Services And The Luck Of the Draw

When we need to access services, how do we imagine them as a product? Is that something we really think about beforehand, or do we simply experience disappointment when the time comes that, yes, some sort of service is in fact necessary so we'll get through the torment as soon as possible and write it off as a necessary consequence of life? Perhaps this is why we don't think about a possible decline in services in the same sense we worried about the decline of our former retail establishments. After all, those were set up for more positive experiences. Indeed we sought them out willingly, and yet the effects of declining service product in a personal sense are every bit as significant. What's more, there's a good chance we wanted to provide something meaningful to others based on our education, yet don't really see how it's quite possible to do so, even with the coveted job. Services as only production residual become a limited hand over time, in which some advantages of skills capacity tend to give way to the luck of the draw. But wait...what about those who still plan to participate in skills offerings and thus hope for the best?

Upon hearing we have the "wrong skills for the market", which market are we talking about, exactly? We can be forgiven for wondering...according to who? What exactly does that marketplace consist of, which supposedly has no interest in what challenged us and what we committed to? What to make of all the other people who were also inspired by courses of study, only to find there is no reasonable way to coordinate our activities for one another? Didn't society have ways figured out, as to how one might line up those multiple capacities with one another? Somehow, our colleagues are not the ones we are "supposed" to be corresponding with even if they share space on our social media. Somehow, everyone's trying to help one another but the next person up is just trying to hold on to what still is...are the ones with the "in" who we are supposed to be replying to? Or, do we keep waiting for the "right" job contact who might actually pick up our resume and call us back in for a real interview?

Before we actually become a customer or provider of any significant healthcare, for instance, we may think of it as a multifaceted range of product not unlike a popular supermarket's range of offerings of goods one can actually see and touch. After all, what we hear about ongoing research and method possibilities is in fact an incredible range, capable of filling libraries of books, the stuff of evening news broadcasts and doctor's shows. Those possibilities include many options and choices from the present, and yet by no means do they all originate in present day terms and in fact some of the products continue in some form from product utilized hundreds of years earlier. Sounds like something any consumer in a developed country would pretty much take for granted, right?

Wrong. Unless one is going back to the somewhat limited and pre-economic method of mostly self reliance (nothing wrong with this, but why is it becoming the default option for so many?), the marketplace in most U.S. healthcare is based on pre-selected options of which the providers are expected to follow. One's personal maintenance expectations likely runs on a different  trajectory, than the expected medication and treatment after the formal healthcare encounter takes place. What's more, the interrelated nature of one's health issues and the ways they interact is not the focus of a Medicare visit, for instance, in the U.S. One issue at a time, please. For those who live in a small town with a doctor's office, there may still be no more room available on the calendar for new patients, or if you can get an appointment in a local office, you might see the physician scurry down the hall, as a nurse tends to your needs.

In other words the multifaceted products of the mind - those that hold composites of one's own experiences past and present, have little bearing on the product that gets served up or recognized by the present day industry of healthcare. Today's healthcare services define product as a specific way to address individual symptoms...even though healing is by definition an act of reconciling what is incomplete or asymmetric. As a product of the mind, knowledge has the capacity to be infinite in nature, even though it is attached to the scarcity of our time - which in turn has always asked us to individually coordinate focused activities in space and time, because of this limitation. Let's consider what happens when our time is used primarily as a residual economic component. What appeared as an infinite array of knowledge choices must now (in the present institutional configuration) be reduced to an agreed upon range of offerings resembling a small cafeteria line.

For purposes of profit in specific institutions, each hour of time is treated as a residual flow, from the physician's oversight of medication to the menial worker who cleans a hospital room. If a hospital patient needs something, divisions of responsibility mean the right designated service provider needs to be in the room, in order to comply...or, don't ask the person checking your meds cabinet for a glass of water. While choices in service options do exist in this setting, they exist as decisions for the institution, not the person receiving the service product, or the individual service provider. While such an arrangement perhaps "made sense" in the 20th century, and still makes sense for manufactured product separate from our time, people continue to wonder why their work remains unfulfilling. This is especially true, as ever growing need for financial accountability only means people will be expected to limit their actual time amongst one another even further than exists now.

In terms of market choice, it is therefore fair to call present day organized healthcare only a small sample of what could otherwise be available marketplace options. Somehow, we are supposed to move forward with these small samples which nonetheless provide the "most with the least" in a profitable way through (highly specific) institutional capture. However, considerable folly can result from such a setup, in which luck (or not), rather than skills capacity, may play an outsized role in terms of the results. Therefore, what one would expect to be optimal in healthcare, may instead  be suboptimal in that it represents sample bias. Shane Parrish at Farnam Street offers an explanation as to what might happen, when a full range of options is not actually accounted for:

• underestimating risk
• over-estimating risk
• undue confidence in trends/patterns
• undue confidence in the lack of side-effects/problems

In other words, it really helps to have larger samples, or more healthcare options, to distinguish between individual skill levels and chances for success, in an aggregate sense. However, with the present day limitations of healthcare service as institutionally directed, we have to cross our fingers and hope that the sample bias of pre-chosen methodologies is going to provide what we need and do the job. In some instances, the luck of the draw with benevolent services as residual is appropriate enough. But in terms of circumstance that call on many individual faculties over the course of a lifetime, getting the "most with the least" does not really serve anyone, in the ways people actually desire to interact with one another. Healthcare services, just like other services, need to be reconsidered in more direct ways which are capable of providing both a fuller range of personal choice options and wealth creation at the same time.