Technology versus Politics

Technology is marvelous. It tends to make things better, cheaper, more available. It tends to make people happy.

Politics, on the contrary, is the opposite of all the above.  The most exciting, promising technology turns divisive, corrupt, costly and deadly once politicians get their mitts on it.

We should never have let them monkey with our healthcare.  I’ve said so many times in the past (see links below), and I’ll keep saying so until we snap out of our stupor …or it comes crashing down around us (at which point I will say I Told You So).

So, let me offer just one, seemingly minor, even merely clerical reason, why your healthcare sucks.

It’s called ICD-10.

First of all, in my business of healthcare information/image technology, compliance with ICD-10 has been an enormous (i.e. expen$ive) undertaking. There are seven squillion, nine hundred and ninety three fillion codes (give or take) to correlate to software hooks and data. It has made the inherently complex business of making products for patient care even more complex.

The mass of codes and interrelations is certainly a hassle for the engineers making stuff to sell to doctors – presumably to make healthcare providers’ jobs easier (at increa$ed co$t, of cour$e).

But what does ICD-10 mean to doctors, patients and the tangle of insurance companies and taxpayers who ultimately pay for all this complexity?

Well, as of October 1, the wrong code can lead to not only a denied claim and/or months/years of costly hassle, but perhaps significant punishment (on basis of “Medicare Fraud” among other things too legally frightening to mention) for the doctor/institution as well.

Good, you say?

You want fewer mistakes in medicine.

Yes of course.  We all do.

Doctors must do better, certainly.  Prescription drugs, correctly taken, kill more people by far than do “illegal” drugs.  And hospital stays in general (with iatrogenic infections, drugs, mistakes, etc.) kill more Americans than everything but cancer and heart disease.

But what does “do better” mean?  And how do we help make that happen?

And how much arm-twisting, lawsuit-hurling, defrocking, fining and imprisoning force does it take to be helpful??

Let’s see how ICD-10 “helps.”

Let’s say a Farmer Andy comes to the Family Practice clinic with an infected wound that he’s not so sure he can explain. Stuff happens to farmers all the time, and he just can’t remember what this wound was from, initially. He’s always getting bangs and scrapes and cuts, after all.

(And let us be truthful. Andy is a terrible farmer. He’s mostly into quixotic politics)

So, what was the injury initiating this visit?

It’s legally critical we get this right!

Was it ICD-10 code W55.21, “Bitten by a cow,” or W61.33, “Pecked by a chicken?”

Was it when he became a V00.01 “Pedestrian on foot injured in a collision with roller skater?”
Come to think of it, he had been visiting his nephew in prison when that happened, which could add a Y92.147,“Courtyard of prison as the place of occurrence of the external cause.”

Does that qualify as a Z63.1, “Problems in relationship with in-laws?”

Anyway, the doctor knows it wasn’t Y92.253, “Hurt at the Opera,” since Farmer Andy hasn’t gone there since the last episode…(we mustn’t discuss it here.  That would be a violation of HIPAA rules which could lead to a revoked license and even prison).

Farmer Andy did mention (under his breath, seemingly ashamed) that it could have been an “Accident while knitting or crocheting,” which would be a Y93.D1.

The doctor hated to ask, but since he knew Andy and his family had been to Sea World, could Andy have been “Struck by Orca, initial encounter,” which would be a W56.22?

No, said Andy.  It certainly wouldn’t have been a Killer Whale, nor was it a strike.

There was perhaps that bite from a Sea Lion, Andy recalled.  Though it wasn’t the first time, or even the second time that had happened.

So that would be a W56.11XS “Sequela…Bitten by Sea Lion.”

Hmmm, the doctor thought. That would have a very specific look to it.  No; it must be something else.

The wound wouldn’t look like this if it were a V91.07 “Burn due to water-skis on fire,” certainly.  He’d seen plenty of those before.

And the doctor could tell just by looking at him that Farmer Andy hadn’t been “Sucked into jet engine,” or X52.

Or was he getting the codes wrong?

Damn!

Wait…X52 is actually “Prolonged stay in weightless environment.”

Was it V95.40? No…that one is the rather vague, “Unspecified spacecraft accident injuring occupant.”

How about Y37.54?  (Doctor types in code and waits…it’s a big database)

When the doctor worked in the hospital, there was an entire department of people whose only job is to “do coding.”  Here in the clinic, they’ve got a part-time/outside IT department, and sometimes their network bogs down, and…
Oh, here it comes…

Oh heck no!  Y37.54 is “Military operation involving nuclear radiation effects of nuclear weapon.”  SMH, he thought.  He should’ve remembered this one from last week’s incident.

Ah, there it is…V97.33 is the sucked-into-jet-engine code.

Dang it, he has to remember that.  The CMS (Centers for Medicare & Medicaid Services) “ICD-10 Ombudsman” was fairly lenient last time.

He can’t afford to make that mistake again!

OK, I have a question for you.  Does the preceding strike you as the best way to improve healthcare delivery?

No?

Now, codifying data is a great idea.  In the right hands and in the right way, when we’re ready (this is a key part), then having convenient, appropriate labels for all our data makes it easier to store, find, and use in a meaningful way.  And I’m even all in favor of people using ICD-10 exactly as it is…if they choose to.

Let me restate that.

If people trained in the care of patients, in their situation (hospital, clinic, private practice) find that using ICD-10 codes helps them treat patients, then great.  Excellent, even!

But that’s not how our $y$tem work$, is it?  It’s not up to the healthcare professional how things are billed and paid anymore.  It hasn’t been for many years now.  In the most practical $en$e, politicians are more involved in healthcare decisions than doctors are.  Doctors can bill for only what they can get paid for by people other than patients; and that is determined by politicians.  In this case, technology becomes more of a parasite than an aid.

As a true-free-market technology guy, that breaks my heart.

Just imagine you’re trying to sell something; a product you make, your old car, cookies at a bake sale…but bickering politicians, lawyers and lobbyists determined what you could charge for it.  Imagine they demand you buy some things, and don’t let you buy others…and that every political intervention not only directly affects your job…it substantially changes your job.

How would that work out in the real world?

And the way “meaningful use” and other “federal” requirements are being FORCED on healthcare providers is, at this state in our knowledge and technology, madness on top of even more madness (do I even need to mention Obamacare?).

To make matters worse, healthcare has been a union shop/monopoly for over a hundred years.  There can be no serious competition with what politicians and lobbyists call healthcare.

If the rest of our technology worked like this, we’d all be clacking away on Windows 3.1, at best.

There were smart people involved in the development of ICD codes.  Lots of them.  But their seemingly dedicated work was performed in disconnection from monetary, human and practical technology concerns.  It’s another good example, in fact, of such obsessive bureaucratic “paperwork” (albeit mostly without paper), that the recording and processing of all this data can and often does compromise patient care in ways analogous to the Observer Effect.

OK, so I have another question for you.

Should we let doctors, who go to school for many years and spend a lot of time in residency and continuous training, actually do the jobs they were trained to do, or should we continue to vote for ever-more intrusion into that profession by politicians, who don’t need any education or even interest in healthcare at all?

Well, please think on it.

It’s your money, your rights, your life and health at stake here, you know.

https://wedeclare.wordpress.com/2013/10/15/can-politicians-even-define-health-care/

https://wedeclare.wordpress.com/2009/07/28/health-insurance…or-healthcare…choose-one/

https://wedeclare.wordpress.com/2009/09/23/a-short-history-of-health-care-let-doctors-be-doctors/

Let’s chase the fox out of the henhouse

Please do me a favor and write letters to the editor, to your local radio and print broadcast, regarding a terrible, destructive, unconstitutional and criminal scam that’s been worsening for the past one hundred years.

The private clubs we call the Demoratic and Republican parties have, as you know, granted themselves special status, powers and advantages.  Taxpayers are forced to pay for political primaries that involve only Ds and Rs, and which give them a year’s head start in public attention, fundraising, and organization.  Only Ds and Rs can have Precinct Committeemen, people with many quasi-governmental powers, yet none of the restraints.  Only Ds and Rs can be on election-related committees – only they count the votes, make appointments and fill public office vacancies.  Only Ds and Rs can have electors, who really choose the President of the United States of America.

All that is immoral, unconstitutional, corrupt and destructive.

I’ve been advised that, while my case is rock solid on fact, merit and law, no court in Indiana, federal or state, would hear my case; at least not until there’s some public attention on this ongoing crime.  Without at least a little public attention, my suit would almost surely be immediately dismissed “with prejudice” as are so many other complaints against our rogue leaders.  So I take my case to you.

Please consider the gravity of my charges; and consider that you and your loved ones are also affected by our society’s worst, and potentially fatal problem.

If you’d like some supporting information to mull over, besides the links above, these might help:

https://wedeclare.wordpress.com/2015/05/18/your-government-is-corrupt-very-very-corrupt/

https://wedeclare.wordpress.com/2015/07/25/wanted-a-lawyer-to-save-the-law/

Click to access andys-complaint.pdf

https://wedeclare.wordpress.com/2015/06/03/lets-clean-up-our-mess/

I sincerely thank you in advance.

Liberty or Bust!

Andy Horning

Freedom, Indiana

Summer 2010 Indiana Policy Review

Here’s the latest Indiana Policy Review summer 2010 journal – “A Tea Party Primer.”  Please pass it on to everybody you know.  Tell them to pass it on to everybody they know.

Etc.

It’s now or never, my friends…

Here’s one last column before I take down this site:

I have never believed in the Easter Bunny, Santa Claus, or that creepy Tooth Fairy thing. 

But that doesn’t mean that I haven’t nurtured other baseless, nutty beliefs until some painful paroxysm jolted me awake. 

Many years ago, under horrible personal circumstances, I endured the same spiritual upheaval you’re feeling right now.  Just as with you, my religion turned out to be a big lie.  My false god turned against me, just as it’s turning against you now.  So like you, I can no longer believe in the charity, peace and love of …politicians. 

While initially painful, there is relief in this truth that sets you free. 

But there’s another problem.  Nobody alive remembers how liberty works.  We cannot imagine how schools, roads jobs, healthcare, or food ever existed without a political genesis, subsequent bailouts, lawsuits and bipartisan bickering.  Only if you’re over 100 years old did you even exist when there was such a thing as a free market; with all the innovation, competition and rapid advancement that entails.

So as we endure the agony of Change that’s not working, we must thoughtfully prepare a better way forward.  I suggest we first retrieve what we’ve lost from the past.

All federal authority is still clearly written into the Constitution for the United States of America (Article I, Section 8; Article II, Sections 2-4; Article III), which you could read in just a few minutes.  All other powers are still very clearly denied by one short sentence (Amendment 10).  Similarly, all Indiana government powers are spelled out in the Indiana Constitution, while every other conceivable power is still denied by a single sentence (Article I, Section 25).

No state or federal constitution was ever amended, altered or suspended to authorize most of what governments now do to citizens.  Nullification of anything unconstitutional is already law at every level of government in the republic.  So we have the right, the power, and the duty, to tell politicians to back off; all the way back to the constitutions.

Here’s a summary of what that means:

1. Citizens can do whatever they want to as long as they don’t harm anybody else, or take what’s not theirs.
2. We’d have no more government than necessary to maintain #1
3. We invite others around the world to emulate our success, but otherwise leave them the heck alone.
4. Your major civic duty is to disobey, invalidate and otherwise eliminate all unconstitutional taxes, mandates, organizations and agents.  Yes, civil disobedience is a duty. 

So caveat emptor would replace the FDA, FTC, FDIC, FCC and a zillion other F’agencies.  Common sense, family ties, competition, voluntary associations, charity and free market options galore would replace union/corporate monstrosities, Medicare, Social Security, lobbyists, regulations, litigation and price controls.  And because of the preceding, you get to keep what you earn, buy what you like (smoke it if you’re fool enough – and as long as you don’t blow it in my face), and live however and with whomever you want…as long as you leave others, and their stuff, alone.

No federal tooth fairies, no President coming down the chimney with presents, no more bogus political promises; just a reality proven to work better than anything else ever tried.

That may not be a Square Deal or a New Deal.  But it’s a fair deal, which makes it the best deal in all of human history. 

Can you live with that? 

People used to call that “freedom.”

And they liked it.

Job Creationism debunked

All my bilious rumination against the media aside, I am pleased that the Indy Star printed what I’d submitted for their Voices pages:

 

Politicians tend to lie.  Citizens tend to believe.  The tragic, interminable history of what happens when governments go bad and citizens go silly is reason enough for a healthy condition of mistrust.  Governments are, at best, protection rackets.  They always extort some opportunity and wealth from citizens even when properly restrained to only protect our rights, property and life from others who’d take them away.  Government is a suppressive force, not a creative one.  So I’m sorry if this is news to you, but the political promise of “job creation,” is hogwash. 

 

A hundred years ago, there were no government “services” as we know them today, and government was leashed to solely a constitutionally limited, protective role.  Americans became the richest, freest and most secure people of all time because people naturally want to do well for themselves, and they were allowed to do just that. 

 

The genius of the founders was unequivocally proven.  Freedom works better than anything else ever tried.  That’s why it’s the law (see it in black and white at http://www.horningforgovernor.com/; it’s my Platform). 

 

But Americans fell for a “New Deal,” slowly devolving back to our brutish default of rulers versus ruled.  Government isn’t about protecting you anymore.  It’s about robbing Peter to pay Paul; with every election cycle merely an exercise to determine who’s Peter, and who gets to be Paul.  We’ve fallen so far toward this pre-Hammurabi authoritarianism that even the word “privatize” means the concentration of profits into the ruling class, while spreading their losses to you.  Now, if you make fat campaign donations and hire a lobbyist, you can live well on other people’s labor. 

 

This hurts Hoosiers more than most Americans.  Hoosiers once made 106% of the nation’s average salary, but we’ve lost twenty percent to that average in the past three decades.  Just in the last 4 years alone we’ve lost 72 electronics companies with over 11000 high-paying jobs; not to foreigners, but mostly to other rust-belt states.  These jobs have been only partly replaced by much lower-wage service industry jobs fueled by our political fixations on foreign corporations, sports and gambling.

 

So I’m running for the constitutional office of Indiana Governor because freedom is still the law.  I would govern government, not you.  I think it’s about time.

 

Prohibitions against firing bad workers increase resistance to hiring.  Such prohibitions are illegal, so I’d remove them and let the hiring begin.

Hiring illegal immigrants is attractive because doing so evades the mandatory costs of taxation, regulation, insurance, pensions and of course litigation.  I’d remove these illegal impediments to hiring Hoosiers, and bid illegal immigrants, ¡adios!

Because there are no impediments to buying foreign products made without our handicaps of taxation, regulation and litigation, we are competing against the world blindfolded with both hands tied behind our back.  I’d remove these illegal impediments too, and let prosperity happen.

 

I would massively cut taxation, regulation and litigation for everybody, not just for the elite.  Not only would businesses do better in Indiana, but so would the people that work for businesses.  Small businesses would no longer be at a disadvantage to the politically-connected corporate giants.  No more political class versus peons.  No more losing a home to property tax.  Everybody, including politicians, would be equal under the law.

 

Hoosiers would thrive because they could, and because they want to, and because nobody would stop them anymore.