Localize to Democratize Heathcare

The role of governments in healthcare, including information technologies, is such a politicized issue, it’s hard to find objective and in-depth analysis of options, benefits, and costs. Virtually every voice is an apologist or protagonist of one position or another interfering in the type of objective analysis that is necessary to have a factually-based, fair, and efficacious solutions.

For example, a 2014 study by the independent Pew Research Center found that government involvement in healthcare regulation is heavily supported by liberals, 89% of whom opined that it is the role of the federal government to ensure health insurance of citizens; however, the general public feels differently with only 47% feeling the government has some responsibility and 50% opining that it is not a responsibility of the federal government. (Pew Research Center, 2014)

Two often overlooked elements in the debate about the most appropriate and ethical role of government in healthcare regulation, including things like genomic uses and the creating and promulgation of standards for technologies, are geography and symmetry of information. Asymmetry of information between patients, patients and providers, technology and technology vendors can create monopolistic type conditions. Intentional applications of asymmetric understandings or information can also result in unethical conditions, for example, pharmaceutical companies repetitively exposing patients to advertisements creating an unequal impression compared to providers’ recommendations. 

Geographically, the needs for government intervention differ because the needs of the people and companies in those regions differ. For example, it would make no sense to regulate the use standards of genomic data or block chain security in India, a country where hundreds of millions of patients still see untrained physicians for a $1. In some countries, these needs differ by region – wealthier regions of India or wealthier US states have different ethical needs for government healthcare regulation than poor regions or states. Alaska’s problems and needs are different than New York.

Government often involves itself in ways that, however well-intended, actually cause harm or massive monetary wastes or opportunity costs – the cost of not doing higher priorities. To quote global news analysis periodical The Economist: “Two forces make American laws too complex. One is hubris. Many lawmakers seem to believe that they can lay down rules to govern every eventuality… The other force that makes American laws complex is lobbying. The government's drive to micromanage so many activities creates a huge incentive for interest groups to push for special favours.” (The Economist, 2012) 

Therefore, this author would advocate these two decision criteria be applied to the discussion of how, when, why, and how government involves itself in healthcare regulation. One way this could be performed objectively and without political or special-interest influence would be for independent, fully-funded, expert panels without ties to any industry or political agenda to prioritize the information needs by audience by region. Thereafter, funding from the federal governments could be provided to state and regional governments to locally administer and address their unique informational needs. 

This model can also be applied to technologies and medications, and at a macro or global level, possibly through the United Nations or World Health Organization. A global panel would, for example, be most appropriate for information technology standards because most technology innovators and pharmaceutical manufacturers and insurance companies are multinational and work around, in the most efficient market-driven manner, inconvenient regulations proposed by any one country. The advent of cloud-based software-as-a-service (SaaS) aligns with these work arounds closely; the model proposed would make such work arounds more difficult to execute.

One challenge though with this approach is distrust between governments. As of spring 2015, 67 countries or regions were attempting to enact data residency requirements for their citizens’ data. In Argentina, Canada, Israel, Russian, and parts of the European Union, financial and health information on their citizens may not leave the country making Big Data analysis and global health approaches much more difficult, even with the option of tokenized or anonymized data. (Hawthorn, 2016)

Works Cited

Hawthorn, N. (2016, October 29). 74% of Cloud Services do not Meet European Data Residency Requirements. Retrieved from Sky High Networks: https://www.skyhighnetworks.com/cloud-security-blog/74-of-cloud-services-do-not-meet-european-data-residency-requirements/

Mor, N. (2015, December 21). What role should governments play in healthcare?Retrieved from World Economic Forum: https://www.weforum.org/agenda/2015/12/what-role-should-governments-play-in-healthcare/

Pew Research Center. (2014, June 12). Political Polarization in the American Public.Retrieved from Pew Research Center: http://pnhp.org/blog/2014/06/13/pew-research-on-the-governments-role-in-health-care/

The Economist. (2012, February 18). Over-regulated America: The home of laissez-faire is being suffocated by excessive and badly written regulation. The Economist, p. http://www.economist.com/node/21547789.