Thursday, February 24, 2011

No Beating around the Jonathon Bush

Jonathon Bush, CEO of Athenahealth, whose firm supplies software to physicians so they can collect higher fees faster, is a Cambridge-Massachusetts-based maverick. Bush does not mince words about his thoughts on the dominance of Harvard-thinkers in the government’s faltering efforts to oversee and micromanage EHR implementation.

Here a few excerpts of his attitude towards top-down government software control from a recent interview with Fiercehealth Care IT. I find Bush's language refreshing but rambling, Nevertheless, he effectively gets across his irreverent ideas.

Of Washington elites out thinking the market

“ I don’t like the idea of a bunch of guys in Washington trying to out think a thousand companies that make EMRs on what they should do--they need to go the other way. They need to think less. They need to think a ton less and let the market think more.”

Of Harvard people knowing more than the average person

“The whole 'top-down, our-people-from-Harvard-know-more-than-the-average-person-and-we-will-make-the-average-person-become-better-like-us' philosophy... I just don't want to be enslaved. I eat vegetables and I work out and I hug people and I'm a good listener and I'm a good dad and I'm a good husband...great! But anyway, I still don't want to be enslaved.”

Of the “Ghettoization” of Innovation

“ I just believe that less good ideas emerge when people are enslaved. They can't talk, they can't experiment, there's no range of motion. Healthcare has literally ghettoized crazy ideas. They do not let people do crazy ideas. What if a hospital paid a doctor $5 every time a doctor sent a patient to them completely electronically from any system. Jail term. Minimum, one-and-a-half years.”

Of the Top-Down Crowd Staying in Power

“Even if the top-down types stay in, that will result in no innovation other than wonderful ideas coming out of Washington, and that will cause the cost of healthcare to eclipse our ability to pay for it more quickly. It's happening now, but it'll just continue. And then there will be a period of time where the government simply can't fund the all-you-can-eat buffet. So they'll put wait lists and queues and they'll do the things that other nationalized health systems do, which will then cause demand to rise up and out of the government and you'll see just like in schools, a private sector emerge on top of the sediment of the public sector.”

All of which leads to this irreverent verse of mine on EHR elitism.

EHRs and “Meaningful Use”

"What can I say about 'meaningful use' that hasn’t already been said?"

Neil Versel, “HIMSS Live,”The Health Care Blog, February 21, 2011

Dear Mr.Versel:
This concerns “meaningful use,”
and its verbal abuse.
Here is something new.
aimed at the top-down few.
I do not like EHR-use mandated as “meaningful.”
It faults EHR non-users in a fashion demeaningful,
as a sub-species not worthy of full payment.
It exalts users to the point of being preeningful,
as heroes deserving full-cost defrayment.
“Meaningful use” is not an incentive.
“Meaningful use” is a disincentive.
“Meaningful use ”is left-leaningful.
It justifies federal policies interveningful,
As if only EHR- users were esteemableful.
It clears a path to government enslavement,
a road to serfdom under federal pavement.


Government may think it knoweth,
What is best for most of us,
But the market bestoweth,
What most of us wanteth.

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