Is it possible to get at least a reasonable estimate of total cost for such a service, including all the required additional expenses? I can’t think of any other business that could get away with telling you or implying that some service might be necessary — and indeed your very life might depend on it — but not telling you what it’s going to cost you.

Then we have the doctors that walk in the room listen to the patient do an assessment and walk out knowing what is wrong with the patient and have plan of care decided. They have . . . . and write up the diagnosis and prescription if needed. These doctors are complained about because they didn’t run test and rack up thousands of dollars in care. (Yes, we have a few of these too). Patients in and out in 30 minutes and my waiting room is empty.

Personally, I like the “treat and street” for many of our urgent care patients. They could have gone to their private physician but don’t have one. After all it is easier to go to the ED, than to go to the doctor’s office.

As to Matt, the cost for a CT is $1200 to $1600 depending on the number of avg. slices (Head 28-36, Chest 40-48, and Abdomen 30-38)(Inpatient/ED costs more than Outpatient). No this doesn’t count the Radiologist, the ED physician, or the Facility Charges. They are all billed separately.

There doesn’t seem to be much correlation with damage caps on a per capita basis on spending:

http://www.statemaster.com/graph/hea_tot_sta_hea_car_spe_percap-state-care-spending-per-capita

Nor does there seem to be much correlation with damage caps when you consider access (physicians per capita). That seems to be more tied to the rural/urban divide:

http://www.statemaster.com/graph/hea_tot_non_phy_percap-total-nonfederal-physicians-per-capita

You say McAllen is an outlier – how did you reach that conclusion? Hopefulness?

Frankly, the whole “we will test less because you cap pain and suffering damages at $250K” doesn’t make much sense. Unless you’re dealing with a child, or a really, really old person, you have no idea what their economic damages would be, so you could still be popped with a million dollar judgment. If that’s your fear, then why would it change?

Is it? Texas is ranked #2 on that “Report Card” and it doesn’t seem to have reduced the testing there:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Is it? Texas is ranked #2 on that “Report Card” and it doesn’t seem to have reduced the testing there:

http://www.boston.com/bostonglobe/ideas/brainiac/2009/07/mcallen_texas_h.html

I have insurance, but it’s a high deductible. I have to pay the first $3500 before insurance starts to kick in. When they want to do tests, a few times I’ve inquired about the cost. I’m told “we don’t worry about that, we’re going to do everything that is necessary” – necessary for diagnosis or necessary for avoiding lawsuits.

I’d rather get full information about cost, what they’re looking for, how knowing that information vs. not knowing that information will change future treatment, and then decide whether I want to take the risk. Let us sign a waiver that if we don’t do that that test and suffer negative consequences we won’t sue. But don’t guilt us into it if we don’t really need it..

Sure, particularly in an ED, there are cases where you simply can’t stop to inquire what they are willing to buy — those are the emergencies. In this story, though, you have a sophisticated customer offered a variety of additional services, and he buys them all without any consideration of the price. It’s not until he sees the bill paid by his insurer that he’s scandalized. Do you think he’d have a different answer if asked, “an MRI costs $X; do you want one just to be sure that there’s no mass?”

I forget if you’re at Harris or JPS, but if I called the ED of either today and asked how much it would cost to get an MRI of my head, could I get an answer? I’m actually curious. Would I also have to ask if there was a separate charge from the physician or radiologist to look at it?

I suspect that if I could get an answer, it would be a hugely inflated number, with the hospital figuring they could always negotiate down, but can’t raise it later, and that it wouldn’t include a host of additional costs (sorry, that’s another $16 for a band-aid). I also suspect that if there were “menu” pricing for additional services, then there would be a huge drop in revenue for the hospitals as the people who would otherwise have the means to pay simply decided not to purchase — I think the only reason that doesn’t happen now is that nobody sees the cost up front, and has no clue until they get a bill and/or an EOB. If they did, there wouldn’t be any $90 saline drips or $130 boxes of facial tissues.