Acting "As If" Hanson's Right
By Bryan Caplan
Last week I went to the doctor for an ear infection. Did I die from the hypocrisy? No, I knew from childhood experience that ear infections are one of the few things doctors can easily cure. Of course, my first choice would have been to live in a country where adults didn’t need to beg doctors for permission to buy medicine, but going to the doctor was better than letting nature take its course.
Today my phone rings. It’s my HMO conducting a survey about my experience. My reflexes told me to hang up, but I wanted to learn more about (a) how surveys actually work, and (b) the health care industry, so I stayed on the line.
Along with the obvious questions (age, race, education), the survey had roughly five substantive questions about my appointment. Three at least arguably fit the usual “doctors repair the human machine” model of health care. On a scale of 1-5, how satisfied was I with the whole experience? How able was the doctor able to answer my questions? Something like that.
But TWO questions were glaringly consistent with Robin Hanson’s story that health care is largely about “showing that you care”:
Did you feel comforted?
Did the doctor show you respect?
Note well: Neither of these components of consumer satisfaction have obviously improved over the past hundred years, or even the past thousand. Back when doctors bled their patients, I have no doubt that many “felt comforted,” and thought their doctor “showed them respect.” Indeed, I bet that today’s most financially successful astrologers give a lot of comfort and show a lot of respect.
Admittedly, interpersonal skills matter somewhat in every service sector job. But it was striking that the HMO assigned them a very high priority. And the person who administered the survey sounded surprised when I said that the reason I was “fairly satisfied” was that “The doctor was able to solve my problem.” Her tone said: “Oh, that’s why? It takes all kinds.”
It’s almost as if people on the business side of the industry have a gut level sense that Hanson’s on to something. Almost as if.