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1
International Federation of
Health Plans
2009 Comparative Price Report
Medical and Hospital Fees by Country
2
The International Federation of Health Plans was founded in 1968 by a group of health plan industry leaders from a dozen countries. It is now the leading global network of the industry, with one hundred member companies in 31 countries.
Federation member plans meet regularly to share information about health care financing and health care delivery in their home countries.
The attached comparative health care provider report was developed for the Federation council meeting, September 2-4 2009, in Preignac, France, as part of a discussion of total health care cost differences between major countries.
COMPARATIVE COST REPORT
3
FOR ILLUSTRATIVE PURPOSES ONLY
4
FOR ILLUSTRATIVE PURPOSES ONLY
5
FOR ILLUSTRATIVE PURPOSES ONLY
CT Scan: Abdomen (US$)Scans and Imaging Fees:
$400$179$161$258$319$248
$83
$750 $530
$1,600
$-$200$400$600$800
$1,000$1,200$1,400$1,600$1,800
Canad
a
France
German
yNeth
erlan
ds
Spain UK
USAUSA M
edica
re
USA Fee Range
Note: Canadian scan prices include the government “reading” fee and the charges used by private scanning facilities for patients who pay their own
USA Average USA High-end
6
Scans and Imaging Fees:FOR ILLUSTRATIVE PURPOSES ONLY
CT Scan: Head (US$)
$179$161$258$319
$212
$41
$300$530
$950
$1,800
$-$200$400$600$800
$1,000$1,200$1,400$1,600$1,800$2,000
Canad
a
Fran
ce
German
yNeth
erlan
ds
Spain UK
USAUSA M
edica
re
USA Fee Range
Note: Canadian scan prices include the government “reading” fee and the charges used by private scanning facilities for patients who pay their own
USA Average USA High-end
7
Scans and Imaging Fees:
FOR ILLUSTRATIVE PURPOSES ONLY
CT Scans: Pelvis (US$)
$300$179$161
$258$319$248$83
$950
$530
$1,700
$-$200$400$600$800
$1,000$1,200$1,400$1,600$1,800$2,000
Canad
a
Franc
e
German
yNeth
erlan
ds
Spain UK
USAUSA M
edica
re
USA Fee Range
Note: Canadian scan prices include the government “reading” fee and the charges used by private scanning facilities for patients who pay their own
USA Average USA High-end
8
Scans and Imaging Fees:
FOR ILLUSTRATIVE PURPOSES ONLY
MRI Scan (US$)
$824
$436
$839
$567
$235 $179
$500
$1,200
$1,500
$-$200$400$600$800
$1,000$1,200$1,400$1,600$1,800
Canada France Germany Netherlands Spain UK USA USAMedicare
USA Fee Range
Note: There are no Canadian government fees associated with MRIs because this equipment is typically purchased by local health authorities and is included with fees for facility-level use.
USA Average USA High-end
9
Well-Baby Office Visit (US$)
FOR ILLUSTRATIVE PURPOSES ONLY
Physician Fees:
$30$38
$15$22
$88
$148
$-
$20
$40
$60
$80
$100
$120
$140
$160
Canada France Germany Spain USA
USA Fee Range
USA Low-end USA High-end
$30 $38
$15$22
$88
$148
$-
$20
$40
$60
$80
$100
$120
$140
$160
Canada France Germany Spain USA
USA Fee Range
10
FOR ILLUSTRATIVE PURPOSES ONLY
Routine Office Visit (US$)
Physician Fees:
$30 $31$22
$32
$15
$72$59
$151
$-
$20
$40
$60
$80
$100
$120
$140
$160
Canada France Germany Netherlands Spain USA USA Medicare
USA Fee Range
USA Low-end USA High-end
11
FOR ILLUSTRATIVE PURPOSES ONLY
Normal Delivery (US$)Physician Fees:
$498$1,023
$622$1,041
$1,601
$2,384
$4,847
$-
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
Canada France Netherlands Spain USA USA Medicare
USA Fee Range
USA Low-end USA High-end
12
FOR ILLUSTRATIVE PURPOSES ONLY
C-Section (US$)
Physician Fees:
US Fee Range
$2,618
$1,812
$6,094
$915 $1,478
$1,051 $1,139
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
Canada France Netherlands Spain USA USA Medicare
USA Fee Range
USA Low-end USA High-end
13
FOR ILLUSTRATIVE PURPOSES ONLY
Appendectomy (US$)Physician Fees:
$600$313
$114$376
$494$285
$629
$1,803
$-$200$400$600$800
$1,000$1,200$1,400$1,600$1,800$2,000
Canada France Germany Netherlands Spain USA USAMedicare
USA Fee Range
USA Low-end USA High-end
14
FOR ILLUSTRATIVE PURPOSES ONLY
Cataract Surgery (US$)
Physician Fees:
$600
$392$573
$302$496
$653 $530
$1,731
$-
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
$1,800
$2,000
Canada France Germany Netherlands Spain USA USA Medicare
USA Fee Range
USA Low-end USA High-end
15
FOR ILLUSTRATIVE PURPOSES ONLY
Hip Replacement (US$)
Physician Fees:
$727$126
$587
$1,554 $1,400$1,269
$3,935
$-$500
$1,000$1,500$2,000$2,500$3,000$3,500$4,000$4,500
Canada France Germany Spain USA USAMedicare
USA Fee Range
USA Low-end USA High-end
16
FOR ILLUSTRATIVE PURPOSES ONLY
Average Cost Per Hospital Day (US$)
Hospital Charges:
$2,200
$579$502$550$1,050$837
$3,181
$12,708
$-
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
Canada France Germany Netherlands Spain USA USAMedicare
USA Fee Range
USA Average USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Average Cost Per Hospital Stay (US$)Hospital Charges:
$9,043 $9,840
$3,535 $2,261$3,388
$12,549 $12,000
$40,680
$-$5,000
$10,000$15,000$20,000$25,000$30,000$35,000$40,000$45,000
Canada
FranceNeth
erlands
Spain UK
USA USA M
edicare
USA Fee Range
USA Average USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Total Hospital and Physician Costs:
$2,436 $2,700 $2,500 $2,700 $2,959 $2,634
$10,400$11,997
$26,373
$-
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
Canad
a
France
German
yNeth
erlan
ds
Spain UK
USA
US Med
icare
USA Fee Range
Appendectomy (US$)
USA Average USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Bypass Surgery (US$)
Total Hospital and Physician Costs:
USA Fee Range
$22,092$12,868$15,761$11,916$14,111
$56,472
$116,798
$-
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
Canada France Spain UK USA USA Medicare
USA Fee Range
USA Average USA High-end
20
FOR ILLUSTRATIVE PURPOSES ONLY
Hip Replacement (US$)
Total Hospital and Physician Costs:
$8,438 $8,200 $8,500 $7,600 $9,152 $8,347$17,500
$32,093
$67,983
$-$10,000$20,000$30,000$40,000$50,000$60,000$70,000$80,000$90,000
$100,000
Canada
France
Germany
Netherla
nds
Spain UK
USAUSA M
edicare
USA Fee Range
USA Average USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Normal Delivery (US$)Total Hospital and Physician Costs:
$1,957$2,800 $3,400
$1,000$2,555 $1,924
$7,259 $7,473
$12,226
$-
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
Canada
France
Germany
Netherla
nds
Spain UK
USAUSA M
edicare
USA Fee Range
USA Average USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Pap Smear (US$)
Tests and Cultures:
$27
$14
$26
$16 $20 $17$24
$64
$-
$10
$20
$30
$40
$50
$60
$70
Canada
France
Germany
Netherla
nds
Spain USAUSA M
edicare
USA Fee Range
USA Low-end USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
Throat Culture (US$)
Tests and Cultures:
$17
$9 $10 $9
$17
$32
$-
$5
$10
$15
$20
$25
$30
$35
Canada Germany Spain USA USA Medicare
USA Fee Range
USA Low-end USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
$40$32
$63$48$53$33
$125
$334
$-
$50
$100
$150
$200
$250
$300
$350
$400
Canada France Germany Netherlands Spain UK USA
Lipitor (US$)
Drug Prices:
USA Low-end USA High-end
USA Fee
Range
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FOR ILLUSTRATIVE PURPOSES ONLY
$65 $67$37
$102
$36 $41
$154
$424
$-
$50
$100
$150
$200
$250
$300
$350
$400
$450
Canada France Germany Netherlands Spain UK USA
Nexium (US$)Drug Prices:
USA Fee
Range
USA Low-end USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
$59$58$77$85$77$85
$133
$540
$-
$100
$200
$300
$400
$500
$600
Canada France Germany Netherlands Spain UK USA
Plavix (US$)
Drug Prices:
USA Fee
Range
USA Low-end USA High-end
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FOR ILLUSTRATIVE PURPOSES ONLY
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Contact information
Tom Sackville, Chief Executive, the International Federation of Health Plans
Tom was born in London in 1950. He gained a degree in Modern History andSpanish Literature from Oxford University, and began his working life in financial services in New York specializing in European and Latin American debt.
In 1983 he was elected to the British Parliament. He served as a Government Whip in the Thatcher administration and later as a Minister in the Department of Health and the Home Office.
Since 1998 he has been Chief Executive of the International Federation ofHealth Plans, a global network of leading health insurers with members in 30 countries dedicated to the maintenance of high professional and ethical standards across the industry.
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Contact information continued
Tom Sackville
Tom is an advisor to various healthcare enterprises, including a hospital IT service provider. He is Chairman of Renal Services plc, a provider of kidney dialysis in the UK and Italy, and of the board of trustees of The Family Survival Trust, a charitable foundation supporting victims of cults and their families.
email tom@ifhp.com
UK cell +44 7710 787 673
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List of Federation Member PlansArgentinaOmint Sa De ServiciosAustraliaAustralian Health Insurance AssociationAustralian Unity Health LimitedBUPA Australia LimitedGMHBA LimitedHBF Health Funds IncThe Hospitals Contribution Fund ofAustralia LimitedHealth PartnersMedibank PrivateNavy Health LimitedNIB Health Funds LimitedTeachers’ Federation Health LimitedTeachers’ Union HealthBelgiumAssociation Internationale de la MutualiteNationaal Verbond van Socialistiche MutualiteitenUnion Nationale des Mutualities Libres (MLOZ)BotswanaBotswana Public Medical Aid SchemePULA Medical Aid FundBrazilAmil Participacoes LTDACanadaAlberta Blue Cross PlanCanadian Life & Health Insurance AssociationCanassurance Hospital Service AssociationGroup Medical ServicesManitoba Blue CrossMedavie Blue CrossPacific Blue CrossSaskatchewan Blue CrossChileBanmedicaColombiaAsociacion Colombiana de Empresas de Medicina IntegralColsanitas SAEPS Sanitas SAMedisanitas SADenmarkDanmark SygeforsikringDominican RepublicArs Humano
FranceMalakoff MedericGreeceInteramerican Life Insurance CompanyHong KongBUPA (Asia) LimitedHSBC Medical Insurance LimitedIrelandVHI Healthcare LimitedItalyUnisaluteMauritiusAdministrators & Consultants LimitedNetherlandsAchmea HealthZorgverzkeraars NederlandNew ZealandSouthern Cross HealthcareHealth Fund Association of New ZealandUnimedNigeriaTotal Health Trust LimitedPeople's Republic of ChinaBUPA China Representative OfficeSaudi ArabiaBUPA Middle EastSouth AfricaAllcare Administration LimitedBathobile Holdings LimitedBoard of Healthcare Funders of Southern AfricaBonitas Medical FundChartered Accountant (SA) Medical Aid FundDiscovery HealthLa-Health Medical SchemeMedihelpMedscheme HoldingsMetropolitan Health GroupNeil Harvey & AssociatesPolmedResolution HealthSizwe Medical FundTransmedUniversity of Natal
SpainCompañia de Seguros Adeslas SASanitas SASwitzerlandHelsana Versicherungen AGTanzaniaStrategis Insurance (Tanzania) LimitedThailandBUPA Health Insurance (Thailand) LimitedTurkeyAcibadem Saglik ve Hayat Sigorta S.A.United KingdomAXA PPP HealthcareBUPAEurope Assistance HoldingsSimplyhealth GroupWestern Provident AssociationWestfield Contributory Health SchemeUSAAetna IncAmerica's Health Insurance PlansBlue Cross & Blue Shield AssociationBlue Cross & Blue Shield of MassachusettsBlue Cross & Blue Shield of WyomingHIP Health Plan of New YorkKaiser Foundation Health Plan IncVenezuelaSanitas Venezuela SAZimbabweCIMAS Medical Aid SocietyThe Medical Aid Society of Central Africa
31
Resources For Health Care Unit Price Comparisons
1. Pricelist for Dutch Hospitals:
http://www.umcutrecht.nl/subsite/Prijslijsten_DBC-zorg/Prijslijsten_DBC-zorg/
(For a description of how Dutch DBCs compare to DRGs, please see: http://www.dbconderhoud.nl/Over-de-DBC-systematiek/Information-in-english)
2. The Canadian Institute for Health Information Health Spending Databases (hospital costs):
http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=spend_e
3. Canada Diagnostic Centres:
http://www.canadadiagnostic.com/fee-schedule.php
FOR ILLUSTRATIVE PURPOSES ONLY
32
4. Selected Canadian Fee Schedules:
Alberta:
http://www.health.alberta.ca/professionals/SOMB.html
British Columbia:
http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/index.html
Manitoba:
www.manitoba.ca/health/documents/physmanual.pdf
Newfoundland:
http://www.health.gov.nl.ca/mcp/html/schedule/toc.htm
Saskatchewan:
http://www.health.gov.sk.ca/payment-schedules
Resources For Health Care Unit Price Comparisons – cont.
FOR ILLUSTRATIVE PURPOSES ONLY
33
5. French Diagnosis-Related Groups (DRGs):
http://arimpl.free.fr/uploads/d96da9ec-081f-106f.pdf
6. German Diagnosis-Related Groups (DRGs):
http://www.g-drg.de/cms/
7. USA Medicare Physician Fee Schedules:
http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp?agree=yes&next=Accept
8. Wiley InterScience Special Issue: Analysing the variation of health care treatment costs in Europe, Volume 17 Issue S1 , Pages S1 - S103 (January/February 2008):
http://www3.interscience.wiley.com/journal/117882416/issue?CRETRY=1&SRETRY=0
9. New Choice Health (medical cost comparison resource):
http://newchoicehealth.com/home
Resources For Health Care Unit Price Comparisons – cont.
FOR ILLUSTRATIVE PURPOSES ONLY
34
10. United States Prices and Fee Sources:
– Scans and Imaging : USA charges include physician and facility fees. Non-Medicare US data reflect the average and maximum quotes provided by an online price comparison site
– Physician Fees : Non-Medicare US low- and high-end charges reflect an estimate of the 25th and 95th percentile of charges
– Hospital Charges / Total Hospital and Physician Costs : Non-Medicare US average to high-end range reflect an estimate of the average and 95th percentile of charges
– Tests and Cultures : Non-Medicare US charges low- and high-end reflect an estimate of 25th and 95th percentile of charges. Medicare US charges reflect the nation wide average
– Drug Prices : Non-Medicare charges, the low-end reflects the lowest prices based on a sample of several online US-based internet retail sites while the high-end reflects the maximum price across 61 counties based on a state-wide survey of New York retail pharmacies
Resources For Health Care Unit Price Comparisons – cont.
FOR ILLUSTRATIVE PURPOSES ONLY
35
Inpatient Utilization(American Hospitals)
Sources: American Hospital Association, “AHA Trendwatch Chartbook 2008,” 2008.
FOR ILLUSTRATIVE PURPOSES ONLY
36Sources: American Hospital Association, “AHA Trendwatch Chartbook 2008,” 2008.
Hospital Revenue and Expenses per Admission(American Hospitals)
FOR ILLUSTRATIVE PURPOSES ONLY
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