As an add-on from yesterday: http://change-congress.org/nelson/.
It’s amazing how much really goes on in the background regarding regulation and government administration. If it were all totally exposed, I think we’d have a completely different national discussion. With respect to the news and information we hear about our healthcare system, I think that just about everyone, at some point has said “this makes absolutely no sense” regarding healthcare. For instance, if our healthcare really is that bad and lags behind the rest of the industrialized world, then why do people from all over the globe fly here for their care?
My hypothesis is that every time you run in to this type of situation/sentiment – when you feel like something isn’t adding up – that if you dive deep enough in to the specific issue that you’ll dig up some sort of special interest conflict. Just a hunch. The business of healthcare is a powerful motivating factor in the behind-closed-doors discussions in healthcare reform.
A semi-relevant example is the adoption of electronic health records (EHRs) and health information exchange (i.e. how we’ll share electronic records between hospitals, practices and regions). In one of the projects I was involved with, a hospital refused to join the local health information exchange effort. After some digging and prodding (and off the record) they told me that they would implement the exchange and necessary EHRs because it would highlight the number of duplicative tests they run each year. In other words, why would a hospital spend a couple million to update their EHR and join the information exchange if it was also going to permanently cut millions from their revenue stream? The incentives are misaligned and we all, as a result, pay for it. But how often do you hear this talked about in public?
And, why wouldn’t politicos adhere to their special interests? If they don’t listen to those interest, this can happen to them as it did in Albany. Obama’s going to need a lot of firepower to get things done in healthcare. I’m wondering how we can get around these special interest issues via traditional business methods.
I’d have to think that inherently, whenever decisions are made for political gain and favor one business over another that a whole new opportunity is created out of the engineered agreement and inefficiency. By definition, those rules artificially favor one party over another, which in turn creates market inefficiencies. Clearly my objectivist side is coming out somewhat here. Any thoughts as to how we can harness this for change?