Happy King Day weekend! Congress continues its work on Capitol Hill this week following the holiday. Here’s a link to the Week in Congress’s report on last week’s Congressional activities.
The Weekend Wall Street Journal which is the FEHBlog’s favorite newspaper published an essay offering “A Cure for Our Fixation on Metrics.” The essay was adapted from Prof. Jerry Z. Muller’s forthcoming book “The Tyranny of Metrics.” Any reader of the FEHBlog knows that everyone and his brother/sister is trying to measure the quality of healthcare with metrics. Indeed, 65% of an FEHB carrier’s plan performance assessment is based on metrics under OPM’s recent rule. So the Professor’s book is a breath of fresh air to the FEHBlog.
These paragraphs from the essay hit home with the FEHBlog.
The more the object to be measured resembles inanimate matter, the more likely it is to be measurable: that is why measurement is indispensable in the natural sciences and in engineering. When the objects to be measured are influenced by the process of measurement, measurement becomes less reliable. Measurement becomes much less reliable the more its object is human activity, since the objects—people—are self-conscious and are capable of reacting to the process of being measured. The more rewards and punishments are involved, the more people are likely to react in a way that skews the measurement’s validity. * * *
Just because performance measures often have some negative outcomes doesn’t mean that they should be abandoned. They may still be worth using, despite their anticipatable problems. It’s a matter of trade-offs, and that too is a matter of judgment.
With measurement as with everything else, recognizing limits is often the beginning of wisdom. Not all problems are soluble, and even fewer are soluble by metrics. It’s not true, as too many people now believe, that everything can be improved by measurement, or that everything that can be measured can be improved.
If only the healthcare policymakers would take this essay to heart.