Friday, January 17, 2014

Whither the Consumer?

“Did anyone fill Mr. Torres’s prescriptions?”

The pharmacist looked with a slightly bothered mien behind the wall of separation to her two colleagues and the cashiers gathered in the back.  They ruffled through some bags and shrugged.

The pharmacist I’d asked checked through the drawer of filled prescriptions as if to upturn the final stone.  Lo and behold!  There they were.

I was thrilled not to be disappointed again.  It was my second trip to the pharmacy for prescriptions I’d phoned in two days before.  After waiting 20 minutes in the morning for them to open, and for a few more to let them fumble around, they gave me the bad news.

“We didn’t have one of them, so we had to wait for the shipment.  It’s here [she nodded to a mountain of boxes stacked along the side wall].  You’ll have to wait.  We can have it in 15 minutes, or you can come back.”

“Did you at least fill the two that were in?”  The staff looked at each other blankly.  No one spoke.  Her face darkened as she turned towards me with a visage that questioned, “Who do you think you are?”

I calculated how long I could hold out on my existing supplies; I wouldn’t run out until tomorrow and made the mistake of telling her so.  She pounced: “You won’t need them until tomorrow, then?”  Her face brightened at the prospect of being able to put off until tomorrow what she could do today.

“I hesitate to tell you that.”  [Oh, no!  I shouldn’t have said that.  It was snarky and uncharitable.]  “Maybe later this afternoon,” I lied.  I had no intention of making another pilgrimage to the pharmacy this day.  I just didn’t want her to know that, or to wait more tomorrow when I arrived.

Nevertheless, I was running errands in the snow and stopped by later in the day.  The prescriptions had been filled.  My strategy had worked.

Sorry to say, this isn’t an unusual experience at the state university hospital where I fill half of my prescriptions.  I fill the other half at a national supermarket chain whose drug store offers $4 prescriptions.  State U pharmacy can't go that low.   

I’d venture that they also pay their people better than does the national chain.

The U is a gargantuan public institution, one of the nation’s most prestigious with lots of important researchers, smart students, federal grants, permanent employees and a hospital system that is the most massive part of all. 

The economy is evergreen at this institution, more so in these past few years of struggle for everyone else.  The U is constantly building, remodeling, acquiring, upgrading and expanding.

The pharmacy, for some reason, specializes in sub-par service.  I hesitate to criticize them for several reasons.  First, I take lots of medicine and am grateful to them for keeping me alive.  Secondly, I'm in there a lot, so they have an inordinate number of opportunities to disappoint me.  Moreover, nobody is perfect, not even the customer.  Pharmacy workers are human beings subject to the same grievances, aches and pains that we all are.  I don’t know the pressures they’re under.  

They’re also pleasant enough when they want to be, and they know my wife and me by name.  I’m certain they’re doing the best they think they can do.

They’ll occasionally work right away on something if I ask.  But, they won’t call an MD to get refills on prescriptions.  Neither do they fill prescriptions when they say they will more than 70% of the time.

My supermarket pharmacy is another story altogether.  It opens earlier and closes four hours later.  I’ve seen as many as two pharmacists working in the back, but it’s mostly just one.  There is often a student intern (sometimes two) from the U’s pharmacy school that occasionally handles the customer counter, as does the regular pharmacist.  There is generally a regular employee, perhaps an undergraduate from the U, to handle the counter and whatever else is needed.

Despite the leaner staff, the supermarket pharmacy provides far superior service.  The treatment I receive is invariably helpful, efficient and friendly.

Like the U, it has a snazzy phone ordering system.  Unlike the U, its automated system calls to notify me that my prescription is filled and ready for pickup, generally ahead of schedule.  Sometimes, a person calls.

They have never failed to accommodate a request, e.g., for immediate pickup.  They smile easily and maintain their composure even when the line backs up.  They automatically call my MD’s when I’m out of refills and are happy to suggest cheaper generics.  They manage their inventory well; I don’t recall their ever being out of a drug.

This is a university town with over 100,000 people in it during the school year.  The pharmacy business is an urgent one.  People need their meds when they need them, and they only call when they’re out of supplies.  Both pharmacies are busy; both place their employees under stress.

The supermarket pharmacy just signals in every way possible that it wants and appreciates my business.  Conversely, my university pharmacy signals quite often that they’re doing me a favor, as if my presence is an interruption. 

Rather than receive their service, I serve the U’s pharmacy and employees.  My taxes (federal, state and local; present and future, due to public borrowing or simple money-printing) pay their salaries and benefits and provide them with the job security and short hours that all people desire and that some claim is a right, a demand of justice given human dignity. 

My voluntary business feeds the supermarket.  And, my, how they work to assure that my volition, like the sun, continues to shine on them.

Consumerism gets a bad rap, and I understand why.  People are more important than things.  Prayer is more important than shopping.   Happiness is found by thinking about other people’s needs, not my own.  Flitting from diversion to entertainment to gadget is unworthy of, and unsatisfying for, the human person, a being made for love.

Nevertheless, even for such a being, there are common, public benefits to ordering economic activity around customers’ preferences rather than employees’ standards of living, toward consumers’ rather than providers’ comfort.  One is that people on the receiving end of the counter (and encounter) are accorded heightened regard rather than condescended to.

Markets also get a bad rap.  We’re presumed to be at their mercy wherever they’re permitted to flourish unshackled by political constraints.   Politicians and the public sector they champion are working for the common good, after all.

From where I sit, however, the politically determined common good too often affronts my dignity, dismisses my concerns and treats me shabbily.

All things considered, I prefer being treated as a consumer than as a ward of enlightened public servants.  Customers have choice, free will, and merchants court us to induce us to exercise it in their favor.  They treat us with solicitude. 

What keeps public institutions and employees focused on service, on the customer?  Elections?  Sunspots are more likely to impact the fortunes of State U than voters are.

The people in my university pharmacy are just like everyone else.  They are capable of responding to challenges or sliding into a comfort zone.  They don’t know the best they can do because they don’t have to.  They are insulated from corrective mechanisms other than political ones within their institution.   

State employment is ordered towards providing stable, secure employment at high wages and benefits for well-defined working hours.  If something doesn’t get done today, there’s always tomorrow.  The customer will suffer the inconvenience. 

If customer demand doesn’t pay the bills, taxpayers and lenders will.  Taxpayers have no choice in the matter, either to pay or to guarantee the lenders.  Ironically, consumers driven away by indifference are taxpayers, too.  Like customers at the Hotel California, they can check out but they can never leave.  

The U pharmacy doesn’t have to operate profitably to survive, though I don’t see how it could fail to make money. 

This arrangement is thought in some circles to safeguard human dignity by providing employees with stability and leisure along with a more-than-living wage and benefits. 

What if it fosters indolence and mediocrity, however, or enthralls State U pharmacy employees to an individualistic, indifferent and self-centered mentality?  Public employees and servants—not just private actors—are fallen human beings riddled with the baneful affects of original sin.

What if the arrangement grinds down those whose needs generate commerce and employment in the first place?  Is their treatment not a concern of the common good?

Volition is not paramount.  The truth to which it’s ordered and good to which it’s drawn—the full reality in which it is exercised, is.  But, it’s a tawdry notion of the common good that institutionalizes so cavalier a disregard of the consumer.

Ironically, if I’m at the mercy of anyone, it’s the public employees I am increasingly forced to interface with--allegedly for my own good and the common good of society--by politicians who are insulated from the electoral marketplace by likeminded propagandists and cronies in business and labor.

If allowed to operate, the market would redress this problem by giving birth to a corrective industry.  It's not likely that politicians will allow that to happen, however.

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