One of the students from our class this fall, Elad Sharon, writes from his journey on a public health school trip to India:
I have been impressed by the number of MRI's here. I suspect that there are more MRI's in the Indian state of Kerala than in Canada (similar populations, but vastly different incomes, of course). It seems that the Indian health system is also enamored of technology, and cost-cutting strategies focus on reducing unnecessary tests and unnecessary care. Insurance schemes are rudimentary at best, and generally organized by government unions or even, in one case, a cancer hospital. Definitely, eye-opening. Labor costs are ridiculously cheap, but the needs are immense. Non-Resident Indians (NRI's) distort the market generally, and may actually inadvertently fund the technology development.
Many countries have far more MRI scanners than the United States on a population basis. For instance, Japan has 40 MRIs per million population, and the US has 26.5. (Canada has only 6.2). The difference is that MRIs in India (not part of the OECD study) cost 5000-7000 rupees ($102-$140), whereas MRIs cost Massachusetts health plans a median of $700 , and the “list price” is probably twice that.
Some Indian provinces have high supply of MRIs, but their cost per unit is quite low. The US has a trifecta - the combination of high supply, high utilization, and high prices.
