The cost of emergency rooms and MRI machines

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Good afternoon everyone,

At a panel discussion nearlythree decades ago the president of Blue Cross Blue Shield of Delaware bemoaned the fact that Delaware had as many MRI machines as Ontario, a Canadian province with 14 times the population of Delaware.

Canadians, despite having fewer MRI machines per capita than their U.S. counterparts, live three to five years longer on average, despite sometimes long waits for MRI procedures.

Thirty years ago, health care costs and runaway technology had already becomea problem. Even then, U.S. health care costs were adding to the price of U.S.-built vehicles, sending jobs north and south of the border.

Over the last month or so we watched a battle involving two health care systems flexing their muscles in Sussex County.

Both Bayhealth – which now has a quarter of a billion-dollar health care campus in Milford and Beebe Health Care, a coastal Sussex system that is moving inland with an expansion program of its own – wanted to build an emergency center

State health regulators, in a ruling that will upset free-market health care advocates, rejected the center.

It is true that emergency rooms are the most expensive point of entry into the health care system and many people who could be treated with urgent care will instead head to more expensive options.

And as we have found out with MRI machines, simply adding capacity does not trigger typical free-market forces.

Instead, our convolutedsystem of Medicare, Medicaid, and private insurance drives up the number ofdoctors ordering MRI tests, sometimes under pressure from “frequent flyer” patients. Costs, for the most part, fail to fall, even as options proliferate.

The reasons for lower life expectancies and high health care costs in Delaware – obesity, air pollution, smoking, drug addiction, suburban sprawl that keeps us in our vehicles, etc. – are not addressed with more emergency rooms or MRI machines.

The health care panel made the right decision on an emergency center, although having rival proposals on the table made the political price less costly. A stronger economy also helped.

Bayhealth is likelyto move forward outside the emergency center business and provide competition for Beebe on its home turf

Not that long ago, tough tactics by the administration of Gov. Jack Markell overturned a decision to reject a rehabilitation center in Middletown. The proposal came as the Delaware economy was struggling to pull out of a deep recession.

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