Software Development Process

Translucency with Turbid Clouds

 tháng 5 05, 2014     No comments   

Did you ever read a seemingly inconsequential sentence somewhere and it then just refused to leave your mind for days on end, triggering avalanches of thoughts way beyond the original intent, if there even was one? It just happened to me a few days ago when I read one more industry article about the recent Medicare data dump. The following remark was attributed to a primary care doctor: “The U.S. is entering an era of more accountability and transparency in all aspects of people's personal and professional lives and “medicine cannot be excluded,” he said”.  Back in 1996 a science fiction author by the name of David Brin, published an article in Wired Magazine, where he too prophetically argued that the era of transparency is no longer preventable. Ignoring an entire branch of physics, Mr. Brin suggested that the only antidote to the floodlights shining on each individual consists of a “flashlight” we can use to point at the elites running the lightshows. But Mr. Brin forgot another time honored use of flashlights: we can start pointing them at each other, no doubt to the great amusement of floodlight operators. This has the twofold benefit of keeping us from staring at the floodlights overhead, and of illuminating any subatomic particles that may have eluded the big lights. And there is no better, or more entertaining, place to begin playing with flashlights than medicine.

I won’t belabor personal transparency, since it is tantamount to invasion of privacy, which should be illegal, but it is not. Invasion of privacy in the U.S. is becoming a business model and a method of governance. If you missed the 60 Minutes segment on data brokers on April 9th, here is a link. In the now customary incestuous relationship between big business and government, the Institute of Medicine (IOM) is proposing to help data brokers clean up the dossiers they are compiling on people. Utilizing the Meaningful Use program lever, the IOM will be delegating this task to physicians, so a doctor visit will include detailed interrogation regarding such things as the ethnic/racial composition of the neighborhood you live in (geocodable, of course), sexual practices, exposure to fire arms, employment, country of origin, previous incarceration, and all sorts of important stuff for the Internet business. It will also help employers do a much better job with hiring good people since your doctor will have to note now if you are a conscientious, optimistic fellow, or alternatively a stressed out hostile, angry and dissatisfied individual. The IOM would have liked to add more of these hard to get data points, but they couldn’t find the faintest indication that those things have anything to do with medicine at this time. I’m sure they eventually will.

Professional transparency on the other hand, is a much more complicated issue. If you offer to sell a service or a product, you should expect some scrutiny of the value you provide for the buyer, unless of course, you have the means by which to force people to purchase your service or product. Legal systems have always endeavored to create moral frameworks for protecting buyers from unsavory sellers, and vice versa. The best buyer protection is full disclosure, or transparency, regarding the service or product being sold, coupled with legal accountability for negligent and intentionally fraudulent practices. With this in mind, shouldn’t it be the government’s responsibility, indeed its duty, to provide the public with as much information as possible regarding services provided by physicians? Particularly since medical services are most often not elective, and one could argue that the medical profession, as a whole, has the ability to force people into buying its services under duress. Let’s assume for a moment that the answer to this question is affirmative, and move on to a couple of more specific questions.

First, what is it that people buy from doctors? Roughly two types of things: expert advice or skilled repairs. When you are considering the purchase of these services, it would be very helpful to have an independent assessment of the level of expertise and proficiency at repairing items similar to yours. And of course, you would want to know how much the service is going to cost. In the pre-transparency era, we did our best to infer the level of physician expertise or skills by asking very simple questions: Where did he go to school? How long has she been in practice? What do my friends think about this doctor? Is he “affiliated” with the shiniest academic center in town? Are his other patients smart, educated people, or maybe even doctors themselves? We didn’t ask about cost, but more often we did ask if the doctor accepts our insurance, because doctor fees were a sunk cost for most people with health insurance.

You don’t have to have a Masters in Health Administration to see that even if we managed to obtain answers to all our questions, the dataset would be incomplete and fraught with inconclusive and even misleading subjective information. The Internet made it easier to both ask and get answers to some of our questions, but hasn’t done a thing to improve the quality of information available to us, and maybe the opposite is true, seeing how we are all perfectly willing to take advice from anonymous strangers who have nothing better to do other than to rate things online (when is the last time you rated something on a vendor site?). If the government is to step in and help us pick doctors, it would have to do much better than facilitate availability of social media gossip about this or that physician.

For example, what type of information could assist young parents with picking a pediatrician? Let’s be honest and admit that in addition to simple facts, such as education, years in practice, location, hospital affiliation, you would want to know what other parents think about this doctor, and what other doctors think about her as well. But in order to provide context to these opinions, you would need some objective measures. Do I get the doctor on the phone if I call with a concern, or do I get someone else? Will she always see my kid, or will we have to deal with a bunch of random people? Does she offer well-child appointments that fit my work schedule?  How difficult it is to get an appointment? If my child needs hospitalization, will she be there, or will I be on my own? How good are the physicians that cover for her? How good are the specialists she usually refers to? How often does she refer and for what reasons? How much time will she spend with my child?

And here are the things we wouldn’t need to know, not because these things are not important, but because they are largely implied and too granular to be indicative of substance. How many kids is she testing for pharyngitis and is she properly treating them? How many kids get weighted and have their height measured? How many are asked about smoking or whether they are depressed? How many girls are screened for Chlamydia and how many kids in her practice got all their shots?  And yet, the government is in full swing to deliver exactly this nitty-gritty information, and absolutely none of the answers most people seek, not because the answers we want are not available, or impossible to generate, but because keeping everybody busy looking at the trees may just be enough to detract our attention from the massive forest being erected in our health care backyard. 

You can easily extrapolate this example to adult primary care and specialty care of all types, including tertiary care. How about prices though? Since health insurance has evolved into indemnity insurance for errors in lifestyle, doctor fees are no longer a sunk cost for the majority of Americans.  Most everybody now, has to pay full price or at the very least a percentage of physicians’ fees in addition to insurance premiums. Our young parents may want to factor the cost of seeing a pediatrician into their decision making process for a variety of good reasons, not just because they are looking to care for their baby on the cheap. And here is where the most absurd facet of our health care system makes its appearance. The prices for seeing a doctor are meticulously defined and used by insurers, but doctors are prohibited from divulging them, and the government is doing absolutely nothing to change that.

What the parents in our example need is a simple table with rows listing all the pediatricians they are considering, and columns across, listing what each insurance plan in their area has decided that parents will have to pay each doctor, at least for the most common services (including facility fees, if any). Using this and similar tables for their own health care needs, our little family could make an informed decision not only about which doctors to see, but also which insurance plan they should enroll in. Unfortunately for them, and for their doctors, and for us all, such tables are detrimental to the moneyed interests of big health care businesses, and therefore will not be forthcoming anytime soon. Instead, the government is throwing out bunches of dollar numbers that have nothing to do with anything, implying that there is great wisdom to be found in partial truths, and that we should get busy trying to find the secret keys to said wisdom. 

Armed with irrelevant quality measures about their doctors and deliberately misrepresented price information, patients recently turned consumers are expected to take on the medical industrial complex, very much like mice are expected to attack the cat amusing itself before dinner. Transparency, we are told is a very powerful tool for an enlightened citizenry, and it is. Translucency by design, and turbidity by negligence, which is what we are being served here, are very powerful tools too. Different objectives though….
  • Share This:  
  •  Facebook
  •  Twitter
  •  Google+
  •  Stumble
  •  Digg
Gửi email bài đăng nàyBlogThis!Chia sẻ lên XChia sẻ lên Facebook

Related Posts:

  • Toca Hair Salon 2 Android Apk Today i want to share a great andriod application that name is Toca Hair Salon 2 v1.0.2 Full Apk Free Download.Andriod App Details:Dl4all24-Cut, curl,… Read More
  • Internet Download Manager v6.23 build 12 Internet download manager idm 6.23 build 11 is one of the most popular software available online. Unfortunately it comes with 30 days trial period and… Read More
  • Clean Master (Boost & AppLock) Android ApkClean Master Boost and AppLock application helps your device to clean out unwanted and useless data. There are also neat functions such as boost gamin… Read More
  • Tetris Game For Android Full ApkTetris for Android is very popular and thousands of gamers around the world would be glad to get it without any payments. And we can help you! To down… Read More
  • Finger Blood Pressure Prank Android Apk download An amazing prank application "fingerprint pressure mischief." If you are a prankster, you will definitely love this application. Fingerprint calculate… Read More
Bài đăng Mới hơn Bài đăng Cũ hơn Trang chủ

0 nhận xét:

Đăng nhận xét

  • Gun Digest Book of the .22 Rifle
  • The Secret Relationship Between Blacks and Jews Volume 1 /2 /3 Physical Books!
  • The Little Book of Hygge: Danish Secrets to Happy Living [The Happiness Institut
  • Adult Color By Numbers Coloring Book: Easy Large Print Mega Jumbo Coloring ...
  • Herbs - A Concise Guide In Colour by Jirasek, Vaclay Hardback Book The Fast Free

Popular Posts

  • Smartphone Using At The Supermarket Can Add 41% To Your Shopping Bill
    It is safe to say that you are always looking at your telephone when you're and about? Do you experience difficulty opposing the bait of...
  • Windows 7 All in One ISO 32-64 Bit Free Download
    Windows 7 all in one ISO 32-64 bit genuine free is now available to download from the secure links provided below. The download comes w...
  • Forgot to post
    sorry travel day.  My bad! 
  • November Technology Updates
    So far, November has been a busy month of technology integration in all grade levels.  Teachers and students use a wide variety of devices i...
  • Morning Charts 04/30/2019 SPX
    Early post
  • Check Out The Science Behind Finding North Korea's Nuclear Weapons
    Arrangements over denuclearization of North Korea fallen at the beginning of today after North Korean despot Kim Jong Un demanded the United...
  • Criteria for Evaluating Web Tools and Apps
    I'm often getting asked what my criteria are for choosing the tools, apps and resources that I feature on my blogs and in my teaching an...
  • Should You Use Hubitat to Automate Your Smarthome?
    The first step in building a smarthome is often choosing a hub, and there are many options. Hubitat is a unique cloud-independent hub. It...
  • Morning Charts 04/10/2019 SPX
    Cause censorship is real. Our Orwellian really coming to life -  https://www.zerohedge.com/news/2019-04-09/leaked-google-docs-reveals-aggres...
  • Microsoft Staff Don't Use HoloLens For War
    Somewhere around 50 Microsoft representatives have requested the organization pull out of an arrangement with the US military to give expand...

Bài đăng nổi bật

How To Swim and Dive in ‘Animal Crossing: New Horizons’

Nintendo Animal Crossing: New Horizons has received a free update that allows players to swim and dive for sea creatures for the firs...



Work freely with Fiverr

Work freely with Fiverr

Money with Adfly

Money with Adfly
Được tạo bởi Blogger.

Make Money MyLead

Make Money MyLead

TẢI PHIM 18+ VỀ ĐIỆN THOẠI Ở ĐÂY >>

Copyright © 2025 Software Development Process | Powered by Blogger
Design by Hardeep Asrani | Blogger Theme by NewBloggerThemes.com | Distributed By Gooyaabi Templates