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Choices
We all have choices to make. Sometimes in the medical business, we are not able, permitted or aware of our choices. We just plod along in a treatment program which is directed by other people. In the real world, we are rarely lead through life without our own ability to direct the process.
A good example of our ability to make choices in business occurred to us here at the Pittsburgh Area Brain Injury Alliance. Our web server company was not serving our needs in a way that was in our best interest. They made mistakes with our site that cost us many hours of labor to correct.
We fired them.
Somehow, after a lengthy period of difficulties with Stargate, our site's navigational structure was lost. This change restricted visitors from viewing every other page on our site. And it meant that we lost valuable files.
We have found a monthly service at a fraction of the cost that Ed was paying to Stargate. This switch gives us three times the space for files and almost twice the bandwidth. As everyone knows, Stargate has gone out of business. They were forced out by companies that offered a better service at a better price.
You see, We have a choice.
In the non-medical world, we can do this as customers, because we can freely choose to terminate the services of the provider and to purchase them from a different provider. This is a prime example of the way that customer/consumer choice would affect the companies that sell medical and rehabilitation products and services. And this is why I am explaining it here.
In the 'free market' the customer can choose to stop buying from a company or person for any reason including if they do not give them what they want, or need and pay for. This is a powerful force in the economy of service delivery. When people disengage their money from a company, it has a financial reason to adapt to the needs, wants and desires of the people who buy what they sell. This is a compelling influence that shapes the choices companies make. Without customers, the business cannot continue to do whatever they do.
For example, if you buy a gallon of Whole Milk at the grocery store, you fully expect to receive Whole Milk in the carton. If you find Buttermilk in your carton, you would most likely return it to the place of purchase and demand a replacement or refund.
It is true that the products are similar because they both originate from the same place and are both dairy products. However, they are clearly different. Whole milk is sweet and Buttermilk is sour. Your grocer could argue that the similarities make them interchangeable. The grocer could even argue that Buttermilk is Whole Milk. You are the final authority because you are able to stop giving the grocer your money if he refused to give you what you wanted and paid for.
Not so in our medical service delivery system!
Our current system of selling medical and rehabilitation products and services is not customer friendly. It certainly is not cognitively accessible. If you are given something other than that which you want or need, you are forced to swallow whatever you get. This is because you do not get to withdraw funding. This current system of funding puts the money into the hands of the "grocer" and gives the "grocer" the power to sell you whatever the "grocer" wants to sell you. And that is the biggest problem with the medical system right now.
In the medical world, the "grocer" is the doctor, or company employee or CEO. We call medical and rehabilitation service companies hospitals and Rehabs. This disguises the fact that they are companies first. Some operate for the profit of a board of directors and shareholders. Others are called non-profit or not-for-profit. Nevertheless, someone makes money. And oftentimes they make a lot of money. Not that the people within these organizations should not get paid. They deserve to be compensated fairly for their time and investment in education. In reality the plain truth is that the profit motive is a driving force in every company and organization. Most need to sell what ever it is they offer to get money to do business and pay all of the people that work within the organization or company. Some are in business with a hidden agenda.
People who buy medical services and products deserve to be treated with dignity and respect.
In the false economy of medical service companies, the money is controlled by the company or the person who sells the services. This keeps the power of choice out of the hands of the consumers. And that shift of control has historically affected the way in which services and products have been (and continue to be) developed and delivered. It also affects competition and price. In the free market, customers set the price through their buying habits. They also drive the development of new and improved products and services.
If a company sells you what you want at a price you are willing to pay, you will buy from them. If this company continues to meet your needs, you continue to buy from them.
In the case of our web hosting company, our needs are not being met at a competitive price. Therefore, as customers, we can affect the change we want by changing providers.
Simple.
And our withdrawal from a company sends a clear message to the company employees and directors. If they see this happening with other customers, they can choose to respond or continue to do business as usual. However, if enough customers stop buying from this company, they are forced to change the way they deliver their service or they will go out of business.
In either case, you win.
That is the beauty of the free market. And that is why people within the disability advocacy movement want to change the way the funding for medical services is administered. If customers control the money, they would be able to affect the development and delivery of services and in many cases costs would be reduced and the products and services would be improved.
All of this would ease the strain that healthcare puts on society, the government, taxpayers and the people who buy the goods and services that these companies sell. And that would be a better way for everyone except the people and companies who are profiting from the current system.
John Pistorius
Comments on this page can be sent to John Pistorius.