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?

Push emails are like good spam

I’ve become a fan of push email to serve up information at Zingerman's Mail Order. By push email I mean a note that arrives in your inbox without you asking for it. It's like spam but good spam. The useful more tasty kind. It tells you something you need for your job—or maybe it doesn't but you might get something out of it anyway. (We don't usually limit the recipients of push emails because it's easy for the crew who don't need the information to delete it.)

For example, we use push emails at ZMO to share information about new foods on Friday product launch days. We announce our web launch with a push email every Tuesday. We share our current financial information both weekly (big email) and daily (shorter one).  In some cases push emails have taken the place of meetings altogether.

You don't want to overdo it. Too many unbidden emails and it turns to spam. This is far from rocket science but I have learned some things that help make push mail work better:

Put a lot of information in the email

Go for a lot of data in one email versus many emails with light information. People can scan vast amounts of data quicker than you think.

Use titles like this
They organize the email and make it faster to scan.

Make a consistent structure
Keep the format of the email—headings, sections and so on—the same each time so readers know where to search—and what to skip—for the info they need.

Put new stuff on top
If something is different mention it at the beginning of the email. Many regular readers will skip to the section that's relevant to them but they almost always have to skim from the top to get to their section.

Get right to the data
Nuff said.

Use bold, use color
Spare use of bold type makes scanning quicker. Colors that are clear—when in doubt, stick to red for bad things, green for good ones—speed up scanning, too.

Use a fixed, repeating delivery date, usually once per week

This might be the most important feature. An email that comes every week allows people to wait to see if their question is answered before asking it. It's easy to remember that the email about new products comes out every Friday. You can have longer waits between delivery times—every other week or once a month—but it becomes more likely someone will need a question answered in the intervening time and call you. More problematically, folks will forget when the next delivery of information is due so they'll ask anyway. 

The main benefits I've seen from a push email is that it lets you communicate with less waste. It reduces back and forth by offering a reliable, regular beat of information. Often you'll find you're communicating less frequently but people think you're communicating more.

Recent Reading

Recent reading, counter-intuitive edition.

Renting versus buying music: the economics of Spotify and iTunes. Is Spotify better for artists than they think? Numbers alert—there are a lot of them in this piece—but I rarely see this much good detail in any business writing, let alone a piece on the music industry.

Want your kids to be smarter? Move them to a country with no oil. The entirely compelling but wack connection between education and natural resources. From Tom Friedman who's almost always worth reading. (Beirut to Jerusalem, his book on the Middle East, is still the best resource I know for understanding what's going on there today.)

"It is not clear that moving around large and largely empty vehicles is much of an improvement over moving around smaller ones. In fact, it may be worse." Why mass transit isn't necessarily more fuel efficient.

Why your friends seem to have more friends than you do: a mathematical explanation. 

Other Merchants...Kermit Lynch

"I have never been one to worry too much about food and wine pairings. I give it some thought, for a minute or less. First, I tend to think regionally. I've always believed that the wine and food of a given region grew up together and go together. Then I ask, what am I in the mood to drink? It's that simple, and it works for me. Maybe I'm missing a lot, but I find that I am not creative about imaging how a wine and food will complement each other. I'm just not wired that way." 

- Kermit Lynch

Kermit Lynch is a wine importer. You'll see bottles with his label in a few wine shops and restaurants, more on the coasts than in the midwest. Buy anything you find without hesitation. They're always interesting, his taste leans toward French and Italian traditionalists who don't filter. He has a small retail shop in Berkeley, California, too. In the heart of American wine country he sells no American wine. The business just turned 40.

I've read his wine writing for over a decade and have yet to find a single thing I don't agree with. When I met him for the first time we tried some wine and he looked up after a couple sips and said, "After all these years I still can't tell what kind of grape a wine is made from just from tasting it. Lots of people can, but I need to read the label." The closer I get to food the more plain arrive the confessions.

Higher Education in America, Follow-up Graphs

Two more tales about education and how it played out in unemployment rates before and after the economic crisis.

Higher Education in America

A few visuals on education, cost and income in America.

Other Merchants...Casa Camper

This is probably the single most boring picture I never took in Spain. It's the refrigerated food case at Casa Camper Hotel (I found the image on the internet). Casa Camper is a blood red hotel, a good looking place in Barcelona, a very good looking city. You might know Camper as a quirky shoe company, which it still is. The hotel is a new thing for them.

They perform a number of interesting service twists that make the hotel feel intimate and alive in a way few other hotels ever have for me. The biggest one is that they give away things most other hotels charge for. Like food. It's all free. The fridge case is just off the lobby. It's filled with little sandwiches, Weck jars of yogurt and fruit, water, fresh squeezed juice, glass bottles of soda and so on. The food is healthy, tasty, easy to graze on. It changes every day. They tell you up front: eat it whenever you want, take it anywhere you want, we want you to enjoy it. That gives you a sense of control while, at the same time, making it feel like you're being given something very generous.