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"If you put the federal government in charge of the Sahara Desert, in five years there'd be a shortage of sand." — Milton Friedman
As President Obama took office in 2009, I sold electronic health records, which track a patient’s medical history by computer instead of by hand. For a couple of decades, companies like mine had helped medical providers save money while they improved their patients’ quality of care. Once we installed and launched EHR software at a doctor’s office or hospital, it was a win for everyone.
Many in the EHR industry were thrilled when Congress passed Obama’s “stimulus” package since it included nearly $20 billion of incentives to help doctors and hospitals purchase software. D.C. is opening the money spigot, manufacturers thought. Let the good times roll!
As any free-market advocate knows, there’s no such thing as a free lunch — or a free software launch. The feds provided yet another object lesson in the perils of government intervention.
Before the industry could start raking in that “free money,” they only needed one clarification. To receive one of Congress’ incentive payments, providers had to show that they are “meaningfully using” their EHRs. Since Congress added that two-word phrase to the 1000-page stimulus legislation, they must have a quick definition right? They should get back to us by the end of the day, and we can get to selling! Okay, maybe by the end of the week? Err… end of the month?
Fifteen months later, a sub-suboffice in the Department of Health and Human Services dropped a stack of dead trees on the industry. The simple two-word phrase had ballooned into a 650-page “interim final rule” which defined “meaningful use” through a series of new regulations, certifications, quality checks and best practices that your local family doctor had to follow if he wanted his slice of government cheese.
Since that interim rule contained several contradictory demands, meaningless requirements and flat-out errors, the HHS later released a “final rule” weighing in at 850 pages. But that was only “Stage 1” of meaningful use; Stages 2 and 3 were promised in the years ahead.
Oh, and in the meantime, Congress passed Obamacare, which added 2,700 pages of new rules never mentioned by HHS's CMS/ONC 850-page EHR Meaningful Use Final Rule (Stage 1). Have a headache yet? Don’t worry; I had one for a year and a half straight. Overnight, my job changed from helping customers to dissecting turgid bureaucratese and offering my own Talmudic interpretations.
As is so often the case, what was intended to “help” instead created a regulatory nightmare. I assume that most of you didn’t know much about the EHR industry nor did you care. But expand this one tiny example into the entirety of government incentives, special tax breaks and outright crony capitalism.
For every highly publicized Cash for Clunkers, Solyndra, or pork-filled Sandy relief bill, there are hundreds of untold stories of wasted time, money and effort by workers in nearly every field. You probably have stories of your own that blow mine away.
“Free money” leads to new rules. When the rules don’t work, even more rules are created with new federal agencies to interpret, measure and enforce them. Then the next president decides the whole system is an over-complicated mess, so he orders more “improvement.” Lather, rinse, repeat.
Perhaps this vicious circle of idiocy could be indulged in good economic times, but $16 trillion in debt later, we no longer have the luxury. It’s past time for every American in every industry to start brown-bagging it. History proves that it will be a lot cheaper than the “free” lunch Washington is offering.
Follow me on Twitter at @ExJon.