Comments on: Vested interests

By: Paul M.

Paul M. — Wed, 16 Dec 2009 23:06:51 +0000

Thanks Nick, and I’m sorry it’s taken me longer to follow this up than intended.
I’m certain there are more factors than the described vested interests that are sources of e-commerce (and e-health) friction. And certainly I wouldn’t want to trivialise all of the other economic, political and technical challenges with creating a straight-through processing world for personal healthcare-related data. The goal of the original piece of course was merely to highlight this one, important, source of friction.
On the issue of incentives and helping people be healthier, I would have thought the argument was simple: If an EHR system reduces to nearly zero the probability of a healthcare worker making an error with my diagnosis and treatment, then I’d pay some reasonable premium in my health insurance or Medicare levy for that.

By: Nick Carr

Nick Carr — Mon, 14 Dec 2009 03:26:41 +0000

Paul, I’m not sure about the ‘vested interests’ argument. I feel like it relies on too many disconnected parties cooperating to be plausible.

Lately I’ve been reading a bit about IT and transaction costs. To me this connection plausibly explains a why an investment in technology can sometimes increase costs rather than reduce them. I think this is where healthcare is.

http://www.instant-science.net/pub/tracost.pdf

Computerizing health transactions won’t be cheaper if the move to technology increases uncertainty. Proving security, certifying the people viewing the data and tracking everywhere data has been used and by who is actually going to be pretty hard.

Until people get an economic incentive to a) accept responsibility for managing their own EHR and b) take some risk with privacy, it is hard to see healthcare being computerized.

As an aside but along the same lines, it seems very rare for this discussion to ever focus on how computerizing will help people be healthier. Until the discussion moves from industry costs to to incentives and rewards to the consumer, I can’t see the change happening.

By: Paul M.

Paul M. — Fri, 11 Dec 2009 03:29:50 +0000

Thanks for this contribution, Brett.
I’d like to have a look at those cases. The ASX one in particular looks pertinent.
Regarding electronic conveyancing and NECS, I think we are seeing an interesting piece of technology ecosystem history being played out. I’m not qualified to comment on the ‘duplicate certificate of title’ issue of course – I gather this is something intimately familiar to conveyancers and land titles offices. But whatever the problem, if it can be resolved and the NECS successfully delivered and adopted, (yes – a lot of ‘ifs’ in there!) it has the potential to be a world class example of infrastructure reform on a whole of industry scale.

By: Brett Hayton

Brett Hayton — Thu, 10 Dec 2009 03:16:01 +0000

Two industry sectors that did manage process change against the established vested interests.

1. Formation of the Australian Stock Exchange, combining the 6 State based stock exhanges. For a complete history read Edna Carew’s book – National Market, National Interest
http://tinyurl.com/yfmgeyt
2. Reform of the Australian Money Market settlements by Austraclear.

A common thread in both the share markets and money markets was doing away with paper scrip and similar steps were taken in the money markets.

But reform of mortgage and property settlements is proving tricky. It is not as if there has been no reform of Land Registries, because there has. All Registry Books are in electronic format, having been converted from paper based registries. In my humble opinion, Land Registries will not be able to introduce electronic conveyancing until they take the bold step of elimination of the duplicate certificate of title.

Until there is no debate left on the issue of the abolition of the duplicate title, I cannot see “electronic conveyancing” advancing, despite the vested interests getting in the way.

By: Paul M.

Paul M. — Mon, 07 Dec 2009 23:18:20 +0000

Thanks for the comment Barry. I'm sure you're right - an industry without vested interests holding it back would likely be the exception rather than the norm. Liming has taken a "comical" approach to describing the same problem, and this immediately evokes thoughts of games theory applied to organisational behaviour. Maybe this could be the topic of a later post (once I understand the first thing about it). In the meantime Liming also claims to have the solution, but like 17th century mathematician Pierre de Fermat, unfortunately not enough space in a tweet to provide it! It took about 360 years to find the proof to Fermat's Last Theorem. I propose we all take a positive, can-do attitude and resolve to crack this one within about the same length of time.

By: Barry Thomas

Barry Thomas — Mon, 07 Dec 2009 00:30:39 +0000

Well, the obvious example that springs to my mind is the mortgage lending industry. Half-decent B2B messaging standards could deliver huge benefits to borrowers (e.g. easy comparison of products and fees, easier switching from a lender you’re not happy with, lower interest rates driven by improved competition, etc.) but aren’t really in the interests of the major lenders. So it’s no surprise that the standards that do exist are a pale shadow of what they could be, and have been widely adopted only where they deliver cost reductions specifically to the big 4 banks.

The proposed National Electronic Conveyancing System is another example – but this time the vested interests largely lie in State government departments that feel threatened by a national scheme, and that can effectively block progress because they hold the keys to the crucial vaults of data.

I suspect a harder question might be to try to think of an example where progress towards some objectively obvious “greater good” isn’t retarded by vested interests (shhh….don’t mention climate change….it attracts trolls.)