Friday, December 7, 2012

The postal system versus the medical system, which is worse?

There are plenty of worries about unknowns arising from the Affordable Care Act (AKA Obamacare). One that I’ve heard is that government intervention will turn the medical system into the postal system.

Forget about the fact that the premise is wrong—private health insurance companies will still pay private doctors, there won't be any government in the waiting room. But perhaps some aspects of the postal system wouldn’t be all that bad. I’d like to take a bleak moment to defend the postal system, at least with respect to the health industry. My examples aren't meant to line up apples to apples—delivering mail and delivering medicine are very different. I write these posts on what I think is the worst run industry in America from a merchant's perspective, trying to look at the problem health care has with its customers, not with its science. I don't think the post office is a beacon of great service so this defense won’t last long. But they do some things well and, in my opinion, a lot more than the health care industry does.

A recent example. I had to get my daughter’s first passport. I went to the passport website, downloaded a form that explained exactly how to go about it, then went to the post office without an appointment. I waited a short time for someone to review all the documents. They told me how much everything would cost and told me when it would arrive (it beat their arrival estimate). I was done in less than twenty minutes. Could any one of those things have happened with a doctor? Well, I’m sure they could. But for me they almost never do. Doctors don’t provide instructions on websites, don’t work without appointments, don’t tell you what anything costs, and I’ve yet to have a visit last fewer than half an hour, even though I only get to talk to the doctor for a couple minutes. Put the two next to each other like that and the post office comes out looking pretty good.

Here's another. The post office delivers—nearly every day, with remarkable accuracy. When’s the last time you mailed a letter and it went to the wrong place? (I can tell you it happens almost a half a percent of the time in the private sector. That’s the number of mis-ship complaints we get about UPS at Zingerman’s. That doesn’t sound like much but I bet it’s a hundred times more than the postal service.)

But I digress. I don't know how accurate medicine is and that's not the point. I'm asking about delivery. Does the health care industry deliver doctors to your home? Why not? Doctors used to make house calls, after all. Wouldn’t it be better for patients—especially the elderly—if they still did? We don’t even ask health care this question any more because we think delivered modern medical service is impossible. It’s not. Virtually everything else we purchase offers home delivery. Why not medicine?

The health industry is often lauded for its innovations in technology, surgery and drugs. Why don't they spend any time innovating on service?

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