Blame the patient first

For some time now IBM has been showing off a report it calls Healthcare 2015.

Its business aim is to support Electronic Health Records, interoperability of systems, and to encourage innovation.

But in trying to win over professionals to its view, the authors go to extraordinary lengths in attacking patients.

Consumers are told to become smart shoppers, they're told to support new models of care based on prevention, but most important they're told to straighten up and fly right.

• Learn about health and take responsibility for living a healthy lifestyle.
• Create and maintain a Personal Health Record to consolidate relevant, accurate clinical and health information.
• Document advanced directives.

This is the kind of talk no politician could get away with. Americans are fat, lazy, passive and they live like pigs.

Maybe. Here's the paper's conclusion about what societies as a whole should do:

• Make realistic, rational decisions regarding lifestyle expectations, acceptable behaviors, and how much health care will be a societal right versus a market service.

Tough medicine. It may well be accurate. And it will certainly build IBM's loyal following within the health care industry market.

But will anyone in a democratic society admit to this agenda? Who's going to tell a fat lady they must die because their cancer is their own fault. Who's going to tell that to a smoker, or a sedentary couch potato?

Reading the report, one gets the impression of a health care profession wanting to scream at its customers, to hector them, and to dictate a stark choice between obedience and death.

It may be good business. It may even be good medicine. But it still reads like political suicide.