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

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.