Health care stimulus is looking more and more like just another giveaway

Dana Blankenhorn reports on some harsh new realities about the cost of the software that will be used to implement some of the new medical information systems used for Obama's health care infrastructure upgrades:

By week's end Trotter was calm enough to explain the problem in simple terms.

• Before it certifies software CCHIT wants to know who "owns" it and thus takes responsibility. The problem is that open source companies like ClearHealth don't have full control of their code. Projects can be forked, then re-certified for one-tenth the cost. Or not certified.
• CCHIT certification requires CPT codes, which are proprietary to the AMA. This makes it impossible to create a fully open source EMR system.

What this means for the public is that comprehensive, open source proposals have been effectively ruled out for the time being. Proprietary, closed-source software is the only kind of software that will be able to be used for systems that get the CCHIT certification and are thus eligible for the health care stimulus package that Obama is working on. Right off the bat this means that competition has been limited, and all of the software involved will be more expensive, regardless of its merits. Good for vendors, bad for the health care industry and the public paying for the stimulus.

Unlike Blankenhorn, I see no reason to celebrate the fact that open source vendors were even given an audience here, as it is obvious that it was a meaningless event for them. It is bad enough that the public will have to pay for this, it's even worse that the public will have to do so with fewer vendor choices and an entire, legitimate paradigm not allowed to compete.

There are fair arguments to be made about having only the most rigorously tested and supported software running critical hardware like X-Ray machines and CAT scan systems. These systems should no more run commodity software than sensitive military weapon systems that need custom systems, often with hard real-time capabilities that are very seriously tested and debugged. However, to just rule out open source, period, especially for systems that have no potential loss of life and limb if there is a failure, is just blatant favoritism.