What is dollars for doctors

Medical treatment costs in the U.S.A. and Germany

The German doctor Dr. Peter Niemann was amazed when he learned that a small medical intervention in the USA costs up to 2,000 US dollars.

Germany not only has one of the most highly developed health systems in the world, it is also comparatively cheap. This can be seen on the basis of an experience report by the German doctor Dr. Peter Niemann understand very well. Dr. Niemann works in the USA and blogs regularly for the Deutsches Ärzteblatt, the specialist journal with the highest circulation for doctors in Germany. In a blog post he describes how accounting is done in the USA. Here there is the so-called "relative value unit", which determines the costs for medical services. A Relative Value Unit (RVU) is then multiplied by a specific dollar value to determine the minimum cost of a medical procedure. This dollar value is determined by the state-operated Medicare and Medicaid health insurance programs. In 2017 it was $ 36.

Treatment costs for a minor procedure in the U.S.A.

If a patient suffers from shortness of breath, the doctor can help with a simple and quick method that has been around since the Middle Ages. In the so-called pleural puncture, after a local anesthetic, a needle is inserted into the space between the pleura and the pleura to remove the fluid there. This procedure can be carried out on an outpatient basis, Dr. Peter Niemann takes 20 minutes for this.

A pleural puncture is assessed in the U.S.A. with an RVU value of 2.27. If you multiply the RVU factor by the value of 36 dollars, the cost is 82 dollars. But that's just the reward for the treatment. In fact, the practice or clinic will propose charges for materials, labs, medication, and so on, resulting in a cost of $ 400. And even here it is a minimum amount. In personal discussions, Dr. Niemann learn that his patients pay over $ 1,000, and sometimes over $ 2,000, for this simple procedure.

Pleural puncture in Germany

If you were to have a pleural puncture performed as a foreign patient, the German doctor would have to bill the service according to the fee schedule for doctors (GOÄ). The fee schedule is a constitutionally binding catalog of costs that all doctors in Germany must adhere to. Private patients are also billed via the GOÄ in Germany.

If you look up in the fee schedule what the outpatient puncture of the pleural space costs, the price is between 14.57 euros and 33.51 euros, depending on the effort. This procedure is twice as expensive in the U.S.A. if you only follow the fee schedule. But Dr. Niemann wrote about further costs. How does it look in Germany?

In fact, further fees are charged by the practice doctor in Germany as well. Let's stay with the example of the patient with the pleural puncture. The doctor can claim a maximum of EUR 3.15 for appointments by telephone. An on-site examination will add a maximum of 21.46 euros. If the doctor advises the patient in detail again in the practice, he can charge an additional 20.10 euros. The patient also has to pay the material costs. For the pleural puncture, the doctor usually uses a pleural puncture set, which costs 13.77 euros each. In addition, other materials, such as a sterile punched cloth, compresses, plasters, blood culture bottles, etc. needed. We want to charge a flat rate of 20 euros for these additional materials.

In total, a pleural puncture in Germany costs a maximum of 112 euros. In the US, on the other hand, a patient pays $ 1,000 to $ 2,000 for the same medical treatment, medical expertise, and infrastructure.