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Stimulus Avoids Serious Solutions For Health IT
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."
A little too opinionated in TFS. What news is this post actually trying to tell us?
If you can read this... 01110101 01110010 00100000 01100001 00100000 01100111 01100101 01100101 01101011
Sounds to me like all objectives were met.
As Richard Nixon said, "Solutions are not the answer."
What?
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.
I read the article.
The guy's central point is that corporate systems are bad, and open, federally funded systems are good, with the further implication that government is good, and corporations are bad.
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". You own as much of something that is public as you do a car by walking past a Ford factory. Ownership at its most practical is, who controls it, and you really don't have any control over the daily disposition of property managed by the government. In effect, when you argue for publicly owned health care, or publicly owned anything, what you are really arguing for is to pay your own taxes to buy something for some administrator either elected or appointed or a lifelong civil servant. In any case, its not you.
There's a lot of good reasons to adopt open source in health care. For one, the creation of a single standard document for representing a medical history would go a long way towards enabling applications across the medical spectrum to coexist.
This will be easier said than done.
A good example is that there were some efforts to do this in insuring property for catastrophic losses - a build is remarkably complex for insurance purposes, but that specification has essentially died by its own complexity. The industry largely and thankfully essentially resorted to using SQL Server copies of the leading vendor of property and casualty software for CAT. Is it proprietary? Yes. But, it allows all the insurers to exchange books in a way that is relatively practical and easy to use.
The moral here is that its not good enough to say that a standard is open for data interoperability. Ease of use and ease of transportability becomes paramount and if open source wants to drive health insurance, it stands to reason that there needs to be a pervasive application that goes along with it.
This is my sig.
The people building health information sharing networks have taken this into consideration and have designed "translators" for all the health record formats.
I'm peripherally attached to the team working on the first state-wide health information network (in Maryland), so I can tell you a lot of these problems have already been solved long ago
... I thought for a second that Slashdot had again updated its interface. Then I realized that this is a random internet rant. Really, not much different from a NYT or WSJ rant, but those at least pretend to have outside expert sources.
Yes, I would like Medical institutions to use GPL'ed software. Yes, I'm disappointed that the government still doesn't think that software freedom and dumb pipes are the keys to a networked future. But am I surprised? No, not really.
Those who can, do. Those who can't, sue.
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.
Here's the last line of the rant/article:
This time it is no different: 'All Electronic Medical Record software purchased with federal funds must be licensed under the Affero General Public License version 3.' This guarantees the requisite transparency. This needs to be written into the law yesterday to ensure our nations Health IT future is a bright one.
So then, not knowing what the Affero GPL is, I go to wikipedia (yeah, I know, whatever, most of the time Wikipedia is good) to see what the heck this version of the GPL is. Apparently it closes an ASP loophole in the GPL. Anyway, while I'm reading that, I see that one of the authors of the Affero GPL is RMS, the other is Henry Poole. Henry Poole created a company called Affero which apparently "is a service which enables personal ratings and donations to causes on behalf of individuals who freely share with others."
Ok. So the author is upset that the government isn't using Open Source software (I am assuming the Affero.com webpage is free, didn't look) and wants them to...because of security concerns?
Is that it? Because the blog/rant/article reads like an angry rambling rant to me. Not trying to troll, just saying if this guy wants to be taken serious, stop with the "people have been telling me to tone it down" rhetoric. Post the facts, not emotion.
Sent from your iPad.
The National Institutes of Health just announced the NIH Challenge Grants that is used for doling out stimulus money to small projects. In it they identified several high-priority topics, which if you look through, you will find includes Information Technology for Processing Health Care Data.
So there certainly is money available for this type of work. And for those not familiar with grant funding by the US government, the NIH is the single largest grant provider for the life science in the US.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
At least down here in Texas, any grant money funded through DSHS as well as HRSA at the federal level have specific sections that state that any system proposed that makes use of the VistA system will receive higher consideration to getting funded above any proprietary solution. Unfortunately the available solutions are still very high risk and many hospitals and other healthcare entities really don't like the look and feel when compared against proprietary browser-based systems.
Unemployment would quadruple overnight if 90% of the "Medical" staff at a hospital were no longer needed to do paperwork for the insurance companies.
Hell no, make more paperwork not less, the country needs jobs.
Nullius in verba
Medical care, on the other hand, has an obfuscated price structure. Do you want to know how much something will cost? You can't find out. There's a price for the insurance company which is a trade secret, a cost for cash paying customers, and another cost for government. What really pisses me off is that there's a price to pay in cash, assuming the doctor won't cut you a discount, is MORE than the insurance price! The insurer will take their sweet ass time to pay the doc (I've seen over a year!) and yet, if I pay NOW, it costs more! I tell you doctors are pretty stupid when it comes to business!
Do you know who the true customer is? The one who pays. That's right! The insurance company is the REAL customer! They're the ones that the docs answer to: not us. That's why health care is so over the top! And the other thing is keeping folks alive for another month or so. My wife had an 89 year old patient who had a heart valve replaced. The doc who did it said that the patient will be gone in a couple of months because he was too old to handle the surgery - at a cost of tens of thousands of dollars to the tax payer. Why are we spending so much money keeping people who should be dead alive for a couple of more months? I'm not suggesting a Soylent Green scenario, but we have to face the facts of life that we can't live forever. Sure the doc could be wrong and that old guy could live to 100, but the odds are, he'll be gone and our health care costs continue to spiral out of control. I'm sorry for being callous, but I have a real problem with spending thousands and thousands of dollars on people who should be dead: they're too old, they lived hard (smoked, drank, fucked everything in sight, etc...)
Nope, IT is not going to help anything. We, as a society really need to reevaluate our priorities and and how we pay for our care.
Chuck Norris doesn't need to stimulate the economy of a nation of 300+ million people. He just stands there and the economy stimulates ... er, nevermind.
Being someone that works in health IT, things are going in the right direction, much to what this article says. There are certifications for the software that state to be certified, compatibility must be included in the software including HL7 (Standards for electronic interchange of clinical, financial, and administrative information among health care oriented computer systems) www.hl7.org. The main certification for the software is CCHIT www.cchit.org. Our clinic has been on an EHR (which is CCHIT certified) for over 4 years. It began as proprietary software, but now with a little help from the software vendor, works very well. I will agree most started out not wanting to share data, but that was only because sharing the data was not a thought back when EHR's were started. PS - Just my opinion, most are now called EHR, Electronic Health Records. :)
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.
I agree and disagree with you! :)
You are SO right that the whole BUSINESS of healthcare is rotten because of exactly the picture you drew - well drawn.
However, I also disagree that IT is not going to help anything! Quite the contrary, IT, BETTER IT, will definitely help Healthcare out of the stoneage that it's at. When you can integrate better you can complete better. Offerings like carol.com are the tip of the coming iceberg unless the Obama Stimulus melts them. IT can certainly help bring transparency, cost-savings and competitiveness, but not alone no.
be0wulfe
The privacy laws aren't anywhere close to where they need to be before this step is taken. Your data is going to be stolen/lost and resold. It is only a matter of time until it ends up in the hands of off-shore brokers who are beyond the reach of US "regulators".
With all of this information sharing, where is the protection for pre-existing conditions? People who have paid insurance their entire lives, then change jobs or move out of state and are denied coverage. Maybe because they simply forgot to disclose some conversation or question they asked their doctor. Humana applications go back FIVE years and they want to know everything you've ever discussed or asked your doctor about.
It is too easy for insurers to deny coverage in order to pump up quarterly profits.
Those issues need to be solved... along with the issue of who owns "my" personal information.
I read all the way through this looking for a single line of content and found none. The author seems to be demanding that it be legislated that all health IT software be licensed under some obscure variant of the GPL that he personally favors. Regardless of what you think about Free software this point of view is completely bananas and makes no sense whatsoever.
IMHO, the only action the government actually needs to take is to mandate consumer access to health records in a standard format. It matters not which format or how good or bad it is. The minute universal access to health records is guaranteed in a fixed format there will be a health IT boom like never seen before as every existing and thousands of new companies spring up to support it, not to mention hundreds of open source offerings. The only thing the government should fund is an open source reference implementation that will kick things off and set a baseline for others to follow.
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?
He put his boots up on the table and made a face. "The sig," he smirked. "You can waste your life in search of the sig."
But you believe Obama really cares about helping poor people.
Simpleton.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
Ever thought of capturing data already generated by most of us who exercise? Why? To create a health platform with already existing technologies and allow those in better shape to pay lower insurance premiums, if any. This implies sharing information which yes, can be sensitive, but with proper regulation from Congress should not go astray. I am actually doing this experiment in (not the USA) but Spain, and of course I get NO support from insurance companies so far because as you all agree they have no interest in innovating given they have hoarded cash for decades without any questioning from the general public. But, slowly bite after bite I am creating a database that will be open and available to all insurance coÂs that will then have to lower premiums to thos e who are healthy or otherwise they loose the client. No need to invent anything today. Just apply what we have, which is far too much in terms of IT and R&D in this HIT world. ;-)
It sounds like you're being ignored because you're coming off as bombastic and shrill.
I have no doubt that you feel passionately about patient care, open source software, open standards, EMR and the range of other issues that come into play, but I also get the sense that you're unlikely to change your position or find a middle path, given that large healthcare companies already occupy a lot of the thought-space. As I listen to you, I get the sense that you see the pool as having already been peed in, and made unfit for you at the outset.
First: Open source software is great for some things, but when it doesn't work, you have nobody to sue.
As for the assertion that healthcare IT companies get their certifications because they have "purchasing power", I fear you are misled. Getting your software to meet the certification requirements, and doing that safely, securely, and in such a way that privacy is assured, is a very long and complex process that takes hundreds of thousands of engineering hours over the course of YEARS. It doesn't come by writing some check. There's a lot of hard work, and a lot of testing and evaluation that takes place. Only the big players have the resources to do that, and do it quickly, admittedly.
The notion that performance can only be judged by having non-proprietary EMR is also a red herring. Clinicians and administrators are able to gather and assess their own metrics to ascertain the quality of adoption and performance. Granted, open (and secure!) EMR standards are desirable and we're not there yet, but the lack of open standards at this time is no direct impediment to assessing performance of Healthcare IT at the hospitals, clinics and offices where it is being used.
I hope that you continue to shake things up, and I have a feeling that you will.
.. pa-ra-bo-la, pa-ra-bo-la, 2 pi R, 2 pi R, where's your latus rectum, where's your latus rectum, 2 pi R
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.
Page 488 of the ARRA:
(b) STUDY AND REPORT ON AVAILABILITY OF OPEN SOURCE HEALTH INFORMATION TECHNOLOGY SYSTEMS.
(1) STUDY.
(A) IN GENERAL. - The Secretary of Health and Human Services shall, in consultation with the Under Secretary for Health of the Veterans Health Administration, the Director of the Indian Health Service, the Secretary of Defense, the Director of the Agency for Healthcare Research and Quality, the Administrator of the Health Resources and Services Administration, and the Chairman of the Federal Communications Commission, conduct a study on -
(i) the current availability of open source health information technology systems to Federal safety net providers (including small, rural providers);
(ii) the total cost of ownership of such systems in comparison to the cost of proprietary commercial products available;
(iii) the ability of such systems to respond to the needs of, and be applied to, various populations (including children and disabled individuals); and
(iv) the capacity of such systems to facilitate interoperability.
(B) CONSIDERATIONS. - In conducting the study under subparagraph (A), the Secretary of Health and Human Services shall take into account the circumstances of smaller health care providers, health care providers located in rural or other medically underserved areas, and safety net providers that deliver a significant level of health care to uninsured individuals, Medicaid beneficiaries, SCHIP beneficiaries, and other vulnerable individuals.
(2) REPORT. - Not later than October 1, 2010, the Secretary of Health and Human Services shall submit to Congress a report on the findings and the conclusions of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Secretary determines appropriate.
I'm planning on using this to justify why we're applying for ARHQ research funding for implementation of a non-CCHIT certified product... we're just trying to help them research open source options. ;-)
Don't you wish your girlfriend was a geek like me?
As a Canuckian who realises that we already have two- or three-tiered health care already, despite all the politicians who deny it (a base level, like the US's medicare, but a bit more pervasive; another level for those who can afford extra health insurance above that; and yet another level for those who get health insurance from their employer, none of which are unlimited health care options), and can't imagine a purely government-run system working pretty much at all, I'll just point out the difference for you: it's a matter of who is making the calls on whether the procedure you want/need is covered. In the case of publicly-funded health care, it's the bureaucracy who calls the shots: people who are beholden only to their next level of management, and the overall budget they've been assigned by the government. An arbitrary line is drawn that weighs cost and perceived lifespan should the procedure be done, and if you fall on the bad side of the line, you're denied with basically no recourse.
In the case of private, for-profit health care, there is an obvious bias toward profitability. It's a delicate line to toe, because if you make an obviously bad decision, you'll end up in court and lose all the profit and then some from that customer, and you'll also get bad PR, which hurts profitability. The former is easier to deal with (bury the plaintiff with your corporate lawyers), but the latter can be a bit more difficult with plaintiffs that show a backbone. Of course, there's the obvious way around both: deny every claim to start with, and pay out all claims that appeal. As long as that doesn't get out, you'll probably pay out next to nothing, with few lawsuits and little in the way of negative PR.
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.
See: Joe the Plumber. Republicans often campaign on small business issues.
Democrats? Not so much.
Blar.
This article is not in any dialect of english that I know of. Can anyone out there translate this for us?
I'm a Programmer. That's one level above Software Engineer and one level below Engineer.
even if making the program was contracted out. The public deserves that kind of accountability, and other corporations deserve the ability to compete they'll only have when it's not a proprietary system.
I recently got delayed in an airport, and sat next to a Canadian doctor.
The discussion led to what I work with and hence Open Source. He said that doctors in Canada use open source software. So I looked it up and found OSCAR which is indeed open source.
No proprietary lock-in for formats, no vendor lock in, and minimal costs.
2bits.com, Inc: Drupal, WordPress, and LAMP performance tuning.
>and yet, if I pay NOW, it costs more! I tell you doctors are pretty stupid when it comes to business!
I do not think anyone would disagree with you on this one, but think about why it does cost more to pay cash. I'll give you a hint: many insurances still pay a percentage of billed charges, and any drop in billed charges = a drop in collected charges.
>I'm not suggesting a Soylent Green scenario ...
I think the problem is that, as a society, we have not decided who gets to live and who does not. Life is about probability, and medicine is no different. The real issue is value for the risk. In other words, if my probability of living 3 more days is one out of a million, but it costs me $0, them why not risk everything? Not my money! But what if living another 6 months, cost me $10 million? Is it worth putting several generations of my descendants out on the streets? Maybe, maybe not. Now the next question would be, what is the magic number where value and probability intersect? Once we decide that, as a society, I think we have our answer. No, we will never get the answer, and that is why we are in the mess we are in.
Frugal Americans buy their meds from Canada. The Canadian system got very good prices by threatening to steal the drugs (ignore the patents) unless they got them at cost. Same as your national health system did. 'It's good to be a sovereign nation.'
Rich Canadians get health care in the US as they avoid the wait and/or denial that comes from government funded care. (You have that too, Your super rich come to the USA as well.)
One question: Where would you like to be if you were a 60+ year old that needed a kidney transplant?
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
We handle everything we make without HL7. But we don't make everything. So we use HL7 to talk to the stuff we don't make. So yeah. There's a standard, everyone who feels like staying in business uses it, and it's not even hard to use. What's the author of the article whining about, anyway?
HI, MY NAME IS ISAAC.
Careful there good sir you almost come off as a HIT Vendor sales critter.
HL7 is a best a recommendation. It's entirely inconsistent in implementation.
All hail the extremely abused Z-segment.
Just because everyone in HIT uses HL7 doesn't mean it's either good or a standard.
With all due respect.
be0wulfe
Spasmodic cynicism. I'm sure none of the IT providers benefitting from this are having any trouble at all. And I doubt this will buy us a standardised, open, or interoperable system. I reckon we should just be glad they hustled this through so fast only a scant 8 billion extra went to buy local votes. The failure of which I speak is the overall system inefficiency, which seems to be designed around cash-extraction rather than service. I, for one, would like to move away from systems that have already demonstrated their inability to provide solutions.
The cost of that cleanup, of course, will be borne by taxpayers, not industry.
I'm not from the US but I understand what the US euphemisticaly calls a health "system" is farked. Your sig seems to describe the overall situation very succinctly.
And did you exchange a walk on part in the war for a lead role in a cage? - Pink Floyd.
Rich, anywhere. If you are not rich then the UK is better than the US.
I thought TFA was a bit rabid, like a lot of you.
Then I saw this NYTimes article about how WalMart will be feeding at the stimulus trough by selling a Microsoft-based EMR system.
That's both scary and ironic. The ironic part is how WalMart will continue to not provide health insurance coverage for the poor minions it pays minimum wage to install this stuff.
Forget EMR - data is already collected in detail on most EMS runs in the nation. Reference http://www.nemsis.org/
What really pisses me off is that there's a price to pay in cash, assuming the doctor won't cut you a discount, is MORE than the insurance price! The insurer will take their sweet ass time to pay the doc (I've seen over a year!) and yet, if I pay NOW, it costs more! I tell you doctors are pretty stupid when it comes to business!
While I have no idea if the practice is universal, my mother works as an insurance coder for a doctor's office and I know for a fact that in all the practices she's ever worked in (3 over the last 15 years), the exact opposite of this has been true. If you have insurance, they'll bill at a higher rate because they know that the insurance will pay up (and sometimes they'll even bill the insurance company for what they can get and so long as they get back a reasonable amount they drop the remaining unpaid portion of the bill rather than charging the patient anymore). If you're paying out of pocket, they'll drop the charges down considerably because they know that an individual has more budget constraints and they're more likely to get paid at all if they keep the cost lower.
"People who think they know everything are very annoying to those of us who do."-Mark Twain
I work in the HIT industry, but I don't particularly care for it, so hopefully I'm a mix of informed and unbiased on this one. There are two types of things to consider as "open source" for HIT. The first, which is what most of this is discussing, is the core software package. This being open source wouldn't really work. For one thing, that would _eliminate_ jobs, which is a rather backwards way to write a stimulus package, and a more important issue, the complication level would be such a hindrance. That being said, we're still in the fledgling years of EMR. It would in no way shock me if, say, ten years down the line, some hospital IT worker sits down with some friends and starts an open-source project. It's fairly rare for open-source to precede commercial, as open source projects _tend_ to copy commercial ideas. Even after that, I would doubt that hospitals would go clamoring for the open source. Professionals still tend to use commercial projects over open-source ones. I alluded to two types of open source possible. The second form of open source you could refer to is with EMRs themselves, that being the ability to pass information from one system of proprietary software to a different system, so that that patient care isn't hindered by a patient going to a different hospital for some reason (usually emergency). I can't speak for other companies, but I know mine, which is one of the larger ones, is working on this fairly actively. So, yes, I understand the "open source good company bad" thought, I just don't think it can be universally applied.
Unless you fall into one of the categories that the English national health has decided is not worth treating. (like over 60 needing a kidney)
If you are employed and/or insured then the US is better then the UK.
Granting it can be hard to get treatment from the insurance company, it is impossible to get from the government once they decide the answer is no.
If insurance companies went too far everybody would take their business elsewhere.
What did you do when the nation health went too far?
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
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.
Yes, I'm so glad this can't happen now. So is Britney Spears.
Paper charts are just as vulnerable as digital records, and moreso in some ways. Get yourself the right kind of lab coat and an ID badge that will pass casual inspection, and you can probably slip into the chart room at most major hospitals. From there, if you have the patient's medical record number (that you saw over the shoulder of the doctor as they walked out of the patient's room), you just pull their chart and use your camera phone to take pictures of all the juicy pages.
The only way in which paper charts are more difficult to access than electronic ones is that they're bulkier and harder to copy. This is a detriment to treatment as well as a "security feature."
Have you ever requested a copy of your medical records? They can charge you a "reasonable fee" for duplication, which can be as much as a couple bucks a page. If your entire chart is 50 pages (and for a condition with a long treatment history, that's totally in gamut), that adds up fast. When records are digital, many clinics routinely hand the patient a copy of the doctor's notes and findings on their way out.
Don't you wish your girlfriend was a geek like me?
One question: Where would you like to be if you were a 60+ year old that needed a kidney transplant?
At the top of the transplant list. But at 60 years old, I'm going to get deferred for younger, healthier people better able to tolerate surgery and with more years of life left. I may luck out, though, and a kidney may come along that matches me better than those younger, healthier people above me.
If I'm in the US, I may be able to bribe my way up the list or to buy a kidney from Asia, *if* I have the money. Of course, if I have that kind of money, it doesn't matter where I am, I can go where there's a kidney for me.
Don't you wish your girlfriend was a geek like me?
"...the nation will spend $30 billion on Health IT..."
Couldn't people just make medical reports with vi and latex? That would be cheaper I think.
Do you have any idea how much it would cost to teach all the doctors to type, though? ;-)
Even the "free text" EHR solutions I've seen have a prompt system that saves folks from doing most of the typing. Which is good, because our Chief Medical Officer still prefers plotting out his schedule on blank paper with a ruler and pencil.
Don't you wish your girlfriend was a geek like me?
If insurance companies went too far everybody would take their business elsewhere.
And where exactly would that be? I ask because they have already done that, yet no magical solution seems to have appeared. But maybe we should all just go back to Linus' pumpkin patch and keep waiting...
What did you do when the nation health went too far?
Um, the ballot box?
You will not drink with us, but you would taste our steel? - Walter Matthau, The Pirates