The Real Cost of Health Care

February 10, 2009 at 10:58 am (Health Care, Politics) (, )

One of my major interests, at least for the past few years, has been the health care industry in the United States.  Frankly, I think it’s crap and needs to be seriously overhauled.  I also think that the best way to overhaul it is to nationalize it.  The biggest reasons for this belief of mine are that I think it’s a mistake to classify health care as a commodity (thus, everyone should be entitled to it by law) and that I think the only organization that could possible fix it and keep it not-for-profit is the government.  I am definitely not of the opinion that government is the problem (though I will freely admit that it is not always the solution).

So when I saw a blog post in the New York Times today, I was intrigued.  You can read it in full here.

The basic premise is that the time people spend waiting for health care services is a hidden cost of the health care industry (based on the idea that time = money, which in this case, it often does).  So, from the blog entry:

If you count health care-related activities writ large – including 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.

If you don’t count quite as many activities as “time spent on getting health care,” the figure is 847 million hours (for all Americans over the age of 15 in 2007).  That is, of course, still quite a lot of time.

But let’s go with the 1.1 hours per week spent obtaining health care.  That means that the average American spends 57.2 hours each year on this activity (and it’s actually quite a bit more than that if you’re over 60 or female).  So how much would that cost, in terms of dollars?

If we value all people’s time at the average hourly wage of production and nonsupervisory workers ($17.43 in 2007), Americans spent the equivalent of $240 billion on health care in 2007.

(Sidenote: I only wish I earned $17.43/hour.  I earn quite a bit less than that right now.)  That’s quite a lot of money.  It’s enough that the official report on health care expenditure for 2007 is 11% smaller than it would have been if that amount of money had been included.

But to put it in more approachable numbers, for the average American earning what’s listed as an average salary, they would have spent nearly $1,000 in wasted time.  Since most doctor’s offices are only open during regular business hours, and most people work between the hours of 8 and 5, I don’t find it hard to believe that it was actually lost income (or used up PTO/sick leave).

Even I, earning substantially less than that and requiring very little health care by comparison, have probably spent over $100 in time over the past year.  Most of that is lost income, because I had to take time off of work and because I don’t have paid sick leave or time off.  And this doesn’t even include the actual cost of going to the doctor, paying for insurance, or buying prescription (and OTC) medication.

This is all interesting mostly because one of the biggest fears Americans seem to have about national health care is an explosion of waits for services.  We’ve all heard horror stories about how long some people in countries with national health care have to wait for non-emergency health care.  Nobody really wants to have to wait years to treat a problem that isn’t life threatening, but does affect quality of life.

But if we include the cost of everyone’s time in our discussions about our current system, and any system we want to implement, we should be able to avoid the worst of the issues that some other countries face.  Talking about time wasted can be somewhat abstract for many people, but talking about money wasted generally is not.

It would probably also serve to highlight the need for more primary care type physicians.  General practice isn’t a terribly popular field of specialization among medical students.  It would probably be well worth creating incentives for people to pursue that if it meant that everybody had more access to GPs or family doctors.  It might keep more people from choosing their medical field based mostly on how much money they can earn performing cosmetic procedures, rather than their interest in that particular type of medicine (dermatology, I’m looking at you).  Even those fields that can most easily turn to cosmetic procedures (like dermatology) are frequently medically necessary.  Dermatologists are needed for treating skin cancer, eczema, acne, psoriasis, and probably a hundred other life-threatening, uncomfortable, or just plain annoying issues.  Even plastic surgery can be considered necessary (or at least, very important) for women who have had mastectomies, or for people who have been disfigured in accidents.  It’s not all about nose jobs and face lifts.

I just hope that, if we ever get to a point where we are discussing national health care seriously, this is a part of the discussion.  Quantifying how much time we all spend sitting around doctors’ offices is a very good indication of the quality of our health care system.  Good health care should be both affordable and easily accessible, and I don’t think that’s an impossible goal.



  1. Kristan said,

    I don’t think it’s impossible either. I know my señora in Spain was a huge advocate of their system, and actually never mentioned having to wait much. (Another interesting tidbit she told me: No one in Spain pays premiums for brand name drugs because the generics are just as good.)

  2. Mary said,

    I’ve read what some people have to say about the system in Canada as well, and I don’t think that long waits are such a huge problem there, either. It seems as though a lot of people look at primarily the UK system (possibly forgetting that a lot of other countries have socialized health care), and most of those people seem to find it rather lacking. Nevermind that the overall quality of care in the UK isn’t actually any worse than in the US, and they pay a heck of a lot less for it.

    Really, the trick is getting enough doctors. Without enough doctors (especially family/general practice ones), wait times will be enormous no matter who pays for the care.

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