Monday, August 24, 2009

Transitioning Health Records

The two party system seems to bring the worst health proposals to the forefront.

This happens because the core of both parties have a stake on centralization. The insiders of the Democratic party want highly centralized big government. The insiders on the Republican side want highly centralized big business.

Newt Gingrich's ideas about health care reform appear on Gingrich's ideas of reform center on technocrats creating a highly centralized technocratic medical records system that will given big medicine a decided edge over small medicine. Our health would somehow magically improve as the technocracy completes the process of weeding small providers out of the system.

I believe that improved handling of medical records is key to health reform. However, I am not a fan of Mr. Gingrich's technocratic vision.

As I have explained in previous posts, the problem with health records is that the records are in the hands of third parties. Our health records follow the money. Since we pay for care with third party pools, our records end up jealously guarded in the hands of these pools.

My solution to health record reform is to create the paradigm where individuals own their health records. Individuals would use a new class of service agents called health advocates. The health advocates would help people budget for their care and would create a repository for health records.

The health advocate is a clerical position. They would number in the tens of thousands all competing for your business.

This class of health advocates would create a paradigm in which there would be a rapid evolution of medical record technology. After all, which health advocate would you choose for storing your health records? People would choose health advocates based on their ability to guard records from prying eyes while making the records available to health care providers when needed.

Transitioning to a system of self funded care with independent health advocates would be a little bit like the internet. The rapid evolution that we saw in internet technology is the result of hundreds of millions of people with computers anxiously working to get connected.

A government of technocrats could not have devised as rich and robust solution.

What we need for rapid innovation in medical records technology is a structure that allowed indpedent evolution of a system.

The top heavy technocracy favored by Gingrich would not be as robust as a system that would evolve in a paradigm where individuals owned their records and sought private technology to help them make the most of their records.


Scott Hinrichs said...

Indeed, when the Internet went from being almost exclusively part of the government sector to being open to the public, many of the Internet's techno-geeks were appalled at the intrusion of private and market-based uses of the platform. They felt that these greed mongers had soiled their domain. I suppose that many of the health technocrats would feel the same way if health care went --- shall we say --- more open source.

y-intercept said...

I had forgotten about the technocratic backlash to both the PC and the internet.

The Health Reform/Insurance debate is exactly the same thing. The insurance companies and government are united in a technocratic vision of health care.

They would lose handsdown if people figured out that the real debate is a struggle of personalized care v. a technocratic vision.