DATA WHINING. How is it that the same presidential administration and federal government "leading" the effort for, and extolling the virtues of, an efficient electronic health record, while dismissing privacy concerns as a non-issue, represent the same groups that can’t seem to protect the data of millions of retired and active military service men and women?

BINDER BENDERS. Forget about those endless committee meetings, droning and circuitous discussions and towers of three-ringed binders outlining the best-laid plans for disaster recovery efforts. Whether dealing with the aftershocks of mad cow, SARS, bird flu, al Qaida flu, Osama heebie-jeebies or whatever other malady Hollywood can dream up as a sweeps-week movie, the healthcare industry overlooks two fundamental flaws that must be solved before all its efforts can be considered legitimate solutions. First, there’s an inventory access problem. Consultants and vendors have been preaching for at least two decades that hospitals should reduce storeroom inventories via just-in-time and stockless distribution programs. Many have done it and may be operating with only a minimum daily stash. Because they’re running so lean on supplies they would have to rely on the Strategic National Stockpile as their salvation when crisis hits – and we keep hearing that even the Stockpile supposedly is ill-prepared for calamity. So if hospitals aren’t carrying the supplies they need and the SNS still isn’t ready even five years after 9/11, what to do? Second, there’s a physical distribution problem. Did we forget what the authorities did in Manhattan right after 9/11? They closed the city streets and blocked all air and water traffic. How do distributors deliver supplies to hospitals? By truck, van, airplane, helicopter or boat, using city streets, airways and waterways. If a group of misguided religious zealots can commandeer commercial aircraft and use them as weapons, could they not do the same with supplier vehicles – or at least place some biological, chemical or mechanical weapons among the drugs and medical supplies? Furthermore, even in the absence of terrorist involvement, how do these vehicles navigate through transportation routes clogged by a diseased and panic-stricken public succumbing to mob tactics just to get help? Let’s face it: A flu-pandemic-inflicted mob of thousands stampeding to local hospitals would make the impatient and irate citizens of New Orleans in the wake of hurricane Katrina last year look downright civil.

CIRCUITOUS LOGIC. Rather than implementing cost-based DRGs to replace charge-based DRGs next month as originally threatened, CMS decided to begin the process next month and phase it in over a three-year period. Whew. Now hospitals can procrastinate until President Bush leaves the White House and then start complaining in the media to his successor about an extension because they still don’t know what their true costs are, thanks to reimbursement cutbacks preventing them from investing in the necessary software and staff to figure it out.

Make sense, readers.