Are Consumers Really Uninformed About Funeral Services?

Thursday, April 26, 2018

“The picture that Mitford paints of the American way of death is one in which the hapless consumer has been tricked into purchasing a funeral way beyond his or her means by the funeral director motivated only by the search of profit. It is a tidy story. It is also, I believe, not entirely correct...that this was a set of goods and services hoisted on unsuspecting, innocent American consumers who longed for a simple pine box carried to the cemetery on the hill.” - Tanya Marsh

Just last year NPR ran a two-part investigation about funeral pricing that was highly critical of the industry. Even without the occasional (and uncommon) negative story, it can seem like the general public opinion of the funeral industry can be pretty low - it's predatory, insensitive, expensive, outdated. Fairly or unfairly, it can in part be traced back to the influential 1963 book The American Way of Death by Jessica Mitford. In it, Mitford takes the funeral industry to task, blaming them for taking advantage of consumers with lavish and unnecessary funerals. Tanya Marsh, the Wake Forest Law professor who organized the death care symposium we discussed last month, analyzed the root of that perception in a second essay for the symposium journal, including what she thinks that Mitford got right - and wrong.

Marsh points to the 16th and 17th century customs of mourning feasts and ritual gifts. At the time, funeral spending was so lavish that by the 1760s, Boston had passed a law to actually limit the number of funeral gifts that could be exchanged. Rural funerals were certainly smaller and simpler, but Marsh makes it clear that in both American and English cities, “people were engaged in the funeral profession from the very beginning. Expensive funerals are not a twentieth century American invention.”

The emergence of the funeral director as a profession is linked to the process of embalming, which to this day is a main feature and significant cost of the funeral. As I mentioned last week, embalming became popular during the Civil War, where it was necessary for transporting soldiers killed in the South back to the North. Public perception of embalming was strengthened after the death of Abraham Lincoln, where his wake generated much positive feedback regarding his appearance.

Josh Slocum, a funeral director watchdog and the Executive Director of the Funeral Consumers Alliance, offers a counterpoint to Marsh in the same symposium journal. The FCA is "a nonprofit organization dedicated to protecting a consumer's right to choose a meaningful, dignified, affordable funeral," and Slocum is extremely critical of funeral homes. His essay, The Funeral Rule: Where It Came From, Why It Matters, and How to Bring It To The 21st Century focuses on The Funeral Rule, a 1984 FTC ruling requiring funeral homes to offer itemized pricing by phone and in person. Slocum wants to see the rule updated to mandate pricing be available online - not a bad idea. All of it is in service of his primary position - that funeral consumers are under-informed and overcharged, and the funeral industry is resistant to regulation and transparency.

Marsh doesn’t see it that way, and cites an NFDA survey from 2016 which found that 81.2% of people contacted only one funeral home before making a choice and only 51.4% called multiple funeral homes “to compare prices.” This suggests that location and past experience are the major factors when choosing a funeral home, not price and competition. Marsh writes: “I think that Jessica Mitford also believed that the best funeral was a cheap funeral. I believe as a normative matter, she is wrong. The best funeral is the funeral that is meaningful to you, your family, you friends, and your community. Nobody, not an English author, not a funeral director, not a state legislator, and not me, can decide what is the best funeral for you.”

I think it's important to take Slocum's argument with a grain of salt. Regarding how informed consumers are about the Funeral Rule, Slocum cites an AARP that indicates very low comprehension of the details of the Funeral Rule. The conclusions that he draws from the data are broad, and presumptive. A questionnaire to retirees (from 20 years ago) regarding the specific details of an FTC regulation does not necessarily demonstrate that consumers are uninformed across the board about funeral services. Consumers should have reasonable expectations for what they want from their funeral and from their cemetery or funeral home and a clear understand of goods, services, and prices that is easy to obtain. They don't necessarily need to be versed in FTC regulation compliance.

Slocum characterizes embalming as an unnecessary and costly service foisted on families. Thought I am certainly no embalming evangelist, the way this practice fits into the funeral industry is much more complicated. Tanya Marsh’s article on how the modern funeral industry came to be does an excellent job of breaking that down. While Slocum's claim that no states in 2017 require embalming is true to the letter, it doesn't reflect the complete reality. Like Marsh discusses, embalming is a central aspect of the funeral director licensing regime. In a review of embalming statutes in the U.S. at the time of the Ebola crisis in 2014, Marsh found “a number of states have statues and regulations that reflect a view that embalming is necessary to protect the public health,” and in effect, would require embalming to adhere to state law and OSHA compliance. Marsh continues, noting that “at least a dozen states still require that remains be embalmed before they are transported out of state or by a common carrier and at least nineteen states require that remains be embalmed, refrigerated, cremated or buried within a certain number of hours after death.” Depending on many factors, embalming might be the best way to adhere to the law.

"Despite the modern scientific consensus that an unembalmed body does not pose a public health risk in normal circumstances, the belief that embalming is necessary as a public health measure lingers," Marsh writes. Still, "many state regulations are premised on this archaic germ theory," and one modern embalming textbook even "asserts that '[t]he dictates of logic, reason, and research all demand that the dead human body be considered a source of pathogenic microorganisms.'" We know embalming is vital for families choosing to have a viewing, but beyond that, its use-cases are more limited. Slocum's characterization doesn't account for the fact that, as Marsh contends, the perception of embalming as necessary persists in part because the laws and regulations haven't changed sufficiently.

I'd suggest that pricing isn't so much the core issue, but rather a lack of pre-planning. Marsh makes it pretty clear, and echoes a sentiment that many of us in the industry share - we are providing a very necessary service that consumers are for the most part comfortable with. Slocum denounces the fixation on "headline-grabbing" stories like grave desecration or burial mix-ups as distractions from the "real" problem of price gouging and lack of transparency. In reality, Slocum plays on the same fears when he hyperbolically paints the funeral industry as an exploitative racket, or sounds a false alarm about "exploding caskets." This takes advantage of misconceptions by manipulating a kernel of truth to fit his quite specific conclusion, and does a disservice to the professionals that are working hard for their families. 

Just last week, the FTC completed an undercover review of Funeral Rule compliance, and found that found 20% of the funeral homes visited not making price lists available. That is not an insignificant number, but it's hardly an epidemic. Furthermore, all of the funeral homes in violation failed to comply with price list disclosure, but nothing was noted about requiring the purchase of items or services, a clearly unfair practice. As the symposium and journal articles thoughtfully illustrate, there are clearly problems for the funeral industry to solve as it responds to changing consumer preferences of the 21st century.


*Photo courtesy of Zach Smith