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willcipriano01/22/20252 repliesview on HN

Its likely true that more procedures are performed and more prescriptions written, but why are those procedures and prescriptions many times more expensive?

Economies of scale should make them cheaper. An MRI machine and technician that sits there unused half the day has to charge more per visit than one used all day long. Have too many customers? Get more machines and techs, now the MRI manufacturer is making more units, offering volume discounts...

Rationing of care doesn't explain why the individual units of care are themselves much more expensive. Compare inhaler prices in Canada vs the US, $10 in Canada $100 here[0], that isn't because too many of them are given out. It's theft.

Addendum: Further, the young and healthy ration their care quite a bit under the current system, they are taxed too heavily (to pay for the care of the elderly) to afford it for themselves so they go without.

[0]https://www.usnews.com/news/healthiest-communities/articles/...


Replies

s1artibartfast01/22/2025

Why charge $138 when your customers will pay $1,145 and keep coming back?

you need someone willing shop and pick the cheaper options for competition to bring down prices. You also need someone willing to say "that's too expensive, I wont buy it" and walk away. Same is true for the inhalers. If someone will pay $100 before switching to the generic, that is what they get charged. In Canada, the state is only willing to pay $10, so that is the price. This is the demand side of the problem.

There is also a supply problem, where the state provides medical company monopolies through "certification of need". It is basically illegal to open an MRI clinic that would compete with an existing one in many jurisdictions.

https://radiologybusiness.com/topics/medical-imaging/magneti...

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whimsicalism01/23/2025

it is generally not true that more demand causes things to be cheaper, economies of scale generally doesn't function for a whole industry but rather an individual firm