Friday, January 27, 2012

Know Thyself

A driving principle of Health Care from ancient times to the era modern was "Know Thyself."

I read this aphorism to mean that the individual mind is the driving force behind the care of the individual body.

My goal in designing the Medical Savings and Loan was to create a structure in which the individual mind had greater control over the care of the body.

For several years I worked as a computer programmer for an insurance company. My job was to take information from paper medical records and to translate it into computer records.

To accomplish this goal, I was granted access to cabinets filled with informative and valuable health care records.

In the insurance paradigm, the health care records are the property of insurance companies, hospitals and other bureaucracies. The bureaucracy does not want people to have access to their health records as they would lose control.

For example, if you knew that your individual expected liability was $5000 a year, you probably wouldn't want to pay the $10,000 a year premium the insurance company charges.

The whole insurance industry is in direct opposition to the classical liberal tradition that sought to empower the individual to live full, happy and healthy lives.

I work in the computer industry. My primary concerns in life usually revolve around system architecture, processing records and writing code.

I know that this sounds as boring as all get-out, but my primary interest in designing the Medical Savings and Loan was the Health Care Records ... not the money.

The foundational premise of the Medical Savings and Loan is that the individual should own his own health care records. People lack the skills to maintain records; so they would hire a professional health care advocate to maintain the records.

Application Service Providers would create the technology used by the advocates to record the records. The service providers would essentially create a distributed network for sharing information about patients.

In this paradigm, you would own your health care records. The records would exist within a distributed network that is maintained by the Health Care Advocates.

Your experience in the Medical Savings and Loan we be a fun game where you would periodically sit down with an advocate in your employ to see how your individual health experiences contrast with the experiences of others.

The key to my vision isn't simply the money. The key to the vision is the ownership of the health records. I assert that the individual has a fundamental property right to their body and this right extends to thelr health records.

In contrast, insurance is built on the concept that they have property rights to your health care information. They use this information to build a massive centralized bureaucracy.

There is a fundamental dichotomy between the Medical Savings and Loan and insurance.  In the former, people own their resources in a distributed network. In the latter, insurance companies own the records and resources in a centralized monolith.

The primary health care debate has been about which big entity should own the monolith: big business or big government.

I don't want either group to own my health. I want to see a system in which individuals own their own resources in a massively distributed network.

Interestingly, this is the exact same issue as the conflict between main frame computers and a network of Personal Computers.

The internet is a distributed network of computers. So, my dream is not just pie in the sky. It has been realized in many areas of computing.

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