Citizen G'kar: Musings on Earth: Why The Healthcare Industry Doesn't Want Electronic Medical Records

June 26, 2009

Why The Healthcare Industry Doesn't Want Electronic Medical Records

...from the it-would-reveal-the-business-model dept

I've been really confused by the whole push for "electronic healthcare records" as some sort of big step for improving our healthcare system. It's such a minor part of what's needed that it seems to be looking at curing a cough when someone has terminal cancer. The cough isn't the issue. Also, it's never been quite clear why hospitals didn't move to electronic healthcare records in the first place. Lots of other businesses with tons of paper records long ago realized that moving to electronic records and making things more efficient wasn't just a fantastic way to make money, but a way to expand their own market. The switch from paper stock certificates to electronic ones didn't just save printing costs -- it enabled the stock market to change in a massive way (perhaps too much, many will note).
Andy Kessler, who's been thinking an awful lot about these issues (and whose book The End of Medicine hasn't received nearly the attention it deserves) has an interesting article discussing why the industry has resisted the move to e-healthcare records. While it would save some money, he notes, it would also expose the entire scam of the healthcare system: which is that they make a ton of money from inefficiencies baked into the system, which are totally hidden from view. It's a massive boondoggle for the industry, and e-healthcare records would actually make it easier for people to understand that the healthcare system profits from people being sick and not from having them be well.
The incentives are totally screwed up for everyone.
Healthcare providers make more money the sicker you are. Pharmaceutical companies make easy money with gov't monopolies limiting the ability to spread useful drugs. The actual costs are nearly totally hidden from most consumers, so they don't make smart choices at all. There's a lot of built in artificial scarcities in the system, and opening up the flow of information changes that.
Of course, in the grand scheme of things, this is dumb. Focusing on preventative care and actually keeping people healthy would actually provide a massive economic benefit not just to the healthcare industry, but to the economy as a whole. More healthy people contributing to production, output and consumption can do quite a lot for the economy. The numbers on some studies are staggering (we're talking trillions of dollars). If the incentives could be aligned such that people paid for staying healthy, rather than having illness treated, then there's a ton of money to be made without resorting to the old inefficient mess that is today's healthcare system.
But rather than tackle any of that, we get attempts to fix the cough in the terminally ill patient -- and the patient likes the morphine drip so much that he'll do anything to avoid getting healthy. It's time to fix the healthcare system. And while I don't necessarily believe that a small step like electronic medical records is all that meaningful, if Kessler is right and it actually drives some awareness to the underlying mess, perhaps it's at least a good start.

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Hitler's Reichsmarschall

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This I believe to be the privilege and the burden of all of us who deem ourselves bound by allegiances and loyalties which are broader and deeper than nationalism and which go beyond our nation's self-defined goals and positions. We are called to speak for the weak, for the voiceless, for the victims of our nation and for those it calls 'enemy,' for no document from human hands can make these humans any less our brothers.
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Somehow this madness must cease. We must stop now. I speak as a child of God and brother to the suffering poor of Vietnam [Iraq]. I speak for those whose land is being laid waste, whose homes are being destroyed, whose culture is being subverted. I speak for the poor in America who are paying the double price of smashed hopes at home and death and corruption in Vietnam [Iraq]. I speak as a citizen of the world, for the world as it stands aghast at the path we have taken. I speak as an American to the leaders of my own nation. The great initiative in this war is ours. The initiative to stop it must be ours.
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Man was born into barbarism when killing his fellow man was a normal condition of existence. He became endowed with a conscience. And he has now reached the day when violence toward another human being must become as abhorrent as eating another's flesh.
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The curse of poverty has no justification in our age. It is socially as cruel and blind as the practice of cannibalism at the dawn of civilization, when men ate each other because they had not yet learned to take food from the soil or to consume the abundant animal life around them. The time has come for us to civilize ourselves by the total, direct and immediate abolition of poverty.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

Discrimination is a hellhound that gnaws at Negroes [minorities] in every waking moment of their lives to remind them that the lie of their inferiority is accepted as truth in the society dominating them.
- Martin Luther King, Jr., speech, Southern Christian Leadership Conference, Atlanta, Georgia, August 16, 1967.

Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that. Hate multiplies hate, violence multiplies violence, and toughness multiplies toughness in a descending spiral of destruction....The chain reaction of evil--hate begetting hate, wars producing more wars--must be broken, or we shall be plunged into the dark abyss of annihilation.
- Martin Luther King, Jr., Strength To Love, 1963

Like an unchecked cancer, hate corrodes the personality and eats away its vital unity. Hate destroys a man's sense of values and his objectivity. It causes him to describe the beautiful as ugly and the ugly as beautiful, and to confuse the true with the false and the false with the true.
- Martin Luther King, Jr., Strength To Love, 1963.

Human salvation lies in the hands of the creatively maladjusted.
- Martin Luther King, Jr., Strength to Love, 1963.

The bombs in Vietnam [Iraq} explode at home; they destroy the hopes and possibilities for a decent America.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

We must combine the toughness of the serpent and the softness of the dove, a tough mind and a tender heart.
- Martin Luther King, Jr., Strength to Love, 1963.

Power at its best is love implementing the demands of justice. Justice at its best is love correcting everything that stands against love.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

The Negroes of America had taken the President, the press and the pulpit at their word when they spoke in broad terms of freedom and justice. But the absence of brutality and unregenerate evil is not the presence of justice. To stay murder is not the same thing as to ordain brotherhood.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

Many of the ugly pages of American history have been obscured and forgotten....America owes a debt of justice which it has only begun to pay. If it loses the will to finish or slackens in its determination, history will recall its crimes and the country that would be great will lack the most indispensable element of greatness--justice.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

We must combine the toughness of the serpent and the softness of the dove, a tough mind and a tender heart.
- Martin Luther King, Jr., Strength to Love, 1963.

Power at its best is love implementing the demands of justice. Justice at its best is love correcting everything that stands against love.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

The Negroes of America had taken the President, the press and the pulpit at their word when they spoke in broad terms of freedom and justice. But the absence of brutality and unregenerate evil is not the presence of justice. To stay murder is not the same thing as to ordain brotherhood.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

Many of the ugly pages of American history have been obscured and forgotten....America owes a debt of justice which it has only begun to pay. If it loses the will to finish or slackens in its determination, history will recall its crimes and the country that would be great will lack the most indispensable element of greatness--justice.
- Martin Luther King, Jr., Where Do We Go from Here: Chaos or Community?, 1967.

Man is man because he is free to operate within the framework of his destiny. He is free to deliberate, to make decisions, and to choose between alternatives. He is distinguished from animals by his freedom to do evil or to do good and to walk the high road of beauty or tread the low road of ugly degeneracy.
- Martin Luther King, Jr., The Measures of Man, 1959.

Nonviolent action, the Negro saw, was the way to supplement, not replace, the progress of change. It was the way to divest himself of passivity without arraying himself in vindictive force.
- Martin Luther King, Jr., Why We Can't Wait, 1964.
ished from animals by his freedom to do evil or to do good and to walk the high road of beauty or tread the low road of ugly degeneracy.
- Martin Luther King, Jr., The Measures of Man, 1959.

Nonviolent action, the Negro saw, was the way to supplement, not replace, the progress of change. It was the way to divest himself of passivity without arraying himself in vindictive force.
- Martin Luther King, Jr., Why We Can't Wait, 1964.