The Electronic Health Record bogeyman

The Electronic Health Record bogeyman

Summary: In the present health care debate, the bogeyman is the Electronic Health Record (EHR). The EHR is said to have magical powers to destroy our lives.

TOPICS: Health

The bogeyman, boogyman, bogyman, boogieman, boogey monster, or boogeyman, is a folkloric or legendary ghostlike monster. The bogeyman has no specific appearance, and conceptions of the monster can vary drastically even from household to household within the same community; in many cases he simply has no set appearance in the mind of a child, but is just an amorphous embodiment of terror. (Wikipedia)

In the present health care debate, the bogeyman is the Electronic Health Record (EHR). The EHR is said to have magical powers to destroy our lives.

These are never explained, but the reality is those most likely to abuse EHRs are insurance companies and employers, because the use of underwriting gives them a financial incentive to do so. Transform the system, remove the incentives, and the bogeyman's ability to harm is lost.

When searching for bogeymen it's important to note whose interests they serve. In most American homes it's the parents' desire for good children who comply with their wishes, the idea being that parents offer protection, and the bogeyman only harms bad children.

In the case of the EHR bogeyman the parent is played by the present health system, the Medical Industrial Complex of insurers, hospitals and suppliers under whose gentle mercies we pay more for less care than citizens elsewhere, unless we're wealthy enough not to count the cost.

All this is by way of Declan McCullagh's latest, which endorses the bogeyman argument while still saying doctors "have been gradually moving in that direction, individually weighing the costs against the benefits and choosing the technology that best suits their needs."

I have two problems with that sentence. First, if EHRs are so bad, why are you taking pleasure in their adoption? Second, based on my own reporting, the sentence is not true. Doctors are not individually choosing EHRs. They are having EHRs pushed on them by hospitals, carriers or both.

What is the real story here?  Politics.

Conservative activists are doing the work of industry in trying, once again, to kill health reform. Opponents of evidence based health care like Twila Brase, a contributor at the right-wing Heartland Institute, are happy to help skewer science by denying it the data it needs to make things better.

And of course, McCullagh offers our requisite Betsy McCaughey sighting. If you really want to trace how this works, nearly every conservative editorial attack of the last week can be traced back to her one screed for the Hudson Institute, which Bloomberg ran as an opinion column.

To McCaughey's credit, however, she is exeedingly transparent in describing her actual policy aim. From the Bloomberg column:

The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. 

A growth industry under which the poor, and increasingly the middle class, have no access to basic care is growth we can do without. If a privacy bogeyman can keep science from playing a role in reform, that's all part of the game.

Topic: Health

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  • Unmitigated ignorance???

    How else can anyone explain Blankie's failure to grasp the concept of PERSONAL RIGHTS regarding not being forced to participate in electronic health records -- which would be a unified database, WITHOUT an opt-out provision??? He is patently WRONG that the only risk is the financial incentive due to underwriting. There are SERIOUS personal privacy issues, and serious discrimination risks involved. This ought to be opt-in, and also should have the option of containment within one's own health provider network, vs. the proposed unified single health record network!!!
    • I disagree

      Discrimination can be legislated against, and
      is. You're in the Google these days almost
      regardless of your belief in privacy, and that's
      a private company.

      If government is to guarantee that everyone has
      health care, and back up your right with my
      money, then we all need to meet some standard.
      And that standard includes having our medical
      records available at the point of care.

      How about this? You opt-out of having any
      electronic medical records (EMRs), and in
      exchange we opt-out of keeping you alive when
      you're sick or in an accident?

      Without access to an EMR, med techs are flying
      blind, and people die. That's the current
      situation -- people are dieing unnecessarily.

      Still want to opt out?

      If you wear a MedicAlert bracelet to warn us of
      allergies to medication, or some chronic
      condition, you should have no problem with an