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Time Capsule: Here’s President Obama’s Mandatory EMR Feature List: Firing GM’s CEO Makes it Clear That Federal Money Has Strings Attached

August 3, 2013 Time Capsule 5 Comments

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in April 2009.

Here’s President Obama’s Mandatory EMR Feature List: Firing GM’s CEO Makes it Clear That Federal Money Has Strings Attached
By Mr. HIStalk


Was anyone but me surprised when President Obama decided it was time for GM’s CEO to quit and that Chrysler had no choice but to merge with Fiat? Man, I guess you really give up day-to-day control when a big lender (like Uncle Sam or the mafia) puts up the cash to keep you in business. Even Nixon wasn’t so bold as to say that what’s good for the country damned better be good for GM or else.

Say, wait a minute … healthcare is getting a lot of government money. Surely the feds wouldn’t start telling us how to run our shop, right?

I wouldn’t count on it. We might be selling our souls here.

This particular government, faced with a dismal economy and an ambition to make major changes in American society, doesn’t seem to be shy about crossing that previously sacred line between government and private industry. It’s surprising that a Democratic government would be as hard-nosed as private equity firms in putting their people in key positions of responsibility, demanding equity in return for financial support, and mandating changes in product development and sales despite the market’s sometimes differing interest (car makers made a ton of profit on gas-guzzling SUVs that consumers apparently wanted, at least until gas got temporarily expensive and financing became unavailable).

Everybody’s clinking their glasses and high-fiving over the gravy train headed healthcare IT’s way. Fear the person from the government who’s here to help: there may be a hidden price.

It’s clear that CCHIT (or something like it) will enjoy unprecedented power to set mandatory product requirements. “Effective use” will do the same for providers, spelling out exactly how they must use their technology. As Uncle Sam becomes an even more dominant buyer of healthcare services, the ratchet may be turned on reducing costs and following somebody’s medical cookbook. Viewer discretion is not advised.

It was flattering when Obama and company got interested in our little world of healthcare IT. Now it’s scary.

There’s not much question that government is now driving the HIT industry. The question is: to what? Will it be just like today, only bigger? Or is the real agenda to use government clout to finally whip private industry around a little, making businesses behave in some unspecified way that runs contrary to the free market?

I’m as shell-shocked about the economy as everybody else, so I get tired of reading headlines of mind-boggling historical significance that still sound like just more bad news. Somehow, Obama’s giving GM and Chrysler marching orders got my attention, even after watching the financial industry basically disappear overnight. The CEO of every company right now, right or wrong, is the former junior senator from Illinois who has never held a real job (I don’t count being a professor or lawyer) or run a business.

All I will say is this: be careful out there. It’s becoming clearer that government gifts, like private equity investments, come with strings attached. I’m really confused at this point whether I should feel proud or disgusted.

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Currently there are "5 comments" on this Article:

  1. “The CEO of every company right now, right or wrong, is the former junior senator from Illinois who has never held a real job (I don’t count being a professor or lawyer) or run a business. ”

    Mr. H, please check this sentence.

    You were clairvoyant. The HITECH funds have strong strings attached and tight scrutiny. Many are getting out of the MU program and many find it more efficient and safer for care to take the penalty.

    The only thing going for those who took the funds is that the sequester has blunted manpower in the OIG and fraud checking departments, enabling cloned and H and P notes constructed prior to an evaluation to become the standard of care.

  2. Take a look at Detroit-and you will see a possible future for healthcare.. The carrot of lots of money to meet the gov’t view of MU has healthcare making quick EMR decisions that are starting to show bad financial outcomes for many hospitals. Then comes January 2014 when the money starts flowing for healthcare exchanges and subsidies (remember for everyone BUT corporate America and the government legislators and aides now that the Pres knows that is unpopular) and the gravy train will be hard to stop. Does anyone else think that the next step is collapse of our healthcare system and the necessity to go national healthcare?

  3. Why is is “Scary” if the government steps in, as you fear, to knock a few heads in healthcare IT as a result of putting our collective snouts in the “gravy train.” I certainly believe that healthcare IT has done a miserable job of things even given the three-legged stool of healthcare. One could argue rather convincingly that GM is a far better company that it was before after receiving the government boot in its backside.

  4. Agent,
    GM is far better today only because they were able to dump all their debt and liabilities into a seperate company and start with a clean balance sheet and a big cash infusion from Uncle. I could turn around the City of Detroit in three days if the feds did the same for them, or any company for that matter.

  5. Why should we expect politicians to be better than the actual people who have to make a product that customers want to buy?
    When the government steps in, to some, they may seem like the white knight coming to save the day, but in fact, politicians are motivated by their own self interest, and use the power of government to achieve it.

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