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James Nick's avatar

It’s more my opinion than any sort of objective observation, but it seems that attempts to manage human behavior, whether through incentives or laws, frequently end up making things worse for almost everyone involved. Lots of people have difficulty understanding the difference between “complicated” and “complex,” as well as a stubborn refusal to take into account human nature.

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Bill Pocklington's avatar

I came across Jane Jacobs about the same time as the ACA was being implemented and the thousands of pages of regulation were being written (bulldozing what little free market there was left in the health insurance business. I also came across THE CLUETRAIN MANIFESTO and the concept of technology allowing consumers to flip the table on the consumer-to-vendor relation model: turn CRM into VRM.

10 years after, the most disappointing thing about the ACA is what it did to health records and any possibility of consumers managing their vendors rather than being captured. Who would have thought that throwing billions of tax payer $ at something would create perverse incentives and lead to the capture of consumer data?

Imagine if something like Microsoft Health vault had taken hold and innovators built easy-to-use tools to move data in and out of the vault. Consumers could connect to digital apps. Consumers could share portions of their health history with brick and mortar providers. Consumers could have aggregated their own data with other consumers and solicited bids to provide them with catastrophic coverage or micro-coverage.

Instead, we have siloed data which is owned by a few select EHR vendors to use as they see fit (like selling it back to the providers who captured it in the first place).

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