Why ICD-10? The “Most of What Government Does Isn’t Cost Effective Anyway” Defense

A.S.S. (4/2/14) Needless to tweet (but I’m sure to do so anyway), this blog post generated a lot of disagreement on Twitter. I’m prepending the choicest here, in what is called an “antescript.” In contrast to a postscript, it occurs at a document beginning. (Skip to blog post.)

A.S. (3/31/14) Well, ICD-10 was delayed for a year, to 2015. I wrote the blog post below the day before the vote. Today tweets containing #ICD10, #ICDdelay, #nodelay and #SGR flew fast and furiously. I predicted the outcome before the vote and extracted what I believe is the fundamental lesson.

My original blog post….

I was a premed Accounting major (from the perennially ranked #1 University of Illinois Department of Accountancy). I believe in cost-justifying anything by anyone, from me to companies to the government. I’m against stuff that harms physician workflow, productivity, and professional satisfaction (best route to patient satisfaction with their physician). So anyway, I’ve been following the debate about ICD-10 and tweeted a link to Kyle Samani’s Why ICD-10?

My, my, my!

I think Kyle wins the debate hands down, but this is the quote from a comment counterargument that gobsmacked me.

“I’ve read all of Halamka’s posts. He’s a smart guy for sure. If you want to take an Expected Value approach to making decisions then probably 80% of the things we do and what the government mandates wouldn’t pass muster. IMO a weak argument.”

The crazy thing is I get the same basic argument from lots of people! That and apparent inability to understand the concept of sunk cost re the potential ICD-10 delay.

Normally I absolutely hate animated GIFs. However, this one for “puzzlement” has a big strong Expected Value!


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