While the Supreme Court ruling on President Obama’s health care law forces states to reconsider its implementation, the question remains whether a nationwide data hub is desirable or even feasible.
One critical aspect of the president’s health care law is the establishment of state health insurance exchanges, which would begin operating in 2014. These exchanges require the construction of a data system capable of handling everything from enrollment data of multiple private insurance providers to individual tax and citizenship information to state Medicaid enrollment systems.
Seton Motley, president of the Less Government organization, says current information technology cannot handle the requirements established for it by Obama’s law.
“I had the same set of X-rays taken three different times in one 48-hour period recently,” Motley said. “Nobody can share this information because the files are too large to share. The technology simply cannot handle it.”
The complex data-sharing goal established by Obama’s law requires thousands of non-standardized computers and incumbent software systems to communicate with one another, which may render such a system difficult if not impossible for most states to complete by 2014.
Fewer than 20 states are working to establish exchanges prior to the deadline, and fewer than 12 will be compliant with federal information technology standards by the deadline, Motley says. This would require them to partner directly with the federal government rather than adopt state-based standards.
“Twenty states is not a coordinated effort,” Motley notes. “Either a government-mandated system or a government-run edifice as required by the healthcare mandate would be a mess because the government cannot be depended upon to do anything efficiently.”
Richard Dolinar, a clinical endocrinologist based in Phoenix, Arizona and a senior fellow with The Heartland Institute, says the state exchanges and the sharing of digital information “are all good ideas…. They just don’t work.”
Dolinar added, “Trying to implement them before the necessary technology exists reveals how arrogant our legislative leaders are when it comes to passing laws.”
‘Hacking, Snooping, and Theft’
John Dunn, a policy advisor for The Heartland Institute and the American Council on Science and Health, says the ideal of a “paperless hospital” is not yet possible without compromising the security of patient records.
Dunn says his experience as a doctor has taught him the emphasis on bedside computing results in a 10 percent to 20 percent reduction of actual patient care while easing the path to central government control of medical practice.
“I’ve witnessed firsthand many other, much larger companies that hit a wall when they tried to integrate systems from a wide variety of medical providers,” Dunn said. “Computerized information is great at creating data piles and tracking financial activity and creating reports, which could come in handy for resource allocation or rationing as we travel down the road of centralized planning of our nation’s healthcare.”