A hidden health-care cost: patients' time

The Times' Economix blog has a good post by Alan Krueger on the need toinclude patients' lost time in estimates of health-care costs.

After waiting more than an hour in a doctor's waiting room, a friend of mine once presented his doctor with a bill for his time..... Although it doesn't currently enter into our national statistics, the time that patients spend getting health care services should be reflected in the way we calculate America's national health care expenditures.....Time spent interacting with the medical system could be used for other activities, like work and leisure. Moreover, spending time getting medical care is not fun. This time should be counted as part of the cost of health care.

Using the American Time Use Survey, I calculate that Americans age 15 and older collectively spent 847 million hours waiting for medical services to be provided in 2007. That's a lot of bills to be delivered to health care providers.

If you count other health care-related activities, writes Krueger, such as" time traveling to a doctor, waiting to see a doctor, being examined and treated, taking medication, obtaining medical care for others, and paying bills, -- the average American spent 1.1 hours a week obtaining health care in 2007."

I would add to that the time that Americans spend trying to extract payments and information from their insurance companies.

In the past 6 weeks I've spend a good half-day -- an intensely frustrating half-day -- trying to get from my insurer a simple statement that shows what claims were made and what claims were paid last year, and for those claims that were not, why not. A half-dozen phone calls, several emails, and four sets of correspondence received from Blue Cross -- and I still don't have such a simple, straightforward accounting. I need it because atop the $10,000 I paid Blue Cross for a $5,000 "stop-loss" policy last year, I also paid out of pocket over $7,000 in medical expenses last year and still owe $1300, and I'm -- let's say politely -- confused about why I've out $7000 for a $5000 deductible policy and am still getting dunned by caretakers. (And no one was even really sick last year.) It's possible they don't owe me money. But I can't even tell because they won't get me the data I need to know whether they've failed to pay bills they should have.

Was even funner when our son Nick was born on 12/29/01. I spent probably 40 hours on the phone and doing paperwork to clear up the confusion that Blue Cross suffered because -- OMG -- Nick was born in 2001 but discharged in 2002. (Epic birth scene: 40-hour labor with 4 hours pushing ... and then a C-section. Thus the 5-day hospital stay.) It was, quite literally, 2003 before we straightened it out.

I'm sure there are scores, hundreds, thousands of other such stories out there. The economic toll must be quite impressive.

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Someone once explained to me that there is no such thing as "saving" money. You are just shifting the cost elsewhere.

A company cuts costs by hiring low-skill (read: cheap) online support staff; customers pay in the increased time it takes to try to get help.

A company cuts cost by replacing live operators with an interactive voice response system; customers pay with the increase in time it takes to get problems resolved.

Sometimes the cost shifting occurs between departments in the same company.

The billing problems you describe are probably the result of a system (or systems) that are saving someone, somewhere $$.