Ignored Consequences

Yesterday was a lovely day – overcast, rainy, a concomitant increase in the number of Kamikaze drivers, and a round with the medical apparat. As a result of all this encouragement, I am going to descend into commentary on political matters.

I observed last evening as part of the news reading on the acousto-optical visualizer/receiver that the administration has issued a fiat that the medical apparat will computerize its records by some near date. Given that the present administration is contemporary democrat social engineers I have grave doubts over this.

Those doubts arise from the fact that we have not had a progressive administration since Roosevelt – the first one. And this sort of thing is definitely not progressive. I fear in fact that it will be like so much of what the modern democrats enact and further sap the rights of the citizenry and their freedoms. As opposed to just sapping their riches like the contemporary republicans.

When they tell the medical apparat to computerize their records what they are really directing is the computerization of our records. ‘Our” in this case mean the humans in the Yankee republic.

This computerization is being mandated based on some expectation of saving monies that may be redirected into providing medical care for the indigent and a reduction of error in treatment. Both are highly specious and ill considered arguments. This after all, is politics, not science or engineering, which it should be, perhaps.

The anticipation of saving money is based on a RAND study from several years ago. The study was performed under conditions of grave data absences and has since been impeached on numerous faults, flaws, and inaccurate assumptions. Since these impeachments are beyond the ken of politicians however, and the study supports the agenda of the administration, it is treated as if perfectly accurate and its “emperor’s new clothes” character is studiously ignored or suppressed.

The anticipation of reducing errors is also political “opium dreams”. Yes, electronic record keeping will indeed reduce the incidence of presently common error modes, such as reading and transcribing and interpreting handwriting. The handwriting quality of doctors is notorious, physicians included.

What is being ignored here are the “anticipated consequences” of adopting electronic records. Many of us are familiar with the ‘effects of unanticipated consequences” but we forget that managers, politicians more so, regularly discount and ignore anticipated consequences. Again, this arises from their inability to understand what they are about and an abiding and deep seated faith, with all the irrationality that word implies and connotes, that they are more knowledgeable than anyone else.

The matter is that going to electronic record keeping will introduce new error modes that will result in new types of errors. As an example, it is recognized that dyslexia and dyscalcula are over twice as common among physicians as in the general population. So incidences of poor handwriting will be replaced with incidences of letter and numeral swapping and substitution, and be considerably harder to identify or correct.

We should also recognize that in effect these records, which are so private now as to be even beyond the ken of their subjects, will now in effect be public information. The administration will argue that they may only be accessed by certified members of the medical apparat. If one however, considers how many people are part of the medical apparat in the Yankee republic, something of the order of 0.01 of the population, then that population is sufficiently large that no secrets may be kept and no barriers may be erected that are not instantly compromised. This centralization is an end of biological privacy.

The uninetended consequences may be considered, however inaccurately. The one that spring to mind first are actual decreases in insurance coverage now that all synergisticly negative (and it is not at all clear there are any positive!) conditions become effectively transparent to employers and insurers. What this centralization is oding is insuring the livlihood of justicers for years in civil rights litigation. Another is that the cost imposed on small practices and businesses may be sufficient to force them out of business, further depleting and degrading the availability of quality medical care in the hinterland. This latter is, of course, of no interest to the administration since the hinterland is largely contemporary republican and hince less than irrelevant.

Anyone for emigrating to Canada?