Go to any ATM in the country and you can withdraw cash from your bank account—every bank across the country is integrated into an efficient information system. Contrast this with the health care industry, where medical records are predominantly paper (as in the days of Florence Nightingale), which means that only your local hospital can access your medical history with any ease.
Why does the health-care industry have such a poor information system when lives are on the line? Well, our free market ideology results in a privately insured, fee-for-treatment maze. Combine that with incentives for health insurance companies and hospitals to be inefficient, and it is not surprising that the health-care industry has not developed an efficient information system. The solution, of course, is pragmatism—President Bush and former Speaker of the House Newt Gingrich actually agree with Sen. Ted Kennedy, D-Mass., that the federal government needs to create a health-care information system.
Health-care information sharing inefficiency can be a matter of life and death. In a 2005 article, researcher and analyst J. D. Kleinke related the story of Joe Wilson, a 38-year-old Pittsburgh software engineer who was on the antidepressant Paxil. Vacationing in Las Vegas, Wilson got drunk and lost $39,428 in a casino's gambling cage. He easily accessed that much cash through the casino's ATM machines, liquidating his savings, maxing his credit cards and crippling his retirement account and home equity. The casino took his money and attained his entire financial history in about five minutes due to finance industry information system efficiency. The finance industry has a strong incentive to share information—to increase profits, financiers increase and facilitate financial transactions.
But when Joe Wilson suffered a heart attack after his bender, the local hospital ER he was dumped at could not access his medical records. Being drunk and sick, he couldn't tell the hospital anything. The hospital found his insurance card in his wallet and spent 20 minutes on the phone with his insurer—but found out nothing useful. Health insurers have no incentive to communicate their customers' medical information. As economist Paul Krugman has pointed out, health insurance companies, operating to minimize financial losses, want to slow down claims payments, not facilitate them.
So, the Las Vegas hospital put Wilson on beta blocker drugs to lower his blood pressure, which should have saved him. However, Wilson's employer had just switched health insurance plans, meaning that before he went to Vegas, Wilson went to see a new doctor for a prescription of the antidepressant Paxil. An assistant faxed the doctor's handwritten prescription note to Wilson's pharmacy, but the pharmacists misread the handwriting. Instead of giving Wilson Paxil, they gave him Plendil, which lowers blood pressure.
If health-care providers had an efficient information system, electronic medical records would have obviated the need for an easily misread hand-written prescription. Recognizing this, companies such as Madison's own Epic Systems Corporation market limited information systems to health-care providers.
However, doctors and hospitals have market incentives not to join a universal information system. If health-care providers integrated into a single system with electronic medical records, the number of billable visits to the hospital would go down, as would the number of unnecessary but billable treatments. Meaning that health providers would make less money.
Because he was inadvertently taking Plendil instead of Paxil, the beta-blocker drug that the Las Vegas hospital gave Wilson was disastrous; his blood pressure, already low from the Plendil, dipped even lower, and he died.
Free markets do one thing well—generate profits. From a market perspective the current state of U.S. health care is dandy, because any so-called inefficiency is profitable; and Joe Wilson's death is merely unfortunate. But from a medical perspective, such inefficiency is unconscionable.
We Americans don't like to think of ourselves as ideologues; this is why we have Bill O'Reilly, cable TV's Everyman,\ who claims to be ""ideologically unclassifiable."" However, many Washington politicians are possessed by self-serving market ideology, and with health care industry campaign contributions in pocket will defend the status quo, despite the reality that Joe Wilson's death is the logical result of U.S. health care inefficiency. Of course, that conclusion begs an uncomfortable question: Why do we, who rightly detest reality-blind ideologues, keep electing them?
Teddy O'Reilly is a senior majoring in international studies. Send comments to opinion@dailycardinal.com.\
