Crist vetoes ultrasound before abortion bill

[kiryan]

http://www.justnews.com/politics/23872269/detail.html

You know I never thought about the fact that it costs money to get an ultrasound. All these years, I've been moderately supportive of anti-abortion measurses like this without really understanding that it amounts to an extra cost let alone an extra 750-1,500. I guess I just assumed because women coming in for abortions typically pay very very little that adding the ultrasound wouldn't cost them anymore... Boy was I being willfully blind.

I'd rather have no abortions, but I don't think raising the cost of one to a million dollars is a valid approach.

[Adriorn Darkcloak]

Good veto by Crist.

[teflor the ranger]

This is solid policy, however, vetoes don't last.

[kiryan]

I still think its wrong, and that women having abortion should really truly understand what they are doing in no uncertain terms including everythign the ultrasound does and shows, but not to the tune of an outrageously expensive ultrasound that someone is paying for.

[Corth]

Ultrasounds do not cost between $750 and $1,500. That is absurd and incorrect. The machine itself only costs a few thousand dollars - most obstetricians have one or more in their office. It takes just a few minutes and a nurse can operate it. Presumably if this became law you would have offices spring up that basically assembly line the ultrasound process - I'm guessing for less than $50.

That all being said, given Supreme Court jurisprudence since Roe v. Wade, I can't imagine such a law being deemed constitutional.

[kiryan]

I dunno corth, 30 bucks an hour + benefits for an ultrasound tech (I didn't know nurses could operate them). $40-50 an hour + benefits for someone to repair them (or a more expensive outside maintenance contract). The cheaper wands (part they rub on the belly) run $600+ and are easily broken, more advanced ones including 3d run several thousand. Maybe $50 to the insured, but someone is paying a lot more than that for each ultrasound. I think the last 3 routine ultrasounds Laurel had were well over $250 before insurance.

I'm pretty sure at least one other state has already passed the same type of restrictions with specific clauses to make it constitutional after being struck down before. Don't know if they have worked their way up through the courts yet... but they did find partial birth abortion ban to be constitutional didn't they? They found that reasonable restrictions could be placed on 2nd amendment rights... and you have a court regularly voting in a conservative manner. I dunno if I agree with you.

[teflor the ranger]

By solid policy, I meant the veto. Not the legislation.

[Corth]

I dunno corth, 30 bucks an hour + benefits for an ultrasound tech (I didn't know nurses could operate them). $40-50 an hour + benefits for someone to repair them (or a more expensive outside maintenance contract). The cheaper wands (part they rub on the belly) run $600+ and are easily broken, more advanced ones including 3d run several thousand. Maybe $50 to the insured, but someone is paying a lot more than that for each ultrasound. I think the last 3 routine ultrasounds Laurel had were well over $250 before insurance.

I'm pretty sure at least one other state has already passed the same type of restrictions with specific clauses to make it constitutional after being struck down before. Don't know if they have worked their way up through the courts yet... but they did find partial birth abortion ban to be constitutional didn't they? They found that reasonable restrictions could be placed on 2nd amendment rights... and you have a court regularly voting in a conservative manner. I dunno if I agree with you.

Let's assume a small office with three examination rooms. A waiting room, receptionist, and 3 ultrasound techs. And you, the boss, getting paid to make sure everyone and everything does what it's supposed to. Each tech works 8 hours a day, with a 1 hour break. For 7 other hours they are banging out ultrasounds at a rate of 5 per hour (total of 105 patients per day served). Your office is open 6 days a week (closed sunday), for a total of 312 open days per year

Rent for a small office would be approximately $3,000 per month. $36,000 per year.

Each ultrasound tech gets about $80,000 per year in salary and benefits. So $240,000 total per year.

Receptionist makes $30k per year in salary and benefits.

Assume that ultrasound Machines cost $10,000 each per year to maintain (absurdly high, but lets go with it). So a total of $30,000 per year to maintain the machines.

Lease payment on each machine is say.. $500 per month, so $18,000 total per year for all 3 machines.

Cleaning service is $1,000 per month - so $12,000 per year.

Liability insurance - not too sure on this one. You aren't purporting to provide any type of medical service per se - just showing the ultrasound picture and explaining a bit about it. But what if in the course of doing so, your tech misses something that could put the mother or fetus in danger, and fails to notice it or disclose it? I could imagine a lawsuit resulting.. so perhaps there could be some decent liability here. Let's go with $100,000 per year insurance.

Advertising of $100,000 per year.

By my count, that comes up to $566,000 per year in costs to run this office. Let's call it an even $650,000 when you take into account misc. stuff like office equipment, etc.

Now look at the revenue side of the equation:

Every day, each technician serves 35 customers (5 per hour over 7 hours) for a total of 105 patients per day in the office total. If you charge each patient $50, your revenue per day is $5,250.00 (105 x $50). Multiply that by 312 days that you are open, and your revenue is $1,638,000 per year.

You just made yourself close to a million dollar per year selling ultrasounds for $50 a pop in a small office. Now imagine doing it on a large scale. Even if my assumptions are off a bit.. and I am sure they are, we are talking about a very profitable venture even at that bargain basement price. $750 to $1,500 per ultrasound my ass. I have been to ultrasounds when my wife was pregnant and if it's just a matter of showing the baby (as opposed to getting specific pictures for medical purposes) it can be done in 5 minutes easily - though I allocate 12 minutes in this example for each ultrasound. It can probably be done even more efficiently if the tech simply takes pictures and hands them off to a lower paid employee who then goes through the script with the patient. Free up more time for the technician to do more ultrasounds.

[Ragorn]

In this thread, we are experts on the logistics of operating and maintaining expensive medical equipment.

[kiryan]

Its very possible you could make those kind of #s and make a small fortune. The current averages seem to be around $300 per ultrasound. Hardly, Christ's 750-1500 per, but a whole week's take home for someone making minimum wage... who you know wouldn't be paying it, tax payers would. To artificially raise the cost of an abortion by $300 for no safety or medical necessity reason seems wrong.

I mean if you just want to make abortions more expensive, read them a description make them fill out a push poll style questionaire against abortion and put a $300 tax on abortions. That's what we do with cigarettes right? Tax it then use those taxes to educate people?

http://www.newchoicehealth.com/Director ... Ultrasound

National Abdominal Ultrasound Procedure Pricing Summary
National Minimum Price $290 (Wapakoneta, OH)
National Average Price $390
National Maximum Price $1,700 (Bishop, CA)

Abdominal Ultrasound Cost Averages Around the Country
Phoenix, AZ Abdominal Ultrasound Cost Average $340
Washington, DC Abdominal Ultrasound Cost Average $370
Philadelphia, PA Abdominal Ultrasound Cost Average $410
Houston, TX Abdominal Ultrasound Cost Average $350
Miami, FL Abdominal Ultrasound Cost Average $370
Dallas, TX Abdominal Ultrasound Cost Average $340
Chicago, IL Abdominal Ultrasound Cost Average $390
Los Angeles, CA Abdominal Ultrasound Cost Average $410
New York, NY Abdominal Ultrasound Cost Average $420
Atlanta, GA Abdominal Ultrasound Cost Average $370

http://www.compareultrasoundcost.com/

Usually stand alone ultrasound facilities, which are not associated with hospitals, cost around $99 to $300. The same ultrasound performed at a hospital may run $200 to $1000

http://www.costhelper.com/cost/child/ultrasound.html

Typical costs:
An ultrasound performed by a licensed medical professional - either a physician or a registered medical diagnostic sonographer - usually costs around $200 according to Parenting Magazine. Medical insurance generally covers the cost of an ultrasound if it is deemed medically necessary.
If an expectant mother gets an ultrasound only to see the baby or to find out its sex, the insurance company may not pay for the procedure. The cost of an ultrasound varies by insurance plan.

[Corth]

Not trying to justify the policy. It's an absurd waste of time and money and likely would be deemed unconstitutional under the Supreme Court's Roe v. Wade line of jurisprudence. Just objecting to the report that it would cost $750 to $1,500 per ultrasound. The fact that they would even report it as such a wide range.. $750 to $1,500... implies that whoever came up with that figure was full of shit.

Ragorn points out that I lack expertise in determining the cost of running and maintaining those machines. I thought my assumptions were fair, but fine, double every single cost. The techs are making $160,000 per year. It costs $20,000 to maintain a basic ultrasound machine per year that probably costs less than $20,000 to buy brand new, etc. etc. You are still making half a million in profit at the end of the year after expenses while charging $50 a pop in a small office.

With regard to the 'national average prices', keep in mind that most ultrasounds have a medical purpose. I have gone to ultrasounds that take well over an hour because they are trying to get very specific pictures which must then be interpreted by a doctor. This particular policy, as I take it, would be to simply show a picture of the baby and explain the picture briefly. Again - less than 5 minutes to get a woman on the gurney, lube up her belly, clean her off, take a couple of pictures, and get her out. Another couple of minutes with a low paid employee reading a script in a separate room. Though I allocated 12 minutes in my example to be conservative - figuring the techs might want to send an email, make a personal call, grab a cup of coffee, etc, in addition to their 1 hour break per day.

[teflor the ranger]

These arguments are completely moot. The issue stopped at government violence forcing unnecessary medical procedures upon patients.

Edit: put back to original post.

[Corth]

Right Teflor. Not a single person in this thread disagrees with Crist's position. We can't discuss the cost of a medical procedure as well?

As for the medical malpractice costs.. I allocated $100,000 for insurance, but as I pointed out that was the one part that I was very unclear on. There is no doctor involved here, so technically it wouldn't be malpractice - as there is no purported medical services being provided, just a picture of the fetus and a script. But I figured that some sort of negligence argument could be made, hence the allocation of $100k. Even if you make it $300,000 and double all the other expenses I listed, which is absurd beyond belief, it's still a profitable enterprise.

Edit: the part about malpractice costs was in response to a part of teflor's post that he subsequently removed.

[teflor the ranger]

Then I would not hesitate to point out that your numbers are low. Especially for the rent, the malpractice, and the wages + benefits. Furthermore, you'll need additional staff to cover for vacations and sick leave. Medical records will require that you hire additional personnel, and since you're a one-service shop, you'll need to shuttle a lot of records back and forth with many other doctors and providers. Finally, the lease on ultrasound machines should be higher, but will include service.

You will also have to outsource for HIPPA compliance, unless you have no computers in your operation.

[Corth]

You are assuming this is a medical office... but the purpose here would be completely non-medical. No doctor would ever review the ultrasound. It would simply be a wasteful legislative attempt to get people to not abort by forcing them to see their baby. So I don't know if medical malpractice would even be necessary, but certainly $300k would cover it, as obstetricians in many parts of the country pay less than $100k per year. But let's call it 300k anyway.

Again, it's not a medical office - so not sure what obligations we would have to store the ultrasounds. If you must store them I don't see it being a very large administrative burden. One $30k per year employee should suffice. As for HIPPA compliance - I would assume the ultrasound pictures would be regulated by HIPPA, but if you aren't keep records.. just destroying them, then there is no issue. If you are keeping records then I agree there would be a cost here for HIPPA compliance, though really I have no idea what this entails.

You are right about vacations for the techs. As I mentioned before I doubled their salary to $160k per year and the operation was still quite profitable. Perhaps a better way of doing it is call it $100k per year in compensation (income and benefits) per tech, which I think is very reasonable, and hire 4 techs. It would be even CHEAPER than the $480k in total salary for techs that I listed.

I don't think $3,000 per month in rent is unreasonable for a small office with 3 examination rooms. Especially in Florida. But even in NY I can get such an office for that money.

My google search for ultrasound machines finds them brand new for around $6k. That renders my lease payment of $500 per month and mainteance expenses of $20k per year for each machine kind of silly. Would be cheaper to just buy a brand new machine every 3 months. So yeah, I was obviously overestimating the cost of machines in my example - and can squeeze out a lot more profit here because the machine costs will probably be less than a quarter of what I estimated.

So lets sum up. After doubling all expenses in the previous version and increasing malpractice costs to $300k per year, I was still making $200k per year. Now I have added two 30k per year employees, dropped tech compensation from $480k to $400k (with a 4th full time tech), I was estimating $26k per year in lease and maintenance costs per machine, and I'm going to drop that to $13k after researching machine costs for a savings of $39k per year. This puts me now at $259k in profit per year with what I believe to be extremely conservative estimates of operating costs.

[teflor the ranger]

So, a legal compliance office with machines and technicians?

Damn Corth, I can't believe you would even want to think about it. By the way, ultrasound machines for prenatal use start at $15k and work their way up to $150k. But for the simple legal compliance, I guess you could pick up refurbished used equipment around $5k and just replace it every 6 months.

[Corth]

Not sure what the compliance issues are. My father has run a medical office for years. Just one doctor (himself) and a receptionist. Somehow HIPPA compliance hasn't put him out of business, and it is a very modest operation. I don't see how it could be very costly for another small operation where there aren't even necessarily medical records being retained.

[Corth]

Would be interested to see what some of the doctors who occasionally post here think. I am guessing that I am missing some expenses entirely. The estimates for the expenses I did list were extremely conservative despite Teflor trying to poke holes in them. But I might be missing one or two large things. As for the 150k ultrasound machine - We aren't doing 3d sonograms Teflor. Just a very very basic picture on a low budget machine. Keep in mind also how many more hundreds of thousands of dollars you make per year if you raise it from $50 to $60. Presumably you will be competing with other offices just like this one - and ultimately if running an efficient operation requires $60 or even $70 per patient to maintain sufficient profitability, nobody is going to undercut you on cost - and the per patient cost will still be significantly less than the $750 to $1,500 mentioned in that article.

[teflor the ranger]

Not sure what the compliance issues are. My father has run a medical office for years. Just one doctor (himself) and a receptionist. Somehow HIPPA compliance hasn't put him out of business, and it is a very modest operation. I don't see how it could be very costly for another small operation where there aren't even necessarily medical records being retained.

By 'legal compliance office' I meant your little ultrasound operation.

[teflor the ranger]

Would be interested to see what some of the doctors who occasionally post here think. I am guessing that I am missing some expenses entirely. The estimates for the expenses I did list were extremely conservative despite Teflor trying to poke holes in them. But I might be missing one or two large things. As for the 150k ultrasound machine - We aren't doing 3d sonograms Teflor. Just a very very basic picture on a low budget machine. Keep in mind also how many more hundreds of thousands of dollars you make per year if you raise it from $50 to $60. Presumably you will be competing with other offices just like this one - and ultimately if running an efficient operation requires $60 or even $70 per patient to maintain sufficient profitability, nobody is going to undercut you on cost - and the per patient cost will still be significantly less than the $750 to $1,500 mentioned in that article.

Like I said, Corth, "I guess you could pick up refurbished used equipment around $5k and just replace it every 6 months."

[Corth]

Not sure what the compliance issues are. My father has run a medical office for years. Just one doctor (himself) and a receptionist. Somehow HIPPA compliance hasn't put him out of business, and it is a very modest operation. I don't see how it could be very costly for another small operation where there aren't even necessarily medical records being retained.

By 'legal compliance office' I meant your little ultrasound operation.

Gotcha. I misunderstood what you are referring to, but yeah, essentially it would be a legal compliance office. Kind of like the mandatory credit counseling that people need to participate in under the recent bankruptcy provisions as a prerequisite towards having their debts discharged. It started a whole cottage industry of credit counseling services (see abacuscc.org for an example). These types of mandated compliance operations are a gift from the government to entrepreneurs. The underlying legislation creates overnight demand, and there is a lot of money to be made (especially in the beginning) for a smart person who can move quickly.

[teflor the ranger]

Corth Co., Grainy Pre-Abortion Ultrasounds we describe to you using crappy equipment while drowning ourselves out in loud music for your legal compliance!

Only 99.95.

[Sarvis]

Corth Co., Grainy Pre-Abortion Ultrasounds we describe to you using crappy equipment while drowning ourselves out in loud music for your legal compliance!

Only 99.95.

Hey, Free Market right?

Why wouldn't the abortion clinics just offer the ultrasounds for free* with the purchase of an abortion.



*of course it's added into the price somewhere hidden

[teflor the ranger]

Corth Co., Grainy Pre-Abortion Ultrasounds we describe to you using crappy equipment while drowning ourselves out in loud music for your legal compliance!

Only 99.95.

Hey, Free Market right?

Why wouldn't the abortion clinics just offer the ultrasounds for free* with the purchase of an abortion.



*of course it's added into the price somewhere hidden

Because intelligent legislators will eventually require an ultrasound to be performed off the premises of an abortion clinic.

Besides, Corth Co. can be the outsource provider! (at a contract rate of $84.95)

[Corth]

Sarvis,

Teflor is right on this one. If they are going to go to the trouble of making women get an ultrasound before the abortion, they certainly will also add in some sort of 'cooling off period' during which the results of the sonogram will hit home and presumably the woman will think twice about having that abortion. Otherwise why have this requirement in the first place?

[Sarvis]

How does that affect anything I said?

Teflor's Scenario: Here, you can go to this guy and get the Ultrasound done at a discount because we're certified partners. (Just like whenever my doctor wants blood work, I go to the guys he uses for that.)

Corth's Scenario: Ok, Ultrasound finished. Come back in a week and we'll perform the abortion and the Ultrasound is free, or if you decide against we'll send you a bill for the Ultrasound.

Just saying that this seems like kind of a useless law.

[Corth]

Wouldn't say useless law. It accomplishes it's purpose. Just bad policy.

Also I would imagine they wouldn't allow abortion providers to also be the ultrasound provider since obviously the intent of the law is to limit abortions. That's like putting the fox in charge of the hen house, so to speak, from the perspective of the pro-life legislators.

[Sarvis]

Wouldn't say useless law. It accomplishes it's purpose. Just bad policy.

Also I would imagine they wouldn't allow abortion providers to also be the ultrasound provider since obviously the intent of the law is to limit abortions. That's like putting the fox in charge of the hen house, so to speak, from the perspective of the pro-life legislators.

What, you suddenly think legislators can do something competently? :P

[teflor the ranger]

It's bad governance: intrusive tyrannical government meddling with the personal affairs and behaviors of the people. More specifically, a large minority of people think abortion is murder and inherently wrong. Because they can't get the consensus to outright call abortion murder, they're taking every step they can in order to make abortions harder to get.

In this case, they are making abortions harder to obtain by increasing the cost to the patient by mandating a medically unnecessary test. This is definitely a component of their reasoning. Additionally, they think it will make the choice to abort a developing fetus harder for the patient by appealing to the instincts of the mother by showing them the little human growing inside of them.

What makes this particular piece of legislation bad by conservative standards is that it allows government to intrude upon what should be a private medical procedure and the private lives of citizens by forcing them to subject themselves to something that is medically unnecessary and financially burdensome in such a manner that creates no value for the public and does not affect other citizens outside of the family.

While the law may help to protect the fetus, it is not a strong enough protection to warrant this particular interference of government (there is little guarantee that the fetus will be protected).

[Corth]

Wouldn't say useless law. It accomplishes it's purpose. Just bad policy.

Also I would imagine they wouldn't allow abortion providers to also be the ultrasound provider since obviously the intent of the law is to limit abortions. That's like putting the fox in charge of the hen house, so to speak, from the perspective of the pro-life legislators.

What, you suddenly think legislators can do something competently? :P

The problem with government usually isn't getting what it wants. Rather, the problem is usually what it wants.

[Corth]

a large minority of people think abortion is murder and inherently wrong. Because they can't get the consensus to outright call abortion murder, they're taking every step they can in order to make abortions harder to get.

At least they are using the legislative process - trying to influence elected officials who have to answer to their constituents. It's a bad idea (and happily was vetoed) but it's not It's not quite as bad as Roe v. Wade which got implemented by an unelected Supreme Court that can find anything it wants in the constitution in order to promote it's agenda. I'm millitantly pro-choice and I will tell anyone who asks that Roe v. Wade is horrible law.

[teflor the ranger]

a large minority of people think abortion is murder and inherently wrong. Because they can't get the consensus to outright call abortion murder, they're taking every step they can in order to make abortions harder to get.

At least they are using the legislative process - trying to influence elected officials who have to answer to their constituents. It's a bad idea (and happily was vetoed) but it's not It's not quite as bad as Roe v. Wade which got implemented by an unelected Supreme Court that can find anything it wants in the constitution in order to promote it's agenda. I'm millitantly pro-choice and I will tell anyone who asks that Roe v. Wade is horrible law.

I wasn't criticizing them in this sentance, merely stating what I thought was going on.