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Subject: Re: [ihc] Operational Model for IHC
Hi Sally, My opinion, as always, is that we need a mix of larger and smaller entities. However, for this field in particular I think it is imperative that we attract at least a few major IT vendors as well as some international governmental players and the public service, non-profit international NGO community, and, as the recent international disaster highlights, the emergency management community. This is due to the overlap of significant communities of interests, none of which should find itself in the driver's seat, so to speak. The primary reason for this is that this is such a highly contentious arena AND it produces such an opportunity for concentration of wealth and power. Largely, that simply hasn't been recognized sufficiently for underrepresented communities to enter the fray. I dislike using conflict metaphors but we do have an ongoing battle and we do have two incredibly important, and extremely lucrative outcomes that need to be understood fully: 1. Monetarily, several groups stand to benefit hugely, starting with the Insurance Industry which can realize enormous cost reductions while maintaining currently rising premium rates if they can control an industry (business-interest) dominated patent pool which can establish unregulated, necessarily grandfathered, de facto standards across the healthcare field ensuring higher profits for interlocking directorates (in terms of intersecting Boards of Directors) among pharmaceutical and medical supplies interests allied to these insurance/financial interests; and, 2. Politically, supporting a greater concentration of economic power for the patent pool mentioned above, can firmly establish a pipeline of ongoing political contributions based on those profits pointed out above, aimed to entrench existing patterns of political dominance, which just happens to be the environment that a powerful economic interest community will usually prefer if it benefits them as it does now, with the somewhat mitigated circumstances in several members of the European Union. Thus, this TC in particular needs to attract the active participation from some large IT vendors, whose wealth and power and legal resources can offset this situation, bring a balance of powerful interests to bear on this environment as they compete for the bulk of IT business--the vast global middle tier of businesses, in whose interest a non-royalty-dominated healthcare industry is clearly of more than passing significance. Please understand that my analysis of the situation is not intended as a diatribe against any specific interests, but only as an advisory that an unfortunately unbalanced and potentially harmful set of factors is currently at play. For their own sakes, these currently short-term-myopic interests which support this trend, should be fitted with corrective lenses. So for us, this trend needs to be headed off by attracting attention to the field, by players who cannot be ignored. It needs to be borne in mind by the global business community that eventually, due largely to the internet, there WILL be a global village, and it WILL become very well informed, and when it catches up with an understanding of how current vulnerabilities are exploited for the profit of a few, there will be a price to pay that is likely to outweigh any current profits. Specifically, I would like to see IBM participate actively in this TC as part of its partnerWorld ISV Healthcare specialty focus. I would like to see that participation bring in Sun and Oracle and Microsoft at least, if not the whole top tier vendor community, at least as observers. I would also like to see DHS and HHS and DoD involved in this work, too, since they all have a stake here whether or not they know about it. Since we already have some EU involvement, and some IBM involvement, I didn't want to appear to be saying that they are not involved nor take them for granted. I would be thrilled if they cared to publicize this effort. Lastly, as shown in the thread following Ed Dodd's post yesterday about the OMG Healthcare group meeting, I would like to see a very active liaison with that group and HL7. Regards, Rex At 1:30 PM -0800 1/6/05, Sally St. Amand wrote: >I joined Brett on the call this morning. I spoke to him about the >'operating model' for this TC. Other TCs I have belonged to have >relied on a (or more) large company to provide the resources that >have enabled the TC to function (picking up the teleconference >calls, etc) and providing a 'spotlight' to attract additional >participants/attention. I have heard some people advocate for this >approach for this TC; or more properly question if the TC can be >successful without the endoresement of major players. > >I suggested to Brett that this TC try and get backing--financial and >media--from one or more of the foundations that have a history of >supporting health care reform. I would like to see this issue be on >the agenda or list for discussion. > >Personally I believe there is more mutuality of objectives with >various advocacy groups and foundations than either the vendors or >the corporations. Most established businesses are more comfortable >getting behind an idea or effort that already has traction. >Foundations are usually more acustomed to initiating ideas. And I am >assuming we are not talking about a huge amount of dollars to >provide the wherewithall for us to do enough work to produce intial >work products. And .. advocacy groups are not infrequently funded by >businesses who want change but prefer to keep some distance at least >in the beginning. > >Any other ideas on an operational model for this TC? Any suggestions >on foundations/advocacy groups to pursue? > >Sally -- Rex Brooks President, CEO Starbourne Communications Design GeoAddress: 1361-A Addison, Berkeley, CA, 94702 USA, Earth W3Address: http://www.starbourne.com Email: rexb@starbourne.com Tel: 510-849-2309
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