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What’s wrong with this string of syllables?

‘Why isn’t there an Uber of health care?” That’s the question that Manhattan Institute health care expert Avik Roy asks in the opening of a must-read paper, “Health Care 2.0: Ushering In Medicine’s Digital Revolution.”

Correct. When someone cites Roy as an expert on anything but shrieking “Bleah bleah Obamacare!!” you’ve got a problem. However, this is an IBD article. IBD exists to make the Wall Street Journal look like it is run by Marxists, so it isn’t terribly unexpected.

OK, asking why isn’t there an Uber of health care is also a problem because call me persnickety, but I believe there are a few differences between driving a car and providing health care.

“Why can’t we deploy, in health care, the same forces that are improving quality and lowering costs in virtually every other sector of the economy?”

Because you free market chuckleheads haven’t figured out a way to outsource face-to-face patient services to children in a developing nation.

Would be my guess.

These are questions that so-called health care experts rarely ask. Instead, they complain about how MRIs are expensive and how breakthrough drugs cost too much and how more government intervention is needed to keep it all in check.

You know the “Evil/Stupid/Both” question that often arises when neo-cons are the topic of discussion? I think the question should be “Who cares why this stupid ass is such a stupid ass?” Articles about health care that ignore the on-going effort to move the health care delivery and payment model from quantity- to quality-based, using technology even, are one of the many reasons why.

But it isn’t just the Koch shillbots pushing this stuff. Doctors are getting Uber Fever too:

The Uber for health care would allow anyone to access the expertise of the best doctor for diabetes, bladder infections, or cancer care. Like GPS once this health care software or app is developed, make it widely available to the public. They will be expertly guided and learn if they need treatment, what type of treatment, or perhaps they might choose no treatment. After all, the problem patients wanted solved is that they have symptoms, want to know the cause of their symptoms, and, if necessary, get the treatment needed to resolve the issue.

While increasingly there is more software and apps that connects doctors to patients, what we need is software that takes medical expertise and makes it available to the public.

Once this class of software is widely available to public, then the Uber for health care will have arrived. People will discover health care can super convenient, quick and easy, and inexpensive.

Just like Uber.

1. Create app.
2. ????
3. Health care!!

I originally saw the article on Kevinmd.com and was actually relieved to learn that version had been edited. The full version is essentially an advert for Dr. Liu’s own app-driven health care service, Lemonaid Health.

He probably doesn’t think that his service can be scaled up to treat skin cancer or congestive heart failure.


You know what? Forget it, I’m not sure about anything any more.

But Dr. Liu’s model does not involve direct patient/provider contact. Patients fill out questionnaires and for some conditions (hair loss, acne) send in pictures. The doctor on the other end writes a prescription et voila! Health care. Or a dramatic and exciting paradigm shift AKA a pending medical malpractice lawsuit. Who can say? The trick is knowing when to dump your stock in it.

A month before Dr. Liu’s article ran, Dr. Jay Parkinson wrote about his experiences as a web-based health care pioneer. His diagnosis? Fuggedaboudit:

Here’s how I spent the day. I’d wake up and hope that I got a few early appointments during the night. I’d read their stories and then email them to arrange the housecall. If I needed to draw blood, I’d ensure the right supplies were in my doctor bag. If I needed vaccines, I’d have to swing by the pharmacy to pick up the vaccine. If I had to draw blood, I’d have to drop that off to be picked up. If I knew a housecall wouldn’t solve the problem, I’d email the patient with a referral recommendation and a reason why. I could do all of this while traveling, which was increasingly being done by cab so I could communicate and travel.


House calls are not only unscalable for an absurd litany of reasons, especially outside of hyperdense NYC, they’re irresponsible for the system. But it boils down to two issues: It’s ridiculously inefficient and very, very few doctors will actually want this kind of life. I do think they should exist as a ridiculously expensive option for people who don’t care about money, because America.

I don’t agree that house calls don’t work, period. However, Parkinson’s experience is informative because it was a lot more like Uber and traditional health care than Lemonaid.

Not that I expect anything to stop invisible handers from going on about UberCare for the foreseeable future. Especially if they suspect it would increase human suffering and Piss off the Liberals.

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