Bret Swanson recently wrote in The App-lification of Medicine, “Between 1990 and 2010, while the rest of the U.S. economy enjoyed annual productivity gains of around 2%, American health care productivity actually declined 0.6% per year. Over 20 years, that’s a productivity differential of around 60%. If we could raise the productivity of health care, which is about one-sixth of GDP, we could substantially improve the nation’s economic health.” That means improving both the nation’s health and economy—not just being fixated on coverage of health insurance.
Unfortunately, the trend seems to be moving away from increased productivity because of government-created uncertainty. Last week Congress held hearings on some of the challenges in the health IT sector, including regulations, and exploring what Congress can do.
The FCC has signaled that it has a role to play in the deployment of health technologies. And the FDA is still trying to decide how it will regulate new medical apps and mobile health driven devices, even though its last guidelines were only set in 2011. While the FDA said it did not have an “overarching software policy,” it did ask for public input. Now, in 2013, the industry still waits for an official position.
The greatest concern with the FDA is that it will regulate first and think later. With apologies to John Lennon, “Everybody’s talking, no one says a word.”
Technology moves fast, with regulators always behind the curve and ill-equipped to regulate innovation before the innovations occur—to regulate before there is any proven need: short-sighted decisions based on best guesses of the future and grounded in laws written long before new health technology was thought of; congressional inquiries; hints at new rules and laws; the response time measured in years instead of weeks; the insistence that somehow government must play a key role. It all adds up to uncertainty.
And uncertainty is certain to drive out investment. As that investment dries up so too will new innovations and the promise that health IT holds for better health outcomes, delivered to more patients at lower costs.
We have wasted public attention and political will on the means instead of the goal. Congress and the White House pursued getting more people health insurance when they should have been removing barriers to better health. They still can. Get government out of the way of innovation and improve the health of the nation.
March 28, 2013