Comments on: Why We Are Doing This Health Care Reform All Wrong

By: Vijay Goel, M.D.

Vijay Goel, M.D. — Thu, 27 Aug 2009 22:13:59 +0000

Peter,
You hit the nail on the head…until “insurance” becomes insurance and not a wealth transfer mechanism, we won’t see the accountability we see in any other retail space (with differing value plays and other things that will improve quality and convenience).

There’s a reason why Laser eye surgery and cosmetic surgery got cheaper and better as the rest of health care continued to bloat.

Check out HealthShoppr.com if you want to see what the retail purchase of health appointments will eventually look like…its very different than the highly variable appointment focused on billing codes that we see today.

By: Allen Stern

Allen Stern — Wed, 26 Aug 2009 22:43:08 +0000

Thanks for your thoughts Francine – I will certainly check out your writings.

We can’t try to use legacy systems – the crap that worked in 1980 won’t work today.

Let’s start over. Sometimes no matter how much bacon you put in a dish trying to fix it, you may have to just scrap it all and begin with new tools and new ingredients.

Look into what Walmart has been able to do to their suppliers – do it Walmart’s way or get out.

By: Allen Stern

Allen Stern — Wed, 26 Aug 2009 22:25:19 +0000

agree with you but… if we fix the tech first, then we can do a better job on the less govt and more comp. otherwise we will have to do it later and it will be even more of a mess.

im suggesting that the tech be the foundation – let’s build it good and strong and build the floors of plans above the foundation.

By: francine hardaway

francine hardaway — Wed, 26 Aug 2009 22:25:05 +0000

Technology is part of the issue. National health IT groups have been working on standards and protocols for years, but can’t come to agreement and finish the job of making everyone’s legacy systems communicate securely. The claims payers have big industrial databases that talk to the hospitals, but only on the claims side, not on the records side. And the marketing leading EHR software products all suck (crummy UI, hard to train, big deployments, blah blah blah) which means hospitals and doctors are loath to adopt health IT on the records side. And that’s why on the front end it isn’t automated. If the automation products were good, believe me, they would have caught hold already. But the people who developed them really don’t understand the complex nature of health care workflow, overlayed with HIPAA regulations and competing insurance providers. On the money side, the software is there, but on the provider/patient side, not yet. Check me at http://ushealthcrisis.com and you can see what I’ve been writing on this and also posting to HuffPo.

By: Peter

Peter — Wed, 26 Aug 2009 21:24:38 +0000

Allen,

I’m all for technology but do you really believe that IT is a big part of healthcare reform? If you do, I’ve got a bridge for sale.

The problem is health insurance. We don’t have it.

Imagine you’re in your 40s, drive a Honda Civic, sport a perfect driving record and have never had a major auto insurance claim. Do you want to subsidize the 20 year old trust fund baby who drives a Ferrari, has 5 speeding tickets in the past 5 years and just had an accident? Of course not, but that’s essentially what takes place in the healthcare arena and with government wanting to increase demand and provide bulletproof coverage to everyone, it’s only going to get worse.

What we need is less government and more competition. Until you have that, technology won’t make a dent.

By: Allen Stern

Allen Stern — Wed, 26 Aug 2009 20:25:06 +0000

I’ve heard of the NHS but c’mon – let’s get it done. All of us need this. But instead we will get some worthless rehab of health care that won’t help a damn.

By: Allen Stern

Allen Stern — Wed, 26 Aug 2009 20:24:06 +0000

Thanks GS – I thought of the card but figured it would be too much hassle to have to carry it all the time and so forth. I think it would be easier if it was centrally managed.

By: Good Start

Good Start — Wed, 26 Aug 2009 19:03:38 +0000

Keep everything on a credit card sized flash drive and put the security responsibility with the owner. Like you scoial security card. If the card is lost they can request another one from the company you choose to store your info with.

By: Darren

Darren — Wed, 26 Aug 2009 19:02:24 +0000

The problem has yet to be solved in the UK with a computer system. The NHS have been trying to implement something like you mentioned but its just such a massive task that they are faling with it.

I can’t imagine any company being able to do it the states, I think that there would first need to be some open doc formats and protocols so that there is an open system for firms to work on.

The NHS has gotten some knocking in the states but its better than the states system.

By: Jennifer

Jennifer — Wed, 26 Aug 2009 18:31:06 +0000

don’t forget the iphone and other mobile apps