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Health care is rationed and people die

The stimulus bill merely accelerates a market process that is already underway.

The greatest myth of the American health care system is that health care is not rationed.

It is.  It has been for years. When you reach the end of your insurance there is no more coverage. Care available through the public system cannot, by definition, be limitless.

Never mind that. Media mavens like Austin Hill (right) are still going to ooga-booga-booga people. He calls the health IT in the stimulus bill a slippery slope toward a government "obligation to die."

Is there anyone with extensive dealings in the present system who is going to buy this nonsense?

The health IT in the stimulus package is the system insurers want. Effectiveness measures, and care based on comparative effectiveness, bring huge volumes of data and the latest research to the point of care. Its aim is to improve doctors' decisions.

No doctor can read all the literature, track all patient data, and still have time to see patients. They may spend time at night reading, they may spend weekends at seminars and briefings, but these are imperfect.

The best way to know what's right is to have all the data, pre-messaged and in your hand.

That is also what insurers want. They don't like paying for doctors taking the wrong path. The whole HMO business was aimed at avoiding that. It didn't work because it was too clumsy, it was too bureaucratic and too inexact.

It was too human, too driven by spin.

Data is different. Data streamlines processes. Back-office expenses can be redirected to patient care. This is why Aetna and Kaiser and US Healthcare are investing in health IT, why hospitals are investing in it, and why both are pushing this down to clinics.

The stimulus bill merely accelerates a market process that is already underway, a process made possible by technology, including the medium you are now using.

I suspect most people understand this. I think it's people like Austin Hill who are out of touch on this issue, because the method through which they decide what to think is as broken as the old HMO system.

I have a theory why this is so.

I think for a generation we have been driven by media, by radio (where Hill works) and TV. Media is driven by a PR process. Representatives (in sports), corporations (in business) or think tanks (in politics) pre-package their views into bite-size chunks. Media is a spin game.

Data is not so easy to spin. Whether it comes from player statistics, a balance sheet or a longitudinal study, data is deep and data is wide.

The tools of this medium connect data to decision-makers with fewer filters than before. Smart businesses like Wal-Mart use data to drive decisions, and succeed. So do smart general managers like Billy Beane, and smart politicians as well.

Anyone can use data. All it takes is a scaled system. The Internet is a scaled system. Health IT is trying to build such a scaled system for doctors. The results won't be perfect. But they will be better than those based on the human media filter data competes with.

Ask yourself. Would you rather have spin or data? I would rather have data. I think most people would.