Thursday, March 5, 2009

Study Finds Universal Health Care Would Cost Less Than Bailouts

How wrong Emily Dickinson was! Hope is not “the thing with feathers”. The thing with feathers has turned to be my nephew. I must take him to a specialist in Zurich.
-Woody Allen

Last month LWOH reported on the stimulus bill’s costly national e-health records (EHRs) designed to monitor personal patient data. Microsoft launched its Healthvault beta program in 2007 and has now partnered with Kaiser Permanente and the American Heart Association, among others, to create a database accessible by patients and authorized care providers. Earlier this year Google launched its own health records beta, Google Health to store online personal patient data. Why is the government spending billions of dollars on EHRs when a new study finds universal health care would cost less than bailouts?

This week, President Obama announced that the economic stimulus package he championed will release $155 million for 126 new health centers in certain parts of the country, enough, he said, “to provide basic care to 750,000 Americans and to create 5,500 jobs.” Great. U.S. citizens need jobs.

Today, an interesting article by Julekha Dash appeared in the Baltimore Business Journal that looks at the prospects for software development firms “seeing dollar signs” to benefit from the government’s e-health records first round of $19 billion spending plan to “modernize IT medical technology”:

“Many firms say they plan to hire more people, create new products and invest more in marketing to grab a slice of the federal government’s spending plan that is part of the $787 billion stimulus package signed Feb. 17. Most of the spending will be in the form of incentives to encourage hospitals and physician practices to adopt electronic health records.”

Although Obama says jobs will be created, neither he nor anyone from his Economic Advisory Board has yet to say whether he will renege on his campaign promise to support H-1B increases and make EHRs a hire Americans job campaign. Note that the two biggest EHR developers, Microsoft and Google, are also two of the biggest proponents of outsourcing/insourcing foreign workers and labor arbitrage.

But didn’t the Obama administration say that, or at least when it came to the banks -- government stimulus bill money would not be appropriated to organizations who hire foreign workers?

Of particular note, the article states that the federal money in the stimulus bill will go directly to health care providers, NOT to technology firms, which is interesting considering the fact that IT development isn’t typically the first line of business for health care providers. Why not give the loot directly to the software companies who could then solicit and compete in the open market for business directly from the healthcare providers who would seek to deem it necessary? I suppose if the American healthcare providers don’t use their in-house IT staff but contract the work explicitly to American and not foreign firms like Microsoft and Goggle, among others, it wouldn’t matter if these firms who have legally hired foreign workers do the work. What will these health care providers do with the all of this first round of $19 billion handed to them? It really does seem a bit demanding to burden healthcare providers who are presumably in the business of healthcare -- to take on the extra, tangential and disparate roles of screening, recruiting and managing costly and complicated IT projects that they, by training, would seem to know little or nothing about. And, with taxpaying physicians and their patients footing this billion dollar bill, do they have any choice but not to take it?

The article suggests that the longarm of Obama’s Economic Advisory Board (including a Google investor and Oracle senior executive) is coming down hard on doctors to push this through to “make health care providers” aware of the importance in “reducing” potential medical errors:

“Still, software developers say the federal government’s spending will make health care providers more aware of the importance of electronic health records. Advocates of the technology say storing health data online allows physicians to receive faster information on a patient’s medical history, thereby reducing the potential for medical errors.”

Putting the cart before the horse? Wouldn’t that initial round of $19 billion be much better spent in kicking off actual, national healthcare access in all states and not privacy invasive software projects to help the near 50 million Americans without insurance?

As for the claim that EHRs will “reduce” medical errors, I might even go as far to argue that medical errors have the potential to increase due to an overflow of complicated IT data and devices. I do maintain that human job stresses that medical personnel occasionally face have, for the most part, very little to do with information technology processes. When a doctor sews up a patient after an appendectomy and forgets to take out the sponge, privacy invasive EHRs help how? To be sure, updated and accurate medical records play a vital role in any smoothly run healthcare setting, and healthcare facilities from small physicians’ offices to hospitals utilize them as they already exist.

Dash also notes some challenges of the stimulus bill EHR spending:

“Competition will be stiff as heavyweights Google and Microsoft have developed products that store medical records online. And even as software executives feel optimistic, some are taking a wait-and-see approach before they make any new hires. Salar’s Johnson said he wants to see how the federal funds will be allocated before adjusting the sales forecast of the $2 million firm.”

Hmph. Will EHRs go the way of another Y2K boondoggle or will this push to put all personal patient data online be a much needed economic kick-start to reforming pro-American technology hiring practices? With Microsoft leading the way, at least someone stands to profit.


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