I have filled this space in the past with either an economic analysis of some issue using theory or have commented on economic policy using my training as an economist. Today, however, is a time for the observations of an economist who is living in the real world.
See, I am having a hip replacement and I am now a health care market participant who spends lots of time waiting. To get to the end of the column, the health care market place is really strange and weird.
My first observation is that there is an amazing profit opportunity found in physician and hospital waiting rooms. While I knew I would spend a lot of time simply waiting, I did not know it would be as much as it has been. As I look around to my colleagues in waiting I see that most of them are playing telephone apps that have the word “crush” in them. Few seem to be stretching themselves with crossword puzzles or word games. It is “crush” this or “crush” that. Mine is “Temple Run.” My granddaughter tells me that my game selection “dates” me and I should not let anyone see me playing something that old.
No matter how this time is passed, it is unproductive. Here is my profit opportunity. Someone should think of something that needs to be done that I could do while waiting. This way I could be paid while I was sitting waiting. What could it be? Don’t know at the moment. It would be like an Uber-type app that I run that tells someone on the other end that I have some time that they can buy and use for their purposes. I believe that it would be easy to get people to do it — they have the time and nothing else to do and get paid for waiting.
In my mind, health care is divided between two parts. There is medical care. This is all those activities that occur between a nurse, a technician, a doctor and me. All of this is focused on me and, for the most part, they are friendly and seem to care about me. I think this is all good.
The second part is health care payment. This part is really messed up. I have asked several people who work in this part of health care how much my procedure will cost. The universal answer is “Well, it depends.” On what I ask? On several unidentified factors, I am told.
We went shopping this past Thanksgiving evening. No one in Target told me, when I asked about a price, “Well, it depends.” When I think of all the major things I have purchased this year no one has said, “Well, it depends.” This is unique to health care and results from a health payment system that is totally confusing and out of control. See, I know the answer — 70 percent of all health care revenue collected by providers comes from government. Governments never seem to know what anything costs. They only know that things costs more than budgeted.
My last observation is that someone has been calling me telling me the amount of my unmet deductible — every week. See, I have a large deductible plan. The person on the other end of the of the conversation tells me that I must meet my deductible ‘before’ I can be treated. Again, this part of health payment is confusing. This is like Target telling me that I cannot come in and shop until I spend a certain amount at Walmart. When I told this to the person who calls, all they say is “Well, it depends.”
So, wish me well. The medical care part is very good and this is all that really matters. A friend of mine has had a similar procedure done in a country with socialized medicine (pay attention progressives.) During one of his consultations he was told that his wait time could be cut in half if he agreed to have something implanted that was “reconditioned.” I did not ask what this meant — other than recycling has gone amuck too.
Dr. Skip Mounts is the dean of the School of Business and Public Management, professor of economics, and an affiliate of the Reg Murphy Center for Economic and Policy Studies.