Joseph Rago on health care

This passage (full article here) strikes me as something Arnold Kling would link to:

Take the nearly $47 billion in stimulus cash the White House has budgeted to prime the pump for health IT adoption. Mr. Bush says he's glad his industry is getting more attention from the bully pulpit, but that "It is kind of too bad that all these software companies that we're really close to putting out of business, these terrible legacy companies, with code that was written in the '70s, are going to get life support. That's why I call it the Sunny von Bülow bill. What it is, basically, is a federally sponsored sale on old-fashioned software."

"It's designed like a box-buying campaign," he continues. "You get this fixed chunk of money for a few years, you get to pay off your EMR, like its a thing. People in Washington think in terms of things that we'll buy and then they'll be there. Buildings. Roads. Tanks. What Lockheed Martin makes. Things.

"And this isn't that. This is a market: its a set of agreements, it's a language. What's needed is a way of exchanging value and making choices, that's ethical–and, you know, nobody, nobody, not nobody, has said a word about that.

Here is Rago on Medicaid:

State Medicaid programs, by the way, are easily the worst payers, according to Athena's annual ranking. In New York, for instance, claims must be tendered on a dead-tree form instead of electronically and in blue ink–black is grounds for rejection–and then go on to spend a full 161 days, or almost a half year, in accounts receivable.

I thank Yana for the pointer.

Comments

Tyler,

Do you know how to obtain a new copy of Samuelson's Foundations? Used copies seem to be going for $70+ on Amazon but I can't find anyone selling it new..

Tyler,
Do you know how I can use Google? I can't find anyone to teach me.

The problem with standardization and markets is that rarely does someone have an incentive to institute and improve them, especially if the government takes it away from you once you do.

One thing I'd like to see that I think would help that the government should have already done anyway is make medical records the property of the person they pertain to and require availability on demand. Not only would standardization and electronification follow in short order but there would also be room for innovation and data mining would be a breeze.

if computers are not going to fix us, who will fix the computers?

One thing I'd like to see that I think would help that the government should have already done anyway is make medical records the property of the person they pertain to and require availability on demand. Not only would standardization and electronification follow in short order but there would also be room for innovation and data mining would be a breeze.

Your records are your property which is why you need to sign all the forms letting the insurers and providers send your records around.

And the standard for the records is paper which can be transmitted electronically by fax. Which is actually a standard set by the one world government.....

The only thing that the government should do with respect to electronic medical records is state the data that must be in them, the security measures needed to access and protect them and the period of time that they should be retained. Then they should put a contract out to have a number of players in the IT industry design, qualify, build and maintain the system.

While many aspects of health reform may be questionable if done by for-profit corporations, these records are an area where efficient companies could create something useful, standardized and cost effective. Having the government doing IT when that is not their strength means that numerous contractors will be brought in and can over charge or simply be on contract at the wrong time, making the costs of the system far too expensive.

Software is a service, not a product. Since the government pretends this is false, it gets bad software, and then tries to keep it for 30 years.

The insurance companies negotiate a lower price than what I could do on my own...

What I find disappointing, yet typical, is that the US Government already has a public domain EMR. It was built for the VA and is called VistA. Interestingly, it's in the public domain because of a successful FOIA request for the source code and is in use at some non-government hospitals.

The current system is driving the wealth from the middle class to the business class. Other nations with universal health care may have higher taxes however, once all other factors are taken into place, American actually pay more then people in higher taxed nations. Health insurance, retirement savings, kids education savings, student loans, 401k†¦.it’s know wonder people can’t make ends meet. The public must get more for there tax dollars. Other empires have fallen only after the governments spend more on the military then it’s only people. We are at that stage. By Hook or by Crook, universal health care is coming. It’s the only way to compete business wise, it’s the only way to bring together the classes, it’s the only way to redistribute wealth from corporations back to the citizens. The rest of the industrialized world is passing us by without looking back, wondering when will we catch on?

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