Monday, October 17, 2011

Customers or burdens?

Adam Smith Institute expounds a typical argument on the subject of private medicine. I would once have dismissed fiercely this way of thinking, but after recent experiences and some alarming news stories I am beginning to wonder.

In a recent book on The Morality of Capitalism, US think-tanker Tom Palmer talks of his treatment for a serious condition in both public and private hospitals. In the private hospital, he was seen quickly by the right people, treated as a human being, everyone took an interest in him, and they respected his wishes. In the public hospital, he waited, was bossed around despite being in pain, had no human engagement with his doctor, and was generally treated as a piece of meat.

I don't think for a minute that working for a private or a public institution fundamentally changes people's basic humanity. But the incentives in a private system nevertheless encourage them to show more of their human side. That is because they see the clients they have to deal with as valued customers: their job, their income, would not exist if those customers were not satisfied. And they know from their own experience that the way a service is delivered – the cheeriness, the human engagement, the concern – are as much a part of a customer's satisfaction as getting the service itself. By contrast, the incentive structure in too many public services induces staff to regard customers as a necessary inconvenience. Shouldn't we prefer a system that positively encourages and brings out people's humanity, rather than one that discourages and so obviously represses it?

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