"EMR, call home"

Can electronic medical records (EMR) save us?

Technology has done marvelous things to better human life. It seems only normal, then, that we would turn to electronic medical records (technology) to help solve our health care spending problems.

Eventually, we might even get there. I sure hope so, but it will take a while – maybe a decade, or two.

Dr. Richard Reece has been reporting on the business of health care for more than 40 years. He informs me that today, about 10 percent of hospitals and a like number of doctors are using electronic medical records. That is a good start.

But there is a huge pushback by doctors, because it is expensive, time-consuming, and is viewed as adding very little to their ability to practice medicine. Before doctors commit thousands of dollars to convert their office and patient records to such a system, they will have to see its medical benefits, or a great deal of savings in streamlined record-keeping.

A second issue, seldom addressed, is that the emerging EMR systems speak but one language – the language of their own kind. That is, they do not speak to other EMR systems operated by other doctors and hospitals. Over time, this should be able to be resolved, but to find the common language and/or the translator that acts as a go-between will be costly, and in itself, create errors and misinformation.

Dr. Reece points out, too, that doctors in one specialty often need to know different information than doctors in another specialty. What is vitally important to the podiatrist, and about which he or she would take pains to record, is of very little interest to the pediatrician (who has his or her own specific needs for patient history).

I don’t write this as a doom-and-gloom commentary, but a realistic one. Reece said, “Someday, I suppose someone will come up with an algorithm to tie all this together,” but it may take 20 years to get there.

In the meantime, the most pressing need is to change patient behavior, in the way they take care of themselves, and how they spend their own health dollars. We cannot hope that technology will offset bad personal decisions.

Politicized health care, the real illness

“You know,” I said to Greg Dattilo as we walked toward the Minnesota State Capitol building, “this is what is really wrong with health care.”

“What do you mean?” he asked.

“Well, we’re going to a legislative meeting where politicians are going to decide the future of our health care system. That’s what I mean.” The Minnesota Health Care Access Commission, chaired by two liberal politicians, was about to hear testimony. Well, it was really about to hear what it wanted to hear to justify further polarization of health care.

When Congress passed Medicare and Medicaid in 1965, it subjected health care to the pressures of elective politics.

Politicians love a void, because they step in and fill it. It’s really a vicious circle. They “solve” a problem and create new ones that they get to solve.

For instance, in 1960, 4.5 million elderly Americans had no health insurance (though they did have health care). In fact, about 22% of Americans went without health insurance, but no one went without health care.

Congress created Medicare and Medicaid and health care spending went through the roof. Congress stepped in to solve the crisis and created HMOs. Double-digit spending ensued. All across America, legislators got into the act, and someone invented the uninsured statistic to prove that politicians needed to do even more.

That bothersome uninsured rate, by the way, has held pretty much steady during the last many years, but it is The Big Crisis of Today which only politicians can solve. Hence, a Health Care Access Commission must meet and decide the fate of our health care system.
Micro-managing health care is a politician’s dream. Tens of billions of dollars are at stake, and interest groups pay big money to get a politician’s ear. The sheet power of even an average state legislator is magnified through their vote on the floor of the house or senate, or better yet (for them), in committee.

What I am looking for are politicians who want to consumerize health care, placing the power of shaping our system into the hands of We the People (what a novel idea; free people making their own decisions about how to live). It takes a Big Man or Big Woman to give up so much power voluntarily, and this is what is really wrong with U.S. health care.

Pollsters tell us that US health care sits atop election year political issues, but not in the way it should. Rather than ask government to back away, American’s misunderstanding of the role of government and politics begs politicians to do more.

Those who have watched health care reform for decades believe that Americans do not have the stomach for government-run health care. Were this true, we would expect a backlash among voters during the next five years, as Congress, a new president, legislators, and governors – politicians – work to solve our current crisis. I worry about this, because I see that few people understand how dangerous and unhealthy such a system will be. What follows after the imposition of a government health care system? Decades more of politicians deciding our health care future.

Politics is what is really wrong with US health care.

They say this is killing us?

The last few days brought profound news to the health care reform movement. Sure to change everything.

First, we learned that a can of soda a day causes heart disease. This we learned as news anchors soberly warned us as we watched images of very obese people wander across the TV; most of them sucking down a soda (even diet soda) along with a Big Mac or DQ Blizzard. Right. Sodas cause heart disease.

Second, we learned that being fat is something you catch from a friend or family member. Now the Authorities That Be (ATB) claimed that just living or hanging with fatties will make you fat. Once again, there were those TV images of large people grazing at the buffet, and washing it down with a soda. But it's not their fault. It's just that they hang with the wrong people.

Third, today we learned from the ATB at Childrens' Defense Fund that health insurance deters crime. Yes, that's what they said! If we just get all the children insured, it will reduce the crime rate. Does that mean that most crimes are committed by sick kids without insurance. I'd love to see that study.

My college statistics professor's first profound statement was, "Correlation does not prove cause." Do they still teach that?