Photo: Mel B. Articles on the health-care industry are a fertile source of large numbers and, sometimes, large errors. In the article “Study of Breast Biopsies Finds Surgery Used Too Extensively,” (New York Times, Feb. 18), it is estimated that nationally 300,000 women a year may be getting unnecessary surgery at a cost of “hundreds of millions of dollars.” I was happy to believe the figure of 300,000 women a year. However, the cost set off my number-sense alarm.
My first mental step was to convert that cost, which is far beyond human experience (at least, far beyond mine), into one that I could judge. A per-person cost is likely to be human-sized. Thus, let’s divide:
“hundreds of millions of dollars” / 300,000 surgical biopsies
To make the mental arithmetic easy, I translate “hundreds” to 300. Then the extra cost is $1,000 per surgical biopsy.
But that figure seems ridiculously low! Once I had to get an ultrasound at a leading Boston hospital. Cost: $1,000. Doing a surgical procedure must cost a lot more than a simple ultrasound, especially in 2011 (my ultrasound was in 2005).
Later in the article, the surgical cost is given: “Hospitals charge $5,000 to $6,000 for a needle biopsy, and double that for an open?[surgical] biopsy…” The doctor’s fees add roughly another $1,000 to the cost of a needle biopsy, and $2,000 to the cost of a surgical biopsy. So, the extra cost of a surgical biopsy is, say: $5,500 (extra hospital cost) + $1,000 (physician cost) = $6,500.
That’s a factor of 6.5 larger than $1,000 per surgery. So the more likely extra cost is $300 million times 6.5 or $2 billion!
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Even if others don’t get it, at least people who work with numbers should know that $6,500 is not 6.5 times larger than $1000; it’s 6.5 times as large (or 5.5 times larger).
It may be worth checking what the doctors and hospitals actually get *paid* – insurance companies routinely “adjust” the prices on the bills they receive. (My father is a physician, and he’s dealt with this for years. Also, my husband and I currently have an HSA, so we sometimes see such medical bills post-adjustment. A reduction of 60-70% seems to be common.)
Just where is all this Extra money they take going, and is that why the prices keep going up to a emergency visit at the Hospital’s, and how are these errors being justified? Why is there so many staff members sitting at the desks and why is it they get every procedure on you they can possibly come up with done before they release you? I know their insurance premiums are high but this is ridiculous! They are like a Butcher with a heavy finger on the scales trying to squeeze everything they can get from you. Is this to counter the 30,000,000 or more illegals they have to subsidize?
Out of curiosity I went and researched what the British NHS would charge you for those procedures, if you were in a situation that you were charged (NHS treatment is normally free at the point of delivery for British nationals).
Fine Needle Biopsy of Breast ?244 (i.e. 244 GBP)
I couldn’t find a tariff price for a surgical biopsy.
Ultrasound depends on type (and you didn’t specify) and will cost you ?32.41, ?73.82 or ?146.29 (the latter is for Doppler).
Now you need to calculate the cost per person-hour for the techs, nurses and physicians.
And what about the fear and anxiety costs?
a few billions here and a few billions there…adds up fast
By “hundreds of millions,” they must have meant “twenty hundred million.”