Two thoughts on health and the economy:

I’d like to be skinny. And have a million dollars. G’night folks!


I have just been informed that, even though it is Friday, I still need to put at least some effort into writing an intelligent blog post.  So, here goes.

Here’s my first thought about health and the economy: Obviously, there have been massive layoffs across the board, and IT has not been spared.  Over the past two years, not only have there been layoffs due to the general contractions (or as I refer to them, death-spasms) of the economy, but since 2006, there has been an increase in the number of internationally outsourced jobs by IT service vendors, according to Network World. 

Data prepared by Everest Group Inc., a research and outsourcing consulting firm, shows in broad brush fashion the shift of jobs overseas by some major IT services vendors. In 2006, U.S. and European firms typically had less than 20% of their workforces offshore; Now, for most companies that figure may well be generally over 30%.

At the same time, many laid off workers are starting their own businesses.  Certainly not all of them, but when you need a job, and no one is hiring – entrepreneurship and despair seem the only logical choices. 

A quarterly survey of 3,000 job seekers conducted by Chicago-based outplacement firm of Challenger, Gray & Christmas, Inc., released Thursday, shows a near doubling in the year-to-year growth of job seekers turning to self-employment.

The problem with this is that because more people are becoming unemployed or self-employed, it creates additional political pressure on the health care debate.  The unemployed and self-employed have to rely on the private insurance market for healthcare, which is where the majority of healthcare horror stories exist, according to NYT opinion columnist and Nobel Laureate Paul Krugman. Krugman argues that government regulations require that employer contributions to health care “can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees,” and thus people don’t see the worst parts of private insurance until they’re either unemployed or self-employed.

Which brings me to my second thought on health and the economy: The “American Recovery and Reinvestment Act” (a.k.a. “the Stimulus”) which give $19B for healthcare related information technology, but also requires that each American has an electronic health record in 5 years.  TechTarget argues that meeting that deadline simply isn’t that easy

“The concern is that when you have these programs that are time limited … that the quality of those implementations could go down,” said Chad Eckes, the chief information officer for Schaumburg, Ill.-based Cancer Treatment Centers of America (CTCA). “There can be spectacular failures of electronic health records, because folks didn’t anticipate what might happen if it was unstable, and that can have disastrous consequences for patient care.”

We’ve seen some of the difficulties with medical data networks before – with the importance of maintaining network performance when lives are literally on the line. 

There’s no question that electronic data records are faster than paper records, and (usually) more accurate… or at least, more accessible in a crisis, which is why there is a mandate.  The problem arises when there is poor network performance, in which case records are less accessible.  Moving the patient records from paper to data places the onus of providing that information from the administrative staff of a hospital or medical center to the IT department.

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