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.
