Wednesday, December 16, 2015

Compassion Is Not Enough and Big Data Is Not The Answer

In watching health reform debate play out, I have concluded compassion is not enough and big data is not the answer to revitalizing and improving the health system.

The root belief behind ObamaCare was that somehow, after Americans had seen would the law could do in reducing the number of uninsured and high costs of care, they would come to their sense of compassion and progress towards single-payer system, which the Democratic party and its liberal wing had dreamed of for 100 years. ObamaCare would follow the path of Medicare and Medicaid and the VA because of compassion for the old, the poor, and veterans.

Yes, there would be problems because of resistance to government mandated controls, bureaucratic complexities, narrowing of individual choices, disruptions of the medical-industrial special interests, health information glitches, and among antediluvians and troglodytes living in caves with their primitive belief systems and complaining of the passing of the golden age of medicine.

These obstacles would become overcome through the application of algorithms, apps, artificial intelligence, and analysis and unraveling of great truths lying in wait in the reams of big data being accumulated and stored in the Cloud and other massive data reservoirs. Cold hard computer-based logic would prevail and replace human intuition/

A hard care core of algorithmic truth would drive higher-value health care, would tell what treatments worked and didn’t work, and who and what and how much to pay on the basis of outcomes.

Once the data was known, the system would bundle, massage, and manipulate the data to pay for episodes of care, for the continuum of care from womb to tomb, and would replace all those individual transactions that occurred in a piece-meal, patchwork, fee-for-service, episodic, hopelessly archaic system.

We would focus on prevention rather than sickness. We would keep people healthy before they left the government barn to wander unprotected into the unaffordable medical-industrial wilderness.

Health Information Technologies would allow doctors and other health professionals, led by data geeks and gurus , to function as teams in large organizations, to provide the best outcomes for the buck, according to guidelines from above.

All would be well, all would be swell, for experts would control all the variables, would dictate the cost of each health care transaction, and patients and doctors would be fully engaged, would carry their electronic records in their purses or wallets and on their iphones. They would eagerly l share that information with each other and their doctors, The would behave themselves by monitoring their weight, vital signs, and oxygen levels, shedding weight and bad habits along the way, and would work together for the Common Good and for Good Health for All.

The problem, of course, is that this rosy scenario hasn’t worked well so far and may not, given the individualism of human beings, their myriad wants and needs, and their desire to innovate and rise above the common herd.

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