There’s two sides to this coin. On the one end, you have insurance companies refusing to pay for anything because the modern industry is just six scams in a trench coat.
But on the other, you have doctor’s offices where the physician literally leases an MRI machine to the tune of several million dollars and then has to run a certain number of patients through the scanner every year or lose money. That’s because the MRI patent is held by GE and they can charge 10-100x markups on hardware that is fundamental to modern medicine.
Its the same with diabetes treatments. Insurance companies will try and refuse service or kick people off their policies if they are at risk. But then pharmacy companies will sell $3 of insulin for $75, then kickback a chunk of the balance to judicial/congressional bribes in order to guarantee the cash flow.
At some level, the only insurance companies that can survive in such a market are the ones that say “No!” to everything. The even-remotely-ethical firms just get fleeced by the for-profit industry until they get bought out or go bankrupt. That, or you’re Medicare/Medicaid and you have an infinite wallet backstopped by the US Treasury. You don’t care if you’re paying multiples of whatever any other clinic anywhere else in the world would charge on an enormous population of poor and elderly patients, because you have an unlimited money cannon to mow it all down with.
GE isn’t the only one who makes MRIs. The other big players are Siemens, Philips, United, and to some extent Canon, Fujifoto, and Hitachi.
No, that’s really how much it costs. The margin on MRI machines is terrible. I’d like to see you do it cheaper… “Just” build then supercool magnet for superconduction for 3T of homogenius magnetic field, build coils that handle KW of RF/gradients that can fit a human comfortably without artifacts, build the high power and precision circuitry to transmit and receive said RF, then control that equipment accurately and safely.
Super easy, off-the-shelf stuff.
Oh, and you can’t use any ferrous parts, nor can your power supplies generate any noise.
The other big factor in cost is supply chain. Everything has to be tracable. So the supply chains have to do a lot of paperwork, inspection audits, since a defective part can kill someone.
This kind of thing is why it bothers me when people complain about “free market medicine”.
A market where only one entity is allowed to build MRI machines, or license the tech to others to build, is not a free market. That’s a government-enforced monopoly.
Even the fact that a patient can’t just go get their own MRI at Scans-R-Us, but needs to get a doctor’s referral first, is a huge departure from what an actually free market for medicine would look like.
It’s an evolving technology. We get new patents with every iteration.
A market where only one entity is allowed to build MRI machines, or license the tech to others to build, is not a free market.
If you spend a few years in Business School getting your MBA, you get an earful about how and why patent law exists. The core argument is that private investment is predicated on returns and we can’t have nice things unless we have men with guns come for the property and freedom of anyone who “steals an idea”.
But more practically, this shit is just a racket. Lots of lobbyist money changes hands to make sure the decks at the casino are properly stacked. Medical treatment is just another opportunity to apply leverage through debt to control other people.
I understand the value of a patent system, but patents should expire.
Is there some reason why previous-generation technology, like the tech being used for MRIs in the 90s, can’t be used to manufacture more competitively-priced machines?
Like, is there a law specifying that the new technology must be used for an MRI to be usable as a diagnostic tool?
They do. It’s just that they can be renewed under various circumstances, typically as an incentive to increase production.
Is there some reason why previous-generation technology, like the tech being used for MRIs in the 90s, can’t be used to manufacture more competitively-priced machines?
You need a certain amount of industrial capital geared towards making these machines and GE is the only one that really does (excepting manufacturers overseas). A big part of the problem is that we don’t have a good mechanism for introducing new small businesses to the market. You really need to know someone that needs a steady number of MRI machines on a regular basis to make a new MRI factory worth it, and unless you have that business connection you have no buyers.
So you’d need to have a single integrated business, just to get all that information in-house.
The same company could build the machines, and sell the MRI scanning service.
Then you’d need a lot of conversations with various doctor’s offices.
But there are probably lots of places who’d rather be able to provide patients with a lower-cost, lower-quality MRI, so it should be possible to collect a number of providers saying “if such a service exists, I’ll use it”.
My guess is there’s gonna be a lot of government money available soon for people who want to build new manufacturing capability in the US
I’d go one further and say a National Health System fixes all this. Rather than paying a guy to pay a guy, you just have publicly financed clinics and hospitals. This is the traditional way of building up medical infrastructure, btw. City hospitals used to be the norm. We only entered the era of corporate consolidation when we sold off our public infrastructure for a song during the neoliberal turn of the 70s and 80s.
There’s two sides to this coin. On the one end, you have insurance companies refusing to pay for anything because the modern industry is just six scams in a trench coat.
But on the other, you have doctor’s offices where the physician literally leases an MRI machine to the tune of several million dollars and then has to run a certain number of patients through the scanner every year or lose money. That’s because the MRI patent is held by GE and they can charge 10-100x markups on hardware that is fundamental to modern medicine.
Its the same with diabetes treatments. Insurance companies will try and refuse service or kick people off their policies if they are at risk. But then pharmacy companies will sell $3 of insulin for $75, then kickback a chunk of the balance to judicial/congressional bribes in order to guarantee the cash flow.
At some level, the only insurance companies that can survive in such a market are the ones that say “No!” to everything. The even-remotely-ethical firms just get fleeced by the for-profit industry until they get bought out or go bankrupt. That, or you’re Medicare/Medicaid and you have an infinite wallet backstopped by the US Treasury. You don’t care if you’re paying multiples of whatever any other clinic anywhere else in the world would charge on an enormous population of poor and elderly patients, because you have an unlimited money cannon to mow it all down with.
Very uninformed take, its almost laughable.
GE isn’t the only one who makes MRIs. The other big players are Siemens, Philips, United, and to some extent Canon, Fujifoto, and Hitachi.
No, that’s really how much it costs. The margin on MRI machines is terrible. I’d like to see you do it cheaper… “Just” build then supercool magnet for superconduction for 3T of homogenius magnetic field, build coils that handle KW of RF/gradients that can fit a human comfortably without artifacts, build the high power and precision circuitry to transmit and receive said RF, then control that equipment accurately and safely.
Super easy, off-the-shelf stuff.
Oh, and you can’t use any ferrous parts, nor can your power supplies generate any noise.
That’s like, senior design level stuff amirite
The other big factor in cost is supply chain. Everything has to be tracable. So the supply chains have to do a lot of paperwork, inspection audits, since a defective part can kill someone.
Shouldn’t that patent have expired by now?
This kind of thing is why it bothers me when people complain about “free market medicine”.
A market where only one entity is allowed to build MRI machines, or license the tech to others to build, is not a free market. That’s a government-enforced monopoly.
Even the fact that a patient can’t just go get their own MRI at Scans-R-Us, but needs to get a doctor’s referral first, is a huge departure from what an actually free market for medicine would look like.
It’s an evolving technology. We get new patents with every iteration.
If you spend a few years in Business School getting your MBA, you get an earful about how and why patent law exists. The core argument is that private investment is predicated on returns and we can’t have nice things unless we have men with guns come for the property and freedom of anyone who “steals an idea”.
But more practically, this shit is just a racket. Lots of lobbyist money changes hands to make sure the decks at the casino are properly stacked. Medical treatment is just another opportunity to apply leverage through debt to control other people.
I understand the value of a patent system, but patents should expire.
Is there some reason why previous-generation technology, like the tech being used for MRIs in the 90s, can’t be used to manufacture more competitively-priced machines?
Like, is there a law specifying that the new technology must be used for an MRI to be usable as a diagnostic tool?
They do. It’s just that they can be renewed under various circumstances, typically as an incentive to increase production.
You need a certain amount of industrial capital geared towards making these machines and GE is the only one that really does (excepting manufacturers overseas). A big part of the problem is that we don’t have a good mechanism for introducing new small businesses to the market. You really need to know someone that needs a steady number of MRI machines on a regular basis to make a new MRI factory worth it, and unless you have that business connection you have no buyers.
So you’d need to have a single integrated business, just to get all that information in-house.
The same company could build the machines, and sell the MRI scanning service.
Then you’d need a lot of conversations with various doctor’s offices.
But there are probably lots of places who’d rather be able to provide patients with a lower-cost, lower-quality MRI, so it should be possible to collect a number of providers saying “if such a service exists, I’ll use it”.
My guess is there’s gonna be a lot of government money available soon for people who want to build new manufacturing capability in the US
*cough* single payer fixes all this *cough*
Sorry, cough has been acting up. I should go see a doctor with a MRI about that…
I’d go one further and say a National Health System fixes all this. Rather than paying a guy to pay a guy, you just have publicly financed clinics and hospitals. This is the traditional way of building up medical infrastructure, btw. City hospitals used to be the norm. We only entered the era of corporate consolidation when we sold off our public infrastructure for a song during the neoliberal turn of the 70s and 80s.