnesota, west of Minneapolis, a company called MRI Pathways sells MRIs for a flat $499, including the radiological interpretation. The company last year experimented with Groupon, the daily online discount deal, which created such a high demand for MRIs that the offer was discontinued, a spokesman said.

Inside the Clermont County office of Advanced Patient Imaging, consumers can also get $125 echocardiograms to check the heart and $95 vascular sonograms to look for potential blockages in veins and arteries.

In the parking lot stands a separate, specially designed facility for the MRI, which the company leases, "exactly the same machine you'd find in a hospital," Durham said.

A consumer can come to the office, pay $395, get the test and receive a radiologist's report within 24 hours. Driggs said the contracted doctors who read the company's MRIs are board-certified radiologists licensed to practice in Ohio.

Other companies around the country offer low-cost MRIs in a price range, depending on the body part examined, and some of them take insurance. Durham and Driggs said what makes Advanced Patient Imaging different is that they have figured out the lowest possible flat price for an MRI – and they have disengaged it from the confusion of insurance coverage.

"We follow the KISS principle – keep it simple, stupid," Driggs said. "There are no additional costs. When you buy a car, you shop around. That's what we're trying to offer in the medical arena."

About a month ago, Jaime Connor's 14-year-old daughter Kasey fell during volleyball practice at Williamsburg High School. Her knee swelled, and the pain increased. Connor grew concerned and worried about getting her daughter medical care.

Connor and her husband are self-employed and do not have health insurance due to political objections to the Affordable Care Act. Connor and Durham know each other through their children's sports activities, and Durham suggested Connor bring over her daughter to Advanced Patient Imaging.

All Connor knew about an MRI was that it involved a giant tube "and it was very expensive." But she gladly paid $395 for her daughter's test one morning, and by dinner time, the family had the radiologist's report with the good news that the injury was not serious. She called the care and followup "phenomenal."

The experience "has made me think outside the box," Connor said. "I think people just assume: Hey, I can go anywhere because the insurance has got it covered. People could be saving thousands of dollars if they had this knowledge."

Though this article is three years old, it is very relevant today. I just heard an ad for this company on the radio this morning and, after arguing this stuff on facebook with friends, it was very timely.

I and my friends without healthcare insurance are finding, everywhere, that health care - even "big" stuff - is not really that expensive. and compared to the cost of health care insurance, it's downright cheap. This is yet another example.

An MRI done, with all the trimmings, with an out the door price of under $400. Why pay the equivalent of your house payment for insurance that won't even touch that until you get to your 20th MRI in a year thanks to the sky high deductible.

Health insurance is a scam and a ripoff.

I made a mistake when I posted this. I had tried to post content from here: http://www.cincinnati.com/story/news/2014/11/22/cheap-mris-proliferate-even-groupon/19431111/

However, the post feature would not let me, so I got the same info from another source and copied that info into the OP. However, rather than delete the original content, it just added it to the top. Sorry about that.

Cash only doctors

http://money.cnn.com/2013/06/11/news/economy/cash-only-doctors/index.html

Insurance is not a scam. It still has a role but it not meant for everyday expenses.

One commentator, I think it was John Stossel, made the point on elective surgeries being enormously cheap based on market forces. LASIK vision correction is highly sought, but cheap and getting cheaper in such an active market.

I can’t imagine any other procedure being different.

I had a relative call toward the end of 2016 ago from an MRI facility. There were 2 options
* Use insurance - pay about $500 left for the deductible that year (the insurer would be billed an additional $200+)
* Pay about $300 cash.

She didn’t know what to do (didn’t believe it). I said to pay cash since 2016 was almost over and no more big expenses would happen that year to make it worth paying the entire deductible. She paid cash and it really was $300 and got what her doctor wanted.

About five or six years ago, I thought I had a torn meniscus and I had no insurance.

I found an MRI in the Pittsburgh area for $350 and all the same included except the professional opinion.

I was thrilled to be able to travel from Dr office to Dr office and negotiate an operation.

Turns out it is RA, but still .... that was not that long ago.

I saw that video on youtube a couple of years ago. It was broadcast before obama was elected. I remember the part about the whole foods employee shopping around for a physical and discovering not only an amazing disparity in pricing, but how many places could not tell her how much it would cost.

That is a serious problem.

There are many doctors now publishing price lists for services. This will be very useful after obamacare completely collapses, which is what will happen if the repubs sit on their thumbs (which may be the plan).

This same thing happened to a friend of mine. I just found out about it last Sunday. And it was around that price too.

This stuff is happening all over the place. I actually got on the air a couple of weeks ago on the Michael Medved show to bring this whole concept up and, comically, a couple of other people called in to confirm it regarding their personal experiences.

He acted like he had never heard of such a thing. Either he’s not very versed on healthcare in the U.S. or he’s being less than honest with his listeners.

It seems like very high deductible insurance combined with health savings accounts would be the way to go.

It’s what I did in the 90’s. I saved $250 a month by going from Group health to $10,000 deductible for my family. After a couple of years, my daughter broke her arm. I thought, “oh boy, now I find out why you don’t want high deductible.” We took her to the local clinic and the entire cost for everything was $275. :-D

I was talking to her last year about health care and discovered she still tells her friends about that when obamacare comes up. I had no idea it had that much impact on her.

And here is another fun fact that we experienced: one of my daughters hurt herself on the playground at school around that same time. The schools insurance covered it, though it took some arm twisting to get them to. They figured our insurance would cover it, but since we didn’t have insurance for something that “cheap”, it wouldn’t. It’s like they had to dust off the policy.

And if you are injured in a car accident or on someone elses property, there is other insurance to cover your injuries. People often forget that as well.

I read some piece from 2015 where a guy from California got fed up with the rates and told his wife (p-t tax person) to figure out a new way of doing this. He wasn’t going to keep paying increased rates.

So she went and talked to the finance lady of the clinic that they used. The finance lady opened up a book and read off the alternate deal....cash or debit-card only. So, the clinic would give you a 25-percent discount if you went this direction. Lab stuff? Same way. They would even open up the clinic on Sat/Sun mornings for two hours just for cash/debit card customers. They even had a private hospital in the area that would be the point if you needed in-patient care....same deal 25-percent off.

So the wife made the husband take the $16,000 a year that he was normally paying for care....go into one special account with two debit cards. The negative of this is catastrophic care and enormous costs. But the couple and their kids had used roughly $3,000 of care over the past three years and really couldn’t see any logic for the continuing trend.

I personally think that health insurance should have been broken up into in-patient and out-patient (catastrophic situations) and the bulk of the public should have signed up only for catastrophic care only.

"Health insurance is a scam and a ripoff."

No, it's the law. As long as the vest interests that benefit from that law finance the campaigns of the politicians it will remain the law.

Outside the district campaign financing is the greatest flaw of our political system.

Back east I forget which state there was a walk in ,any blood or urine test you wanted prescription free medical lab. It was right next to the whole in the wall mini Chinese restaurant.

America is bypassing the insurance mafia.

I swear this is true. Two otherwise smart and savy people told me, in all seriousness, that they had never had of this so called “cash for services” when going to a doctor or hospital. They found the whole thing shocking and repugnant.

They were retired unionized steel workers. One got so upset he was almost in tears saying that if he didn’t have insurance he would have been left to die (from a recent illness).

They are both supposedly very conservative. But they are Trumpians and like him believe in wonderful, cheap, preexisting conditions should not be excluded, healthcare for everyone.

As I am learning from others on this forum, they may well be a majority.

“I can’t imagine any other procedure being different.”

Agreed.

A little anecdote - I couldn’t believe it when after our youngest was born I saw the itemized expense list: ~$10k total!

Wow - this for a normal hospital delivery - attended only by a mid-wife. The baby was delivered, and my wife went home the next day.

$10,000! - I’m guessing some enterprising group could offer a “groupon” for 1/4 or even 1/10 of that cost (with the stipulation being that “complications” incur additional fees).

fwiw - I often use your LASIK example, as it perfectly illustrates how market forces can control cost.

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