Stimulus Avoids Serious Solutions For Health IT 184
ivaldes3 writes in to note his post up on Linux Medical News, pointing out the severe shortcomings of the Health IT provisions of the just-passed stimulus bill. "The government has authorized enough money to purchase EMR freedom for the nation. Instead the government appears set to double down on proprietary lock-down. The government currently appears poised to purchase serfdom instead of freedom and performance for patients, practitioners and the nation. An intellectual and financial servitude to proprietary EMR companies for little or no gain. A truly bad bargain."
Opinionated much? (Score:4, Insightful)
Why Is Health Care even in the Stimulus (Score:3, Insightful)
On top of all the other crap that certainly won't really stimulat the economy.
Here's the bottom line. The problem with the economic crisis today lies with the financial and banking system. Health care wasn't the reason for the collapse, and fixing health care isn't the core issue here.
Its funny how liberals were complaining that invading Iraq had nothing to do the GWOT. This is the liberals version of 9/11, using the crisis as a pretext to remake the US economy and set their agenda.
Re:Opinionated much? (Score:4, Insightful)
What news is this post actually trying to tell us?
They didn't get the money sent to them so they are calling the others bad names and getting all pissy about it.
*blink* (Score:0, Insightful)
Say what? Can someone tell me what language that summary is written in so I can work on getting it translated.
From the poorly written article it sounds like the healthcare industry is sticking with proprietary hardware/software/whatever. Is this really big news in a highly specialized and highly accountable field? (If my code explodes a few records in a database may be lost. If healthcare code/hardware explodes someone literally dies.) Personally, I wouldn't want to take on that kind of responsibility as an open source developer.
Healthcare is full of closed apps (Score:5, Insightful)
Healthcare is dominated by application vendors who each make their own megaplatform for healthcare records. Cerner, Meditech, Siemens, et al. are all trying to keep as much of their system closed as possible, and aren't particularly interested in opening it up to third party systems. They don't particularly want open interfaces, their goal is to keep their customer locked in as much as possible.
So the healthcare IT companies get what they want, i.e. a bigger push for electronic records, selling the software they already have.
The stimulas package isn't going to add an open spec for EMR because nobody in the healthcare industry is bringing it up that they want one.
Re:Why Is Health Care even in the Stimulus (Score:5, Insightful)
It's tempting to think that, but the truth is McCain would've done pretty much the same thing. Except he would have cried more.
Re:Not as big of a deal as you might think (Score:3, Insightful)
Quick, what's the proper race code to send in PID-10? What about PID-17 (that was a fun one to standardize)? Not to mention the mess with PID-18, PID-2 and PID-3 across disparate systems, and every mind-boggling combination of ways that different systems treat persons, encounters, orders, results, reports, and images.
Basically, the government will have to throw out or severely limit the use of most medical software, and enforce its replacement with something standard if they want to make health information electronically available to any provider. Otherwise the "solution" will be sending PNGs of medical records back and forth.
Re:Criticisms and a Better plan (Score:5, Insightful)
I think it was Heinlein that said something like: You only truly own that which you can carry in both arms at a dead run.
Re:Why Is Health Care even in the Stimulus (Score:4, Insightful)
This also goes to show that Republicans aren't really the party of small business.
Neither party is the party of small business. They're the party of the party, for the party, by the party.
It's not a democrats versus republican thing, it's an US versus Politicians thing.
Re:Criticisms and a Better plan (Score:4, Insightful)
You're only half right. The problem is that HIT vendors are generally well behind the times, slow to innovate and closed and proprietary as all get out. You think MS is bad? You haven't seen highyway robbery until you've seen the shit in a box most HIT vendors push. The technical implementation is lacking and the SOLE focus, the SOLE focus of every sale is simply to further ensare the particular customer still deeper into more from the same proprietary stack. Integration is a joke, made challenging by intention rather than accident.
This is a HIGHLY lucrative market. Any given vendor has ZERO interest in open systems and will push to make sure you buy their entire stack.
Thankfully, there are exceptions to the rule and there are many CIOs and CEOs that are wising up to their antics.
This stimulus plan, unfortunately, only makes things WORSE backing proprietary vendors and closed systems over open standards - real standards, not the recommendations AKA HL7.
Re:Given that nobody read the bill... (Score:2, Insightful)
Not that I'm particularly a fan of Democrats, and in fact prefer the Repubs on almost (not quite) every issue, but I suspect that if you just scratch "Democrat" from both occurrences in your post, you'd probably still be right.
Re:Opinionated much? (Score:5, Insightful)
Thomas Jefferson disagrees with you (Score:5, Insightful)
Now, the reason, though, that he gives for this is that a private corporation owns his data in the present system, but if the government owned, then, somehow, he'd own it more.
That's the crazy thing. There's no such thing as "public ownership".
I visited Washington DC a while back. I stood on the Mall. I stood on the Lincoln Memorial. I own a piece of it. So do you. I ran my fingers down the names on the black Wall, and I knew that my family had bought a piece of it at the cost of blood. I looked up at the top of that giant obelisk and knew that Washington had given me a piece of it. I walked through Arlington. I for damn sure own a piece of that.
Yes, if the government owns it, you absolutely own it more. You own it more because there's a huge difference between being a citizen and being a customer. I own it more because generations of my kin have stood in uniform and fought and bled for it.
If there's truly no such thing as "public ownership," then why is my family pulling on uniforms and strapping on guns to fight for it?
Re:Thomas Jefferson disagrees with you (Score:5, Insightful)
You don't own any of it.
If you own something then you can sell it.
Try and sell 'your share' of the Washington memorial.
You family protected the nation. The nation government used to mind its own business (courts, national defense, some infrastructure...nothing else) and mostly leave us alone.
You can say you have a stake in the commons, but that is nothing like ownership.
With businesses you can choose which company you deal with. Government pretty much always grants itself a monopoly.
Re:Why Is Health Care even in the Stimulus (Score:3, Insightful)
Re:LOL, right he's simple minded. (Score:1, Insightful)
Since when is trolling considered Informative?
The point of the system: Ammo against your enemies (Score:1, Insightful)
The point of digitizing your health records is not to "lower costs" the point is to maintain a record of your political enemy's health issues.
Take a look at the "leaks" of the taxes, etc. of Joe the Plumber once he became a political liability.
Or take a look at how often political candidates "sealed" divorce papers are leaked to the press.
I believe there is an instance of the ex-husband of 7 of 9's divorce records becoming "oops, unsealed". Allowing a certain candidate to run unopposed.
What this will mean is that when you (or someone else) runs for office, your medical history will be leaked to the press.
"Oh, Candidate X, I see you took anti-depression medicine after your divorce."
"Oh, Candidate Y, I see you got treated for an STD in college."
The purpose of the digitized medical records is to provide an automated muck-racking system for people who run against the favored party.
Re:Why Is Health Care even in the Stimulus (Score:4, Insightful)
Our economy is broken in more ways than just the financial system. Our Car companies have been mismanaged for years, our healthcare system is derided worldwide for being incredibly expensive and backwater, our education system is a joke.
What we need to get out of any economic downturn is higher per-capita productivity. Health Care has been a big drain on our economy for years, and a distributed automated health records system is long overdue. My Mechanic has better records of the work done on my car than My Doctor. I've seen doctors prescribe to my grandmother treatments that had serious interactions with drugs she was already taking, and treatments that she was simply allergic to.
We need growth and efficiencies, and this is one area where a little expenditure would save a lot of lives. And I hate to sound this crass, but saving lives cheaply is good for the economy.
Re:Why Is Health Care even in the Stimulus (Score:5, Insightful)
No, the problem lies with the lack of availability of credit and the lack of consumer demand. The primary direct cause of that may have been actions in and affecting the financial services industry including the banks, but that doesn't mean that the most effective way of dealing with it is exclusively with policies directed at that industry, in the same way that bad diet and inadequate exercise may be the principal cause of a heart attack, but the best response to a heart attack may not be limited to diet and exercise changes.
Liberals, in fact, were not generally complaining about that. Liberals were complaining that Iraq (not "invading Iraq") had nothing to do with 9/11 (not "the war on terror") and that invading Iraq was directly counterproductive in (not "had nothing to do with") the war against the people who had actually attacked the United States on 9/11, and that contributed to producing more people who would be more easily recruitable by groups wanting to attack the United States through terrorism.
The first half relates to the justification, the second to utility. Confusing different parts of two distinct-though-related criticisms of the invasion of Iraq misses the point of both criticisms rather completely.
That doesn't make sense. The economy is broken. Liberals are proposing a particular way of fixing it that, they argue, apply both to the immediate problem and the longer-term structural problems that make problems like the immediate one both more likely to occur and more damaging to individual citizens when they occur. As you note, what they are doing is directed at the economy, which is where you admit the problem is, not at some unrelated thing. Now, you might argue that the proposals are not directed well to fix the problems in the economy, which would be a legitimate point to debate, but you fail to make that argument, instead making an argument by analogy (though, as noted, a poorly-crafted analogy that reveals poor understanding both of the immediate situation and the one to which an analogy is drawn) that seems to rely on the idea that it is not directed at principal immediate cause of the problem, rather than arguing that it is ineffective at solving the problem. But being effective at addressing a set of undesirable conditions is logically orthogonal to being directed at the events and conditions which contributed to the development of those conditions.
Re:LOL, right he's simple minded. (Score:3, Insightful)
Obama likes power.
He knows which side his bread is buttered on and will serve his masters (none are poor) in order to be re-elected.
Same as all politicians.
Re:Please, get the government OUT of healthcare (Score:4, Insightful)
Isn't it the other way round? Don't Americans by the thousand drive across the border to get their drugs from Canadian pharmacies?
The bureaucracy of the American system is much, much higher than that of the UK NHS (which is no model of streamlined elegance). Just looking at the messaging protocols for the IT systems will tell you that. We don't have to implement half the messages because they relate to billing.
On top of that, the US system is treated as a for-profit endeavour. I'm told that a 15% profit margin is considered to be at the low end.
In the UK we spend only 40% per head what the US does, yet we have universal coverage, flat-rate prescription costs, and no co-pay. Access to treament is based on what is cost effective within the NHS budget, not which loophole your policy manager can use to yank the rug out from under you.
I'd much rather be ill here in the UK, especially if I was poor, than in the USA.
Republicans always talk up the small business. (Score:3, Insightful)
See: Joe the Plumber. Republicans often campaign on small business issues.
Democrats? Not so much.
Re:Thomas Jefferson disagrees with you (Score:4, Insightful)
If you own something then you can sell it.
This right here, ladies and gentlemen. This is the cancer that's killing /b/^H^H^H America.
Re:Why Is Health Care even in the Stimulus (Score:1, Insightful)
That's the dumbest idea ever besides using hydrogen in the Hindenburg. I own a small business, nationalising healthcare would do nothing but raise our taxes for ALL, thats bad.
Re:Please, get the government OUT of healthcare (Score:4, Insightful)
Rich, anywhere. If you are not rich then the UK is better than the US.
Re:Republicans always talk up the small business. (Score:1, Insightful)
Let's see: Not taxing him out the wazoo....Not destroying the currency with $3T worth of pork spending...Not taking away his choice of health care...Not forcing him to unionize...Letting him be free to do what he feels best for his business, not "we're from the govt and we're here to help....
That enough?
Re:Criticisms and a Better plan (Score:3, Insightful)
You do realize that in certain (urban) areas, the vast majority of people can't afford houses with yards? Are you seriously proposing a society where the only places children have to play are (sneaking into) McDonald's play areas?
The premise of your original post was that only the government can provide "free" parks. I pointed out that there are privately owned parks which are also free, and that you're forced to pay for those "free" government parks whether or not you want them and regardless if you intend to use them.
The key difference is, we're all forced to pay for your park. Nobody is forced to pay for the park run by the generosity of another individiual. That's something the big government types like you don't grasp unless you're complaining about the government spending money on something YOU don't like, and only in that case, is the government being abusive. Any time you force people to pay for something they don't want against their will, you're being tyrannical. Government is a tool to protect our rights, not to force your beliefs and priorities onto someone else.
The essence of capitalism is that the owners of capital (that is, the rich) get paid just for owning the capital (being rich).
The rich don't make money for simply owning something, they make money for investing their asset. Land left undeveloped doens't make the owner money. In fact, if there are property taxes, undeveloped land COSTS them money, possibly even faster than the land appreciates.
Currently the US government is around 10 trillion in debt. But what if the US government could save up 30 trillion and what if the government could get a 10% real return on investment? That would be 3 trillion per year which would be enough to fund the entire federal government - no more federal income taxes.
The government's debt problem isn't in how much they tax, it's in how much they spend. We've been living beyond our means for decades, spending like drunken sailors in the best of times and doubling down with borrowed money like a gambler chasing lost money in the worst of times. Proposing even more spending and the government taking on more functions will only further drive us into the hole.
Re:Republicans always talk up the small business. (Score:1, Insightful)
That enough?
That's nice and all, but none of that does jack for Joe until they're for letting the guy practice without a license.