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Comment by adewinter | Hacker News Reader

It's weird that CT scans cost hundreds (thousands?) of dollars when used in medicine but at the airport everyone's baggage is routinely scanned for approx. $free.

Is the hardware and software needed for CT scans really that expensive or not?

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People are saying it’s not the same but counterpoint: An MRI scan in a state of the art facility in Chennai India in at least 50 different facilities costs 2000-4000 Rupees or $26. The machines cost the same if not more here due to import duties. Labor is cheap but these labs truly compete with each other and that’s what drives the price down. So please acknowledge that the healthcare system in the US and other places is broken.

> US and other places

Is there really another "first-world" country on earth with healthcare broken like it is in the US?

Here in Switzerland healthcare is pretty much broken when it comes to prices. Everything is pretty expensive. But is it broken like in the US? No way! Our healthcare works very well and its prices are okay ;-)

I think it could be much cheaper in CH if we had public insurers instead of private for profit ones.

A pure CT Scan in Germany (paid for by public health insurance unless you do one for fun), without anything else (consultation, contrast materials, etc.) is billed 110-170 € (USD 120-190). Considering labor is more expensive here, that sounds comparable.

For contrast (pun!), Switzerland just across the border charges 6–7 times as much for the same thing. And medication too, it costs multiples more for the same medicine in CH than anywhere else in Europe just because.

You also earn closer to US salaries. A friend of mine moved to Switzerland, and he jokes that Swiss cleaners at the border hire German cleaners for their places ;)

> You also earn closer to US salaries.

Indeed. It doesn't mean either the US or the Swiss aren't getting gouged when it comes to health prices (and prices in general in CH).

But yes, AFAIK, there is no minimum wage in CH but the defacto minimum wage hovers around 50--60k CHF a year and 20 or 25 days PTO. On the other hand, health insurance alone with a 2500 CHF deductible and 10% copay afterwards costs 300--400 CHF a month no problem.

"You also earn closer to US salaries."

You say this like it is a good thing. Do folks at the bottom third have to endure the same sort of poverty, earning wages their parents earned yet paying more for everything?

Oh, I'm guessing you just mean folks that are in certain fields, and that really isn't representative of US wages. Normal folks are pretty poor.

> You say this like it is a good thing.

No, I did not. It was pretty value neutral.

> Oh, I'm guessing you just mean folks that are in certain fields

I guess it was a bit roundabout. The USA being the USA, people are often severely underpaid, which does not seem to be the case in Switzerland. But considering where we are, I mean tech salaries, which are pretty high.

But what is the 'real cost'? Is it that much higher in Germany than the USA? What does the CT tech make, how much was the machine to buy, how expensive is the rent where the machine is installed, what are electricity costs...

I’m confused, US costs are far higher, so I don’t think I understand what you are asking.

Airport baggage scanners are nowhere near the complexity of CT machines. Not even the same kind of device. They also don't have to be designed and certified for human subjects.

> The CT scanner can create 3-D images of the contents of a bag, allowing TSA officers to rotate the images to better analyze the contents. In the future, the CT scanner may allow passengers to leave laptops and liquids inside of their carry-on bags, TSA officials say.

https://www.courant.com/la-fi-ct-scanners-20180730-story.htm...

Airport scanners are not CT. They will only give you one projection. I would also be willing to bet these CT machines can only scan a very small volume. Typically, they will rotate the sample, not the X-ray source and detector. I’d imagine some of the cost comes from being able to move the source and detector while keeping everything in alignment. (Disclaimer: My experience is secondhand with scanning metals)

The passenger checkpoint devices are projection imaging, but they do use CT (with rotating source/detector, just like a medical CT) for checked bags. https://www.envimet.com/en/product/examiner-xlb/

Newer ones are actually moving to CT. If you go through one of those security checkpoints, you don't need to take anything out of your bag. They were being used at some terminals at Heathrow - but confusingly not all. I think T2 has them, or at least were trialing them when I flew in September 2020. T5 definitely didn't in January.

Nitpicking detail; the standard belt-scanners don't give you 'one' projection, but have (most probably) a linear detector with a (nearly linear) x-ray source pointed at, so they give you a slit-scan image, which is not one projection, but a veeeeery long image :)

I think it's several reasons. One more complicated machine. Two higher paid professionals. And finally healthcare is a racket in the US (cost to value wise).

I had a scan done a few months ago and marveled a bit at the machine. It was 20 years old but the room it was in was probably very expensive to build. There was a considerable amount of electrical power going to the room. And you can't just let a newbie run the machine. The liability alone of having a patient with a metal sliver in their eye or piercing still installed must be insane.

A private full body cancer search MRT (the most expensive diagnostic I could find) costs 1340€ in Germany, many common use cases much less (340 for a joint).

Naturally it‘s free if a doctor decides you need one.

Of the two applications you describe, one is a super serious life or death situation where a single mistake could harm human life.

The other is an institutional monopoly that, while initially set up with lofty goals to save lives, has devolved into a suppressive tool that works against the common man.

No, it is the wetware.

The air port has an x-ray machine, not a CT scanner. The CT has a ring the spins around the object making a 3d image - they don't have that at the airport.

X-rays are quite cheap in the medical world (reading them is where the cost is, not taking the x-ray).

I suppose a CT is what I saw at the airport earlier this year then - maybe Houston? The technicians clearly had a 3d model and were manipulating it to view it from all angles.

There are CT machines at airports: https://petapixel.com/2019/10/21/beware-new-3d-airport-scann...

Technically, one can also get a (simple) 3D model of something with 'linear tomography', e.g. when the 'sample' is moved under the x-ray source, which happens in classic baggage scanners.

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