Wednesday, February 11, 2009

stimulus for electronic medical records = corporate welfare

Part of the 2009 economic stimulus plan making its way through the Congressional "sausage factory" includes money for electronic medical records (EMR).

EMR itself is a good idea. Healthcare industry is horrible at using, er not using, information technology to increase productivity. For example, the practice of some physicians poorly handwriting a prescription that a pharmacist can't read is excessive industry inefficiency, not to mention extreme incompetent arrogance (a deadly combination) for the physician offenders.

However, I don't see why in principle the Fed Government should be paying for EMR, this is straight corporate welfare for the healthcare industry.

To my knowledge, no other industries have gotten such corporate welfare for their IT. I suppose their may be some tax credit, but even so this would be at worst a partial deduction of the cost. Eg if a grocery retailer buys a $2 million transaction information system, they don't pay $2 million less in taxes, maybe at best they get to deduct $200K from their tax bill or some such.

Speaking of grocery retailers, I heard that they are often the least profitable industry in the US, with a slim profit margin of say 3%, which often times is less than that of a regular savings account (depending on the interest rate level). If grocery retailers can pay for their own IT, why can't the super-expensive health care industry?

Perhaps the Feds should just mandate/regulate that EMR must be implemented by say 2014. Or implement EMR corporate welfare as an low-interest loan of sorts. Various healthcare industry participants could be levied a tax to ensure that they pay back the EMR corporate welfare within say 8 years. The tough thing would be ensuring that the healthcare industry doesn't just pass the tax on the consumers. Perhaps health care insurers & pharma companies company profits, as well physician/dentist/pharmacist incomes should get an extra 10% tax for the 3-10 years it takes to pay off this EMR loan.

Another point about EMR, is that the Feds should insist that any software used in the EMR should be completely FOSS (free & open source). This way whoever is paying the EMR bill, Feds &/or healthcare industry, they would be paying only the initial implementation/consulting fee, & a minimal annual maintenance fees. I don't want to see the closed proprietary enterprise software cartel of Oracle/SAP get paid off of this EMR corporate welfare, with their ridic initial license fees & usurious 22% annual maintenance fees. If there is any "functionality holes" in what is needed, the Feds could hire maybe at most 100 of the vast sea of US unemployed IT professionals to develop the missing functionality. If a small software vendor is already working on this functionality, the Feds could give some free IT workers' time in exchange for the vendor's committment to FOSS. Wikipedia notes that several FOSS EMR apps already exist.

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