There is a small medicine cabinet at home. Whatever medicine we buy usually ends up in it. Strangely, it is almost always full, even though my wife clears out expired drugs from time to time.
Why is it always full? Or, put another way, why do we buy so much medicine and then fail to finish it according to the doctor’s instructions?
I used to give this question very little thought. The simplest explanation seemed to be that everyone in the family was in reasonably good health: before we could finish the average course of medicine prescribed by the doctor, the illness had already improved. But last night, in a dream, I found myself thinking about medicine as a peculiar kind of commodity. In that hazy state I arrived at a few answers. None of them is especially original, but at least they prove that a person can still think while dreaming, so they are worth writing down.
First, medicine is not an ordinary product. There is a serious information gap between patients and doctors. Patients often know very little about the drug itself, while doctors may know far less than the patient about the exact intensity of the suffering. This easily leads to treatment courses that are longer than what the patient later feels is necessary.
Second, for certain unspeakable reasons, doctors may have a strong incentive to prescribe more medicine than a patient actually needs in order to recover.
Third, people usually go to the hospital when their symptoms feel most severe. At that moment, they use the peak level of pain and anxiety as the standard for judging everything. They are willing to pay more than they normally would, and they accept the corresponding pile of medicine. But after taking the medicine for a short time, the symptoms ease. Once the pain index drops sharply, the perceived value, or effect, of the medicine also drops sharply. Then people begin to take it irregularly, and eventually stop before finishing the course.
Fourth, we seriously underestimate the body’s ability to heal itself. Many minor illnesses may not require a doctor at all. Yet once we see a doctor, psychological relief often arrives immediately: symptoms seem to lighten or even disappear. The medicine then becomes something left unused.
Fifth, we keep a lot of “basic medicine” at home, but the illnesses those drugs are meant to treat may not actually occur that often. The stockpile is excessive.
Sixth, sometimes the medicine cabinet already contains what we need, but we forget it is there. So the doctor prescribes it again, or we buy another box ourselves.
There are probably many more reasons why a household medicine cabinet stays full. But the question I was thinking about in the dream was not simply why medicine piles up. It was why, when buying medicine, we do not behave the way we do when buying ordinary daily necessities: buying according to need, and using things until they are used up.
When buying medicine, we rarely think about price. We rarely ask whether the purchase is truly necessary. We rarely consider whether the medicine can be used before it expires. In reality, we often buy a large quantity of not-so-necessary medicine while ignoring price, throw it away once it expires, and then buy it again not long afterward.
Why does this irrational buying behavior repeat itself without ever making us alert?
The answer is still hidden in the points above. Medicine is a special commodity, and the buyer and seller do not possess equal information. Patients tend to overestimate the suffering caused by illness, and are willing to pay a high price to escape it. We also overestimate the probability of common ailments when stocking “basic medicine,” but when we actually fall ill, we overestimate the harm of the illness and forget what we already have at home.
Medicine looks so special that it often pushes us into irrational purchase decisions. Common sense would suggest that there should not be many products like this, and that in most areas of consumption we are generally rational. But after thinking about it carefully, that does not seem to be the case.
In recent years, cigarettes priced below ten yuan have become hard to find. Some people say cigarette manufacturers deliberately push up prices. But even if five-yuan cigarettes were widely available, would many people buy them? Cigarettes are similar to alcohol in this respect: the cheaper they are, the larger the market does not necessarily become. As incomes rise, this tendency becomes more obvious. The biggest consumption often sits in the middle tier and the tier just below it. Yet everyone knows perfectly well that the quality of cigarettes and alcohol is not directly proportional to price. The higher the category, the weaker the relationship between price and quality. Still, people chase the high end and avoid the low end.
The price of a dish has no necessary relationship with its nutritional value, or even with its taste. But in many settings, people feel compelled to order the expensive “face-saving” dishes, often far beyond what can actually be eaten.
When weight begins to get out of control, or after reading a news story about a shut-in dying suddenly, someone immediately signs up for a gym membership. A yearly card is purchased, and then the person goes only two or three times.
Minor cosmetic procedures have become increasingly popular in recent years. The effectiveness of such procedures is often something over which the clinic effectively holds the “right of interpretation.” Yet many women pay more than they can afford for them, and some fall into a cosmetic-surgery addiction they cannot easily escape.
Most retail investors enter the stock market full of confidence. Very quickly, they discover that they are the leeks being harvested. The frightening part is that many will then volunteer to be harvested a second time, and a third time.
For the sake of socializing,<sup id="fnref:1">1</sup> people spend enormous amounts of time and money. But does socializing truly produce any utility? More than 90 percent of it produces none at all. Even so, some people spend the greater part of their best years, and much of their lives, on it.
Life is full of small medicine cabinets. They contain all kinds of special commodities bought irrationally. When the cabinet is full, we clear it out; after clearing it out, we fill it again. Rarely do we stop to ask whether these things are useful, or what exactly makes them so special.
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This refers specifically to socializing driven by practical interests or expected benefits. ↩