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Question: What are some of the shortcomings of our current health care system? 

Jay Parkinson: I think the main shortcoming is that patients aren't the customers of health care.  Customers are people who purchase or buy goods or services.  And as patients, we just sort of turned that duty over to insurance companies.  To sign contracts with large groups of hospitals or doctors and all of a sudden you've sort of relinquished control of customer status.  And when you do that, you're not really treated like a customer.  You're not really treated like the Apple store treats you whenever they're trying to take care of your computer when it breaks.  And that's sort of what health care has become, a sort of faceless institution that really isn't focused on the patient's needs, you know like satisfaction.  

Question: Are there any countries getting it right in terms of health care? 

Jay Parkinson: There's countries like Norway.  The deal is, Norway has 4.8 million people and Kaiser in California covers about 10 million people.  So, you can't really say are there any countries doing it correctly because that's like apples and oranges.  Are there systems in the United States that are doing it properly?  Absolutely.  Kaiser, Geisinger, Inter Mountain, Bassett in upstate New York.   Absolutely.  Those guys are just really, really narrowing the proper delivery and payment for health care. 

Question: What are your views on universal health care?

Jay Parkinson: I think it's a bad policy given the current situation of paying for sickness because the sicker a population gets the more expensive it's going to get.  The older a population gets, the more expensive it's going to get.  So, in the widget that we sort of live and die by in health care is sickness, it's designed to skyrocket out of control.  So, the business model of health care delivery has to change before we institute everybody -- you know mandating everybody paying into a system that's designed to not do what's best for you, it's designed to do what maximizes their profitability.

Question: Would a shift to electronic medical records help the situation?

Jay Parkinson: Theoretically, a shift to electronic medical records would help significantly; however, electronic medical records don't solve the problems that doctors face.  They're designed for insurance billing as well as protecting them legally from lawsuits.  So, they're designed to produce as much information about an interaction as possible and data is often irrelevant to actual clinical care, to the case at hand, because the last visit, it might have been a one minute visit, but it's five pages worth of notes that are just designed to protect your butt. 

So, the interfaces are designed like Windows 95, these things were built 15 years ago, these legacy systems.  They are built in like the Windows 95 era.  They're siloed pieces of bad technology.  So, I do not support current electronic medical records being mandated across the United States because I think the electronic medical record industry needs to be disrupted with today's technology.  

Obama has appropriated about $20 billion to get doctors to use electronic medical records.  How much would it cost to Facebook if it were designed to power medicine to sign up all 11 million health care workers in America?  It surely wouldn't cost $20 billion.  It would actually cost significantly less because the building technology today that is flexible enough and platform-like, like Facebook for health care, would absolutely be the proper way to go.  But the deal is, as in everything, the money and the corporate interests control the welfare of our country, so it's a real problem.

Recorded on March 9, 2010

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