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Comment by mixdup | Hacker News Reader

It's not even about inventory of individual items (like blood or enough scalpels) it's that they need to have every expensive machine. They need x-ray machines and MRI machines and proton beam cancer treatment and that stuff adds up very quickly. That's why a trip to the ER for stitches can cost five figures in the US, because a large amount of that bill is covering the hospital's cost to be ready not just for the stitches but also car crashes or mass shooting events or whatever

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Then why does the expensive treatment cost 7 figures? Estimating hospital costs is hard, but a quick glance at many buildings/offices would tell you that they are by no means struggling.

We overpay for healthcare because we must pay, and it has institutional and natural bottlenecks which restrict availability and choice.

Because they are going to allocate as much as they can to that service that is actually using those advanced facilities. The stiches patient in the ER is carrying some load for the cardiac surgery suite just not as much as the person who actually has quadruple bypass. Plus that is just part of it. They're also covering uncompensated costs across the whole system

Even if you only have stitches you want the ER to have those machines just in case the doctor looks at your injury and says "wait, this isn't the standard routine thing everybody has we need to get you into the expensive machines". Probably this will never happen - the doctor will always look and see the standard routine things that everybody has and you don't need the rest.

This is why urgent care exists and is why if you don't have something that you think is life threatening, that's almost always better. If you need more than they can provide, they can and very much will forward you on to an ER

If you need stitches then the ER is the correct place to be.

Most of the minor lacerations which require stitches to heal cleanly can be handled perfectly well in urgent care. There's usually no need for ER level care.

Elective surgeries have fallen in price because many no longer occur in hospitals. In the USA, ERs have to treat everyone regardless of their ability to pay. That's why you see a lot of urgent care.

We've socialized healthcare, just in the worst possible (but politically easiest) way.

The machines cost the same in Poland and yet the personnel costs are still over 80% of the expenses.

X-ray machines aren't all that expensive.

MRI machines generally run close to capacity because of how expensive they are. There is very little slack.

Cancer treatment already costs a fortune.

there's more expensive equipment than just an x-ray machine and MRI machines, those were just examples. The building itself is expensive. Having the labor there ready to respond and service patients is expensive. Overall there is a ton of overhead with very expensive inputs that even if you come in and end up just getting a tylenol, you're going to pay for part of it

A quick Google search shows me that I could afford to buy a used lower-end MRI machine... (not that I would) They don't seem that expensive (though there's a factor of 10 difference between the cheapest lower-resolution used machines and the high end)

The ease of availability of same-day MRI services in London suggests to me there's quite a bit of slack here at least.

EDIT: Though one solution to preparedness for temporary capacity issues without as much over-provisioning everywhere: Mobile suites. My local hospital currently has a mobile MRI suite parked outside to clear their backlog.

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