Sneaking In National Health Care
Via the WSJ, here's one of the little turkeys in the fine print of the stimulus package.
Both the House and Senate stimulus bills include about $20 billion in incentive payments (mainly through Medicare and Medicaid) to encourage the digitization of medical records. Fair enough. But one of the reasons only an estimated 17% to 29% of doctors use health IT is because there are still many technical issues to work out. Different systems must be compatible so doctors can communicate with each other, coordinate care and share information -- and they don't want to invest in a platform that could become as obsolete as HD-DVD.Democrats have decided that the way to jump this gap is for government simply to pick the next Blu-Ray. Instead of building on a voluntary public-private standard-setting body created by the Bush Administration, the stimulus bill codifies it as a federal office and gives it broad new powers if private companies are not "substantially and adequately" meeting the needs of doctors and hospitals. The health IT outfit will soon be deciding which platforms are up to code and shutting down competitors.
This will certainly muffle innovation, given that high-school dropouts have been known to scam U.S. health bureaucrats out of millions of dollars that should be preventable with off-the-shelf auditing software. Anyway, what's the rush? Democrats give the game away by mandating that most medical providers who aren't linked into the government-approved health information network after 2016 will start to be penalized. Their real political goal is to make a down payment on national health care.
Why do we never learn? Why are people so naive as to think government will save them and make things better? Government involvement in business is the land of buying $1,000 doorknobs, as one of the guys -- a former non-commissioned army officer who works at the coffeehouse I go to -- told me about his experience in the armed services.
Yes, the government mandating the format that electronic records will take is probably a bad idea, but saying that "their real political goal is to make a down payment on national health care," is quite a stretch. The argument against the government mandated standards is strong enough to stand on its own. And on the issue of national health care, of which I am rather ambivalent, I would like everyone who is against it to please pledge to never draw on Medicare, to never utilize a senior center flu shot, or draw VA medical benefits.
Scott at February 11, 2009 6:06 AM
Scott, that is the weakest argument I've heard in a long time. We are forced to pay for Medicare. It comes out of my check every other week. But I'm not supposed to use it because I think the program is bad?
How about allowing me to not pay for it and not receive the benefits? Do you think our overlords would allow that?
MarkD at February 11, 2009 6:35 AM
Amy Alkon
https://www.advicegoddess.com/archives/2009/02/sneaking-in-nat.html#comment-1625924">comment from MarkDThat's right -- there's no opt-out. VA medical benefits are something we owe to those who've served in the armed forces. My grandma, who was not poor, should not have been on the public dole for health care, but everybody's grandma is.
Amy Alkon
at February 11, 2009 6:56 AM
Scott, you're also missing the part of the stimulus bill that essentially says
the "Federal Coordinating Council for Comparative Effectiveness Research" setup will be making decisions on what is the best treatment or if you're getting the right treatment.
Bloomberg opinion piece:
http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs
Sio at February 11, 2009 11:00 AM
"This will certainly muffle innovation," Horse shit. This person has no fucking clue how medical IT works and how much of a flaming pain in the ass it can be without standards. Stifling creativity is the insane amount of time spend connecting two fundamentally non compatible software/hardware solutions. If you have a 6 month contract to connect a hospital to a network and then add XYZ features most of your time will be spend getting HP Vue link to talk to NovaComm3. Pick any two proprietary standards to substitute. You have no time for innovation cause your too freaking busy getting basics to work.
You standardize the communication front end properly and the whole things gets much smoother and easier. There are medical standards for every device out there and as long as you not either too damn stupid or stubborn they will not affect you creative edge. The standards define a minimal frame work for communication or operation. Adding stuff is not in anyway restricted as long as you prove that no harm will come from it. You don't even always have to prove efficacy either.
"My grandma, who was not poor, should not have been on the public dole for health care, but everybody's grandma is. " Amy your kidding right. Are you honestly and with a straight face using the old if everyone else does it it's ok?
vlad at February 11, 2009 11:01 AM
No Vlad, she was saying her Gma should not have been, nor should many others. Just like we should not all be on medicaid.
momof3 at February 11, 2009 11:06 AM
I'm still not sure how mandating a specific comms protocol has anything to do with Nationalized Healthcare? The government would be doing the same for the Va which it really needs to do any way. This way all the hospitals are linked properly.
As far as grandma ma being on medicaid or medicare. It depends heavily on which of the two systems she was one. Medicare is more like insurance, you pay in like you would insurance, yes it's less but the coverage is less. Yeah it's costing us but not as bad as you think. Now medicaid is free which is the one all the illegals are under and the one most of the griping should be about. Now I'm very much against medicaid but no one really has an alternative and "Nothing fuck em" doesn't really work either, maybe in principle but not in practice.
BTW as a DINK (at least for now) the baby makers (3+) are bleeding me far deeper than the elderly.
vlad at February 11, 2009 2:04 PM
Scott, this provision is not merely a down-payment on nationalized health-care.
It's a down-payment on forced euthanasia.
As I said elsewhere, it's a ballsy opening move.
brian at February 11, 2009 2:05 PM
"It's a down-payment on forced euthanasia." Huh?
vlad at February 11, 2009 2:21 PM
"the baby makers (3+) are bleeding me far deeper than the elderly. " This is only true on an an individual basis, which I may not have been clear. The neonatal care of 3 or more children is higher then the EOL care for one elderly person.
vlad at February 11, 2009 2:30 PM
dunno Vlad, some of that language looks a lot less like deciding on Lastname, Firstname vs. Firstname Lastname, but establishment of an overseeing body that would deFacto " will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective."
me no like.
SwissArmyD at February 11, 2009 2:43 PM
Vlad. Read the whole bloomberg article. Then look up relevant stuff that Tom Daschle (failed nominee for HHS) said in his book (upon which most of this shit is based).
He or someone else involved in the "health-care crisis" debate is on record saying that costs are running away because we engage in too many expensive treatments for old people. That person also said that we would be better off if we were like Europeans, and more willing to accept a "hopeless prognosis".
Which leaves only one interpretation.
Congress to the Elderly: "Drop Dead."
brian at February 11, 2009 2:51 PM
To some point I have to agree. I do not believe anyone in their 70s or 80s should get organ transplants or other super-expensive and by definition limited-availability treatments unless they can pay for them. I do not at all agree with the government making that decision, however. It's a steep slippery slope.
momof3 at February 11, 2009 6:20 PM
"That person also said that we would be better off if we were like Europeans, and more willing to accept a "hopeless prognosis"." Yeah and quite frankly he's right. Doctors are forced by patients and families to perform procedure that will not work. I'm not talking about unlikely but just won't do shit. The worst being the section 8 (name will vary by state) shit where the patient wants to die but because he/she wants to die they have been declared incompetent and forced to undergo the treatment. This is all done with the idiot relatives standing around with their family lawyer (usually some shit bag personal injury lawyer) holding a gun to everyone head. I had a transport patient who spoke Russian and very much wanted all this shit to stop. I was told in no uncertain terms that I was to drop this and never bring it up again as the family had nurses and doctors sued for mentioning it.
Also the later part of the OpEd piece is more the opinion of the writer than actual facts. I can and do choose to interpret the facts differently.
"I do not believe anyone in their 70s or 80s should get organ transplants or other super-expensive and by definition limited-availability treatments unless they can pay for them." I agree but be very careful about payment and organ transplants. Not everything should be available on the free market.
vlad at February 12, 2009 7:05 AM
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