The Costs vs. Charges of Health Care, Part 3

The basic myth of modern American health care is that it’s costly. Expensive. We’re routinely reminded of this almost every day, when we’re told by the media about the “rising costs of health care.”

But how much does a mammogram really cost, anyway? An MRI of the neck? An ankle x-ray?

Not much, or not as much as you’d think. But the cost isn’t what we’re presented with when we’re asked to pay for health care services. No no, we’re given a charge. Which is vastly different from the cost.

To illustrate what I mean, check out this list of charges for diagnostic services at the Dartmouth-Hitchcock regional hospital system in the Northeast.

Take a close look at the list. In every case, the facility fee is much more than the actual professional charge, which is what the doctor gets paid. And while I understand that the equipment is expensive to buy and operate, how much does an MRI truly cost?

Perhaps a better question would be, what’s the best way to determine a fair price for these types of healthcare services? I would say, the good old-fashioned American way. By being a smart shopper and looking for the best deal.

Here’s a comparison of the hospital charges to what patients at my clinic pay:

  • For a Mammogram, the hospital charges $592; my patients pay $99
  • For an MRI of the Cervical Spine, the hospital charges $3962; my patients pay $400
  • For an Ankle X-Ray, the hospital charges $464; my patients pay $50
  • For an ECHO Cardiogram, the hospital charges $3902; my patients pay $99

I also offer my patients a combination of four blood tests that I call a Health eCheck, for $65. Here are the charges for each of these four blood tests from the Dartmouth list:

  • Complete Blood Count – $62
  • Complete Metabolic Panel – $198
  • Lipid Profile – $112
  • Thyroid Stimulating Hormone – $143

TOTAL  = $515

How can I offer a $515 series of tests for $65? Again, a better question would be “how can they CHARGE $515 for something that only costs $65 with Dr. W?”

Well remember:

It’s not the COSTS of health care that are outrageous…it’s the CHARGES.

Sorry for the redundancy, but it’s important to understand that what we’ve been told for years about “the rising costs of healthcare” is a myth. And with the coming changes to your health insurance, it’s time to rethink how you will pay for your health care. Start by asking, how much should health care cost, anyway, and where can I go to find the best deal?

Remember, from Economics 101: CHARGES = COST + MARKUP

You don’t have to pay the outrageous markup. Take a stand.

Physician. Health Insurance Agent. Author. Health care humorist. Medical satirist. Disruptor. At your service. My name is Kevin Wacasey, and I’ve been practicing medicine since 1994. When I graduated from medical school, I took an oath to do no harm to my patients. To me, that includes financial harm. But since health insurance took over health care over 40 years ago, health care prices have skyrocketed. And despite what we’re told by the media every day, it isn’t the costs of health care that are outrageous; it’s the charges. So if you’ve ever wondered why we spend so much on health insurance and health care, then come along and join me as I explore the crazy world of Healthcareonomics. Health care doesn’t have to be expensive. Let me show you how. For speaking opportunities and to pass along your questions/comments, please email me at

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