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Thursday, January 07, 2010

An Encounter With Gubmint Health Care Efficiency

One reason that I had a busy day today is that I had to go back to SuperDoc's. I am still hot and heavy at the project of civilizing his network. Mind you, I don't expect it to ever emerge from barbarism - I just hope to get it so that most of it is wearing some sort of clothing and not lurching around waving shrunken heads, scalps and stone axes at the office personnel. The reason I do not expect this thing to ever get to the Irish monastery stage of civilization is the efficiently wonderful encroachments of government healthcare.

Today, today, today (here M_O_M cracks and starts singing the Stanford drinking song) I installed the bleeping update for their bleeping Medicare claim software. CMS, in its benevolent and efficient wisdom, contracts with some firms to provide claims software. Oh, frabjous day! The software is free. Gurgle. How efficient. You submit claims electronically, which is of course very EFFICIENT.

This, mind you, is the gubmint that is so worried about everyone's privacy that it has strict privacy and security rules for all health care providers, mostly contained in HIPAA. There are major penalties for violating those rules. Now SuperDoc is quite worried about the security of his network, and that is one of the problems I am trying to address. Thus I was amazed to discover that the gubmint-provided Stone Axe/Shrunken Head EFFICIENT claims software is created in a manner that requires you to violate any reasonable network security standards if installed on a network.

Abruptly it became clear why all his office personnel were fleeing to one computer in the back room to process or transmit claims - a notably efficient procedure! One doctor has four administrative people in his office, all hopping from computer to computer to do their jobs. I spent half the day going through the most incredible contortions to install this on a network without completely laying the whole thing open. I now know how to make a really good living poaching highly marketable data off physicians' office networks, because I can guarantee you that not one in one hundred offices is going through these contortions. You have to defeat the software and add in a bunch of batch files a la the ClimateGate procedures for building databases to do it. A theme emerges here....

Just to liven things up and make it clear that this is a very efficient, modern and 21st-century type of deal, they only accept claims transmitted via modem. Yep, modem. You've got to have a modem to transmit your claims electronically. A modem, for God's sake. A modem. Preferably one decorated with a few feathers and shell beads.

Only the US government. Dragging us back to the nineteenth century and trumpeting that they're moving us forward into the twenty-first. You know why Obama's administration wants the electronic medical records? It's not for the patients. It's not for the doctors. Oh, no. The insurance companies want it. They want it so they can deny claims and get evidence to use against tort proceedings. It will be a hopeless boondoggle, but it will ensure that any doctor can be audited and fined. Obama's campaign got huge greasy gobs of money from insurance firms, and I am sure the top buffoons crafting this legislation are as well.

Of course, that will be another mandate for each individual doctor's office. I am sure they will manage to simultaneously require health care providers to violate at least three federal laws carrying significant civil penalties in order to comply with that one in order - you guessed it - to avoid significant civil penalties. Why the h__l would anyone do this for a living? I mean, provide health care? We're going to be left with the dumb and the insane as doctors. And the saintly I suppose, but there are very few of those....

Gubmint health care efficiency is a lot like a mandatory close personal encounter with Ariolimax Dolichophallus, that's for sure.

Oh, it's gin, gin, gin, that makes you want to sin, on the farm, on the farm. It's gin, gin, gin, that makes you want to sin on the Leland Stanford Junior farm...

My eyes are dim, I cannot see, I have not brought my specs with me! I have, hey, not, ho, brought my specs with me...

Oh it's rum, rum, rum, that makes you want to hum on the farm, on the farm. It's rum, rum, rum, that makes you want to hum on the Leland Stanford Junior farm.

Oh it's hot roast duck, that makes you want ....

Had forgotten the Stanford drinking song. 56 years since my wild, carefree youth of drinking, singing and such.

If this healthcare bill is as bad as it seems, I may revert to drunken singing again, just to drown my sorrows.

"Oh, it's gin, gin, gin that makes me want sin......."
"Why the h__l would anyone do this for a living? I mean, provide health care?"

Why indeed.

It'd be amusing, had this not been health care, to recollect that one of the rallying cries for reform was the supposedly "High" and "Unnecessary" administration costs incurred by private insurers.
Sad as the fallout of the financial crisis is, this is the worse tragedy. Appalling really.
Ah well. Relax, and enjoy the chaos. At this point, the worse, the better, at least for those that survive it.
And everyone laughed when I said the country was going to head right. There's only so much of this people can take.
President Merkin Muffley's dire prediction is coming true - we may actually be envying the dead.
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