Please correct me if I’m wrong, implausible though that may seem, but has the House just passed a bill establishing a Czar for Health Information Technology? Since when, in general, has central planning worked? And, more specifically, can we honestly predict good things from a top-down approach for the implementation of health information and data technologies? I rather doubt it. Where—-anywhere—-in the federal government does there exist a modern system of information technology that is internally consistent, compatible with other systems both within and without government, and that adapts quickly to changing economic and technological conditions? There is no need for a reply; the question answers itself. And once the feds get done, if ever, forcing a one-size-fits-all system on everyone, how will new technologies and approaches be integrated? Does HHS actually have powerful incentives to do so? Please… The adoption and implementation of information technology, particularly in a sector as large and complex as medical care, is a classic example of the prospective advantages of bottom-up investment, that is, the substitution of market in place of bureaucratic incentives. The Romanovs were murdered by the Bolsheviks; may the new Czar be stangled in its crib by our version of the Bolshevik Party, to wit, the U.S. Senate.
The Return of the Romanovs
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