How business, doctors and journalists prey on your food anxieties I

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ii 14 : i : I
A White House challenge to telemedicine
"W2 V6[IIASOTHER DAM\ COMMISSION On
this like we need a hole in the head," complains
one member of a ,roup stud\ ing te!emedicine-the
apn!ication of tre!ecommunications
<strong>and</strong> electronics to medicine . The group is
headed br Dr . C . E\ erett Koop, the :ormer U .S .
Surgeon General .
What irked this corporate health care esecuti%c
%cas a courtesr call b% Hillan- Clinton on the
mostly pris'ate sector Koop group's meeting at
the White House on July 11 . Bur courtesr
wasn't at the top of the First Lad% 's agenda .
Instead, she informed the group that the White
House is about to create its o~~n commission
to study telemedicine . The White House's
group will be be chaired bv Health & Human
Sen-ices Seaetan' Donna Shalala .
Many of the Koop group's members suspect
the White House is tning to delay remm -
ing barriers to telemedicine . The members of
the proposed Shalala commission arc not expected
to be in place for six months or more .
And Shalala's agenaseems to ha~e little interest
in telemedicine : Probablc to protect cn il seraicejobs,
die Ht-is' Heaith Care Finance Administration,
uhich supen'ises the 5250 billion a
year spent on bledicare <strong>and</strong> -Medicuid, refuses to
hare anything to do ~k'ith telemedicine .
P.11 of Nrhich is a shame- Telemedicine is
esscntialhabout mocing X rays, CAT scans <strong>and</strong>
Out of date indicator
other test data di¢itallv, across phone lines .
The Koop group's members are top health care
people from such diserse companies asATeT,
GI . Kaiser Permanente <strong>and</strong> sotrn are maker Oracle
Corp . It also includes Defense Department
medics aho ha~e considerable practical
experience with telemedicine .
Done right, telemcdicine has the potential
to make top-grade second opinions (even priman7
diagnosis) affordable <strong>and</strong> available more
or less amlchere . Simple cost-cutting examples :
eliminating duplicate patient records <strong>and</strong> duplicate
X ravsTelemedicine is already a $20
billion <strong>business</strong> in the U .S . <strong>and</strong> is expected by
the Koop committee to gro%% to S 100 billion in
the coming fik e vears or so .
But there are barriers that need removal .
For example, state licensing of <strong>doctors</strong> would
ha e to be eliminated to allo« etficient crossborder
diagnosis bv wire . And «hat about malpractice?
Who sues whom <strong>and</strong> where over a
problem a!legedh• eaused b~remote electronic
diagnosisi
The Koop group's people saN thet' intend to
push on regardless of the ne«, Shalala commission
. The group does have one potential
weaoon : Thev were convened in the first place
bN 1~ice President Albert Gore Jr . If the First
Ladv becomes an obstacle . the First Renlacemenr
might hare a word «ith her .
WHAT i5 .4IIOL;T TO HdPP-\ to im-entorles in
the coming months, whether stocks of unsold
terpoint . His concern that excess <strong>business</strong>
stocks might continue to put a severe crimp in
cars or s weaters in retailers' w arehouses, is "a growth has been echoed by mam, other economic
crucial element in the near-term outlook for the
econonn _" Federal Resen°e Chairman Alan
Greenspan warned Congressin mid-Juh,soon
torecasters .
Greenspan et al . can relax-on this point at
least . The buildup of inventon• caused bv die
after the Fed had cut interest rates bv a quar-
slo~cing of demane9 that began in the fall of !ast
year has already peaked (see chrtrr)
The chart also suggests that imenton' leve!s
~" have reached a lower plateau as computers are
diffused into dte economs . "The combina-
-t . .- rionofnearly instantinformationonsales,justt
1 i n-time-de ! ivenststems <strong>and</strong> b rutal
competi-
'85- '87 '89 '91 '93
_~ w4-Eabe!_Resax 6enF ut St. toud
As computerized inventory systems
spread, companies can adjust inventory
levels faster <strong>and</strong> get by with less .
tion means rhat %%•hat used to take 12 months of
pain, to ~se>rk down excess stocks, now takes
no more than 6 months," says Adrian Dillon, 2L
vicc president, p!anning at Eaton Corp. O
The speed svith schicl : <strong>business</strong> reacts these M(i
dar's to changes iu dem<strong>and</strong> adds its own nesti' Ql;
twist to economic volatilite . It also makes it O~
harder for the Fed to trv to micromanage the 1I
econom v . These davs, the central bank's W
«'eapons, mostly interest rate changes, take ~7
much longer to have an effect, <strong>and</strong> exhibit GD
more sariabie lags than decisions made in the
nation's boardrooms . 111111111
Forbes m August 14, 1995 37
http://legacy.library.ucsf.edu/tid/agf97d00/pdf