A premonition at the Boca Raton mall

Dow up strongly. Gold off $19, back below $1,300.

Trend? Not sure.

In the meantime, we have seen the future. Yes, in Boca Raton. At the mall.

We’re talking about the future of healthcare. It’s already the nation’s biggest and fastest-growing industry. And it’s ripe for disruption. A big fat plum, waiting for a worm.

In fact, were it not for the poisonous gas laid down by the US government and the healthcare oligarchy, the industry probably would have met its Napster already. For those who are not hip to the music world, Napster practically destroyed the whole industry when it made it possible for people to download music directly, without paying the band, the label, the distributor or the retailer.

Of course, the internet itself practically destroyed the print media, too, and has made it so cheap and easy to distribute information in any form that hardly any old-style ‘information business’ can resist it. Newspapers are sinking. Bookstores are closing. Directories and databases are all abandoning dead trees for the fluid freedom of fast-moving electrons.

Which brings us to the Apple store in the Boca Raton mall.

“What’s the problem?” asked a confident young woman with an iPad in her hand.

Elizabeth explained that one of her email programs wasn’t working properly. The woman took notes, or ticked off boxes. After a brief set of interrogatories, the woman announced: “A technician will be with you soon. Most likely, he’ll already know what the problem is.”

He would most likely know because he had probably seen it before. And the iPad had set him up for it. The information fed into the iPad helped the machine identify a range of possible problems and solutions. The technician must have had a fair idea – even before he saw the patient (that is, the laptop computer) – what was wrong and what to do about it.

Bill Bonner on markets, economics & the madness of crowds

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Most people do not have unusual computer problems; they have the problems that most people have. Similarly, most people do not have exotic or rare health problems. They have common health problems, the kind of problems most people have. These problems can be fingered in just a few questions asked by a competent clerk, tested with a few additional questions, instantly assigned probability scores for the accuracy of the diagnosis and given additional probabilities for the effect of suggested treatments. The whole software system could be of the open source variety, updated, improved, and deepened second by second, by doctors, tech assistants, clerks and patients, so as to record, recall and deliver far more information than a doctor ever could.

After pointing to likely problems, the software could print out hundreds of pages of documents, histories, studies, science, articles and so forth – including dissenting opinions and alternative recommendations – allowing the patient to become as much of an authority on his illness as he chose to be and to take as much charge of his treatment as he wished to.

The program could also recite the risks and downsides of drug treatment much more clearly and unabashedly than the typical medical professional. Clients could then purchase the drugs just as though they now buy additional accessories and software at Apple.

Questions could be easily enhanced by visual scans and more objective tests, where necessary. Complications, confusions and uncertainty could also be easily flagged for further study or more traditional medical treatment.

In any event, patients would have no obligation to use this new service. Nor would they be limited to it. It would be a cheap and easy alternative, at a fraction of today’s prices.

But wait, what about the risks? What risks? We presume the questioning/software would make wrong diagnoses from time to time. We presume treatments would be inappropriate, occasionally. But is there any reason to think there would be more errors in this system than in the system as it is now? Probably not.

In fact, modern internet communications allows patients to report on their progress on a daily, or even hourly basis. This would permit the software to ‘learn’, adjusting its models naturally and automatically, depending on the reported effects.

But wait. We must be dreaming! The healthcare/insurance industry is so rich, so successful, so fat and sassy. There’s no way the conniving partners – in the industry and government – will permit competition. Remember, we just saw a university study proving that the US is ruled by an oligarchy of rich special interests. Few special interests are as rich and powerful as healthcare.

What would the quacks and specialists do? Who would buy the worthless drugs and treatments? How would the health insurers make their money?

And what about the tort lawyers? Who would they sue if the advice came from an open source computer program, with perhaps thousands of contributors, including patients themselves?

Nah, a disruption in the healthcare industry? Not going to happen. The future will have to wait.

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  • Ralph

    Great article and absolutely spot on. Logically the NHS should have thought of this idea years ago. I am sure they did and equally sure it was rejected for the reasons that you mention.

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