I continue to deplore Congress for not talking about the real problem in American healthcare, the cost of delivering healthcare. Premiums and deductibles are high because the cost of healthcare delivery is high. Drug prices are in runaway price growth. When the CEO of a major drug company was asked why they keep raising prices, he said, “Because we can”.

The ACA has many problems needing a fix, and I offer solutions in Health Attitude. One of my recommendations is to combine Medicare and Medicaid and then turn it over to the states to run, with certain standards provided by the Federal government. It is clear from the current situation states are different. They are also big and know how to run healthcare systems. They have been doing it with Medicaid for many years. Trying to force all the states to manage healthcare in the same way will never happen, in my opinion.

One of the Federal standards which should be strengthened is compatibility of Electronic Health Records (EHR). At many hospitals, the EHR in the ER cannot be read in the OR, let alone trying to transfer your medical records from CT to FL. Congress, as with other special interest groups, is in the pocket of the EHR software vendors. They claim government should not interfere in the private sector. Fortunately, Congress did not understand the Internet in the early days. If they had taken the same approach, there would be no Amazon or eBay or millions of other globally reachable websites. 

There is some progress being made. Yesterday, I had a routine echocardiogram at 8:30 in the morning. Thankfully, the result was good. At 1:30 PM I received an email saying there was new clinical information in my EHR. I read the complete report of the doctor who read the data from the procedure with my EHR iPhone app. Later yesterday, my doctor sent me an email confirming the good results. That is how healthcare should work. There are two missing ingredients: a national standard for interoperability of the EHRs and more effective and more affordable EHR software. The Federal government should put down an iron fist, and tell the vendors it is ok to compete on price, ease of use, features, support, etc., for EHRs, but not on data compatibility.