Dana Blankenhorn seems to have missed the fact that the Federal Reserve is one of those institutions that one should not cite as an example of success when discussing federal regulatory policy, which is probably why he doesn't get a chill down his spine at the thought of the Obama Administration creating a parallel institution for the healthcare industry:
The different problem that healthcare companies face is finding out the context of the information about healthcare. It's not enough to know whether or not a procedure was done, a bureaucrat (corporate or government) needs to know whether it should have been done and should have been done at that price. The information need of a Federal Healthcare Board would be enormous to the point that they cannot even be reasonably compared to any other regulatory agency in the country.
This is the classic conundrum of a central planner. Obama may not be planning on enacting a typical socialist central planning scheme, but if this agency is to even just aggregate this sort of data about the true state of healthcare, it will run into most of the same hurdles.
Practically speaking, it'll be extremely difficult to get private businesses to comply in an effort that works. Compliance will be the biggest problem that they face right off the bat. It'll cost a lot of money, require incredible planning and engineering to get it done, and will be very costly in terms of actually implementing it once it gets down to making the changes at hospitals and private practices to allow the data collection. That's not even counting the amount of money the government will have to spend to build the infrastructure to manage and mine all of that data.
Going back to the comparison with the Federal Reserve, if the Great Depression, which they've accepted responsibility for creating, and the current fiasco are any indication, no thanks! The federal government has already shown that it has an ideological aversion to simply allowing the market to recover on its own, and is convinced that pumping more of the poison into the victim is the way to cure it. This rash, disregard for basic economics, observation and common sense will undoubtedly just get carried over to healthcare under this plan.
Lastly, one reason that I think most Americans can agree is a good reason to be wary of this sort of change is the implications that it has for allowing health insurance companies to get access to a lot of data that they otherwise might not have. For now, any data that is created from a report that isn't filed against an insurance policy is one that stays with the doctor's office. Not so, if data is being aggregated by the federal government. It's also just a matter of time before the federal government wants to collect genetic samples as part of the health data, since DNA could provide federal regulators with a breathtaking amount of information about the state of our population's health.
Insurance companies will get their hands on this data as surely as mass marketers often get ahold of personal information from DMV offices in states that sell that information. One would have to be naive to think otherwise.
What makes the Federal Reserve tick is data. The need for accurate economic data, for better collection and better presentation, is a never-ending preoccupation for Fed policymakers.This is an apples-to-oranges comparison, in my opinion. The Federal Reserve does not need to know much of anything about the information generated by the transactions from electronic payment systems. Aggregate data, showing the general flow of wealth, perhaps, but the actual details of who bought what are minutia that is of no relevance to it. The Federal Reserve simply has no regulatory need to know what is going on behind the vast, overwhelming majority of economic transactions because they are of no significance to its role in the federal bureaucracy. For them, it might be good to know what my credit card debt is at any particular time, but my spending habits are well outside the scope of their role and interest, but the same could not be said of a healthcare analog.
Data should also be a big part of the Federal Health Board effort. Only when we have a clear idea of where we are can we start managing to results, which is the ultimate aim.
Compare the sophistication of modern electronic payment networks, and the quality of the statistics they generate, with what we know about American health care and you start to see the size of the problem.
The different problem that healthcare companies face is finding out the context of the information about healthcare. It's not enough to know whether or not a procedure was done, a bureaucrat (corporate or government) needs to know whether it should have been done and should have been done at that price. The information need of a Federal Healthcare Board would be enormous to the point that they cannot even be reasonably compared to any other regulatory agency in the country.
This is the classic conundrum of a central planner. Obama may not be planning on enacting a typical socialist central planning scheme, but if this agency is to even just aggregate this sort of data about the true state of healthcare, it will run into most of the same hurdles.
My guess is the first job of a Federal Health Board would be to seek better data on both wellness and illness. This implies the creation of vast, interlocking databases on all Americans, matched to medical transaction data.If information on wellness and illness are all that this is for, then the CDC is already sufficiently equipped for that, which is why I suspect that it's about a lot more than that. It's about getting the government into providing more health insurance coverage, and in a more intelligent, less expensive fashion than it currently is. Finding out what treatments are actually necessary will be dicey, and could very well pit doctors against regulators. It certainly wouldn't be the first time, since the DEA already considers itself to be the arbiter of what is the medically-necessary level of pain killers in all cases.
By seeking to make this "above politics," Daschle gives the work a technocratic base that hides resistance to having our health tracked behind a simple need for accurate data informing policy.
If we could make it a goal to have health data as good as our present financial data within 10 years, we would be guaranteeing a revolution in health IT. It would be the Obama Administration's moon shot.
Practically speaking, it'll be extremely difficult to get private businesses to comply in an effort that works. Compliance will be the biggest problem that they face right off the bat. It'll cost a lot of money, require incredible planning and engineering to get it done, and will be very costly in terms of actually implementing it once it gets down to making the changes at hospitals and private practices to allow the data collection. That's not even counting the amount of money the government will have to spend to build the infrastructure to manage and mine all of that data.
Going back to the comparison with the Federal Reserve, if the Great Depression, which they've accepted responsibility for creating, and the current fiasco are any indication, no thanks! The federal government has already shown that it has an ideological aversion to simply allowing the market to recover on its own, and is convinced that pumping more of the poison into the victim is the way to cure it. This rash, disregard for basic economics, observation and common sense will undoubtedly just get carried over to healthcare under this plan.
Lastly, one reason that I think most Americans can agree is a good reason to be wary of this sort of change is the implications that it has for allowing health insurance companies to get access to a lot of data that they otherwise might not have. For now, any data that is created from a report that isn't filed against an insurance policy is one that stays with the doctor's office. Not so, if data is being aggregated by the federal government. It's also just a matter of time before the federal government wants to collect genetic samples as part of the health data, since DNA could provide federal regulators with a breathtaking amount of information about the state of our population's health.
Insurance companies will get their hands on this data as surely as mass marketers often get ahold of personal information from DMV offices in states that sell that information. One would have to be naive to think otherwise.
Perhaps the new Fed (Federal Reserve Health Bank) will inflate the supply of health care for all of us? Yay! I'll vote for that!
"...and could very well pit doctors against regulators"
To say nothing of leaving the consumer / patient in the lurch.
You laugh, but they could actually do that if they had the power to grant acreditation to new medical schools.
S'up, baby!
The Fed is a little like the negative-feedback control on you A/C. When the markets gets too hot or too cold, then it sells or buys T-Bills. Not much else, really.
The same applies with socialized health care. Parkinson's Law on a good day, shooting in the dark the rest. Problem is, monies pissed off when stats looked good on paper is now tied up with things that were never needed to begin with.
Like Arnie sez, "It's not a tumah!"
He's back from the dead(ish)! Long time. Where've you been?
The creation of a Federal Health Board sounds somewhat reminiscent of DHHS' National Center for Health Care Technology (1979-82) whose charge was to assess the value of established and new technologies. Although its tenure was short lived, one should learn from the reasons for its demise.