When the Solution Has No Price

One problem faced by a society that is always working toward solutions to various problems is that certain solutions, however effective, may go unused because they cannot be commodified.

Consider obesity. True, billions of dollars have been made selling all sorts of diet and exercise and weight-loss products, but perhaps the best solution is the free one: eat a bit less and a bit better and take a good 30-minute walk every day. But it’s hard to make money pushing that idea.

In this interview with The Takeaway, the author and surgeon Atul Gawande offers another compelling example. Gawande’s new book, The Checklist Manifesto (see Levitt’s strong endorsement here) describes his effort to create a checklist for use in surgical settings that could cut down on errors.

The checklist, piloted in eight hospitals around the world, proved to be very successful. It was also essentially free. But, as Gawande explains in the Takeaway interview, widespread adoption has been far slower than he would like. Why?

If a pharmaceutical company came up with a drug or a device that offered the same improved outcomes as the checklist, Gawande notes, that drug or device would be worth billions of dollars, and would be marketed accordingly. The lowly checklist, meanwhile, has no such sponsor and therefore is far slower to spread.

Here’s hoping that the checklist, along with other cheap and simple solutions, can somehow keep worming their way into the marketplace, despite competition from much better-promoted (and often inferior) ideas.