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July 4, 2003

 
E-Health: A prescription for wealth

By Karl Flecker, Polaris Institute

On a cold weekend in January 2003, nearly 200 grassroots activists from across Canada gathered in a small community centre just outside of Moncton, New Brunswick to participate in the annual Solidarity Network Assembly. 

Solidarity Network is a national Canadian organization that brings together community based social justice activists from a variety of struggles.  The annual Assembly contributes to coalition and skills building by offering workshops on topical struggles.  This year the battle to save and expand public Canada’s Medicare was a key workshop issue.

Polaris Institute offered a healthcare workshop titled ‘Waiting in the Wings’.  The session focused on identifying some of the for-profit health care corporations or perhaps more aptly dubbed ‘corporate sick shops’, that are positioning themselves to exploit public Medicare for private profits.  

Medicare in Canada is an integral part of Canadian society, it is a part of who we are - like an arm or leg, and it is essential and visible to us.  However, Medicare is under attack by corporate interests.  The healthcare privateers are largely unknown, unseen – nearly invisible to us. 

It is important that healthcare activists dedicated to saving and expanding public Medicare focus their campaign attention on unmasking these corporate sick shops. Medicare campaigns must identify and expose the track record of healthcare privateers and the level of political influence they have.  After all –public scrutiny is like a disinfectant that can cleanse our public healthcare system of skulking pests.

Healthcare services are very lucrative – globally this sector generates 5 trillion dollars/year in economic activity and in Canada healthcare services are a 90-billion/year operation.

Lets understand what such large numbers mean simpler terms. If you were to receive a 100-dollar bill every second- you would be a millionaire 8 x times over in just 1 day.  But if you received a $100 bill every second, you would have to have your hand out for 317 years – for just 1 trillion dollars!

Make no mistake, corporate sick shops are determined to privatize Canada’s healthcare system- and they won’t stop at our domestic systems.  Through corporate lobby groups they doggedly push for further privatization of healthcare systems worldwide via trade and investment agreements like the GATS.

Their motivation is clear. It is for the money.

Healthcare privateers are sophisticated and are often difficult to spot appearing in places we least expect.  The technology sector holds great promise for health care privateers. Globe and Mail, columnist Jack Kapica reported early in 2003 that the technology sector was regaining its allure to investors because of important public policy and private sector developments.

Kapica has written about a the results of a significant e-health project that were released in March 2002 showing “ how telecommunications could help governments ease the stress on the health care system.”  

Who conducted this project?  It was private healthcare and telecommunications companies, with indiscernible names like, ‘Ottawa’s March Networks’, ‘Aliant’, ‘Canarie’ and ‘We Care’. With such unclear monikers it is not surprising that healthcare privateers remain invisible to the general public. 

The study paid for by private sector Internet and healthcare service corporations’ proclaimed “remote health care can maximize resources without sacrificing patient care.”

Study that phrase carefully and take note that it does not say – governments will save money, rather there will be a ‘maximization of resources’.  A good thesaurus suggests other ways to phrase this concept with words like, ‘exploit’, and ‘take advantage of’. 

Do you wonder who is likely to get the ‘maximization of resources’?

The final report from the Commission on the Future of Canadian Health care also known as the Romanow report is supportive of the increased use of  ‘e-health and tele-health’ projects.  The Commission’s final recommendations include a call for the expansion of tele health projects for remote and rural communities and for the development of a pan Canadian electronic health record system.

Kapica also notes in a related public policy initiative, supported by former Health Minister, and now Industry Minister Alan Rock has put two-dozen Canadians (not likely candidates for the new I am Canadian beer commercial) on a special committee that will oversee the development of a major ‘e’ project to bring remote communities within Canada on-line.

Taken together, the tele-health and ‘e’ project for remote communities has the potential to bring both healthcare and educational services to remote communities.  Of course it also yields business opportunities for information and technology based companies that can orchestrate a convergence with healthcare and educational service providers.

It matters not, that the meteoric rise and fall of the dot-com sector merits little attention to financial investment advisors who notice that government, healthcare and information technology [IT] industry players are increasingly cooperating.  

Without missing an opportunistic beat, financial advisors exhort investors to join the convergence game.

But where will the great speculative gains be made? What are the most lucrative applications and who will finance the ‘maximization of resources’? 

Perhaps the treasure will be found near a Golden Pond.

Consider, that today the planet is hosting the largest group of elders alive in human history.  In fact between 2010 and 2030 says Philippe Fauchet, director of the Center for Future Health at the University of Rochester, says we can expect a huge explosion in the senior population. Fauchet notes that in 2000 about 22% of the population was over 55, but in 2030 it will be around 32% and during that period the percentage of the population over 65 will jump from 14% to 22%.

The growth of our elder population also includes a growth in the number of people who suffer from ‘cognitive decline’ – an inevitable fate that accompanies the aging process.  

Corporate sick shops are not troubled by the possibility of large groups of addled elders roaming the streets in pursuit of yesterday’s memories.  Instead information technology [IT] corporations like Intel see a great investment opportunity ahead --especially if they partner well.

In fact, the Intel Research Institute has set up a multi-phase research ‘partnership project’ with US based health care researchers. Through its support of the Proactive Health Research Project, Intel is learning how it can garner new technology markets to ‘prevent disease, foster independence and improve quality of life’.

Intel capitalizes on both the research interests of universities and government agencies addressing healthcare policy and at the same time, taps families who are in need of in-home assistance for family members who are suffering from cognitive decline ailments, like Alzheimer’s.

Volunteers offer homes and their loved ones to be equipped by Intel’s Research crew with high-tech technologies – essentially a network of micro sensors embedded throughout the home, in clothing and furniture which tracks the daily routines and behaviours of Alzheimer’s patients to a central computer for analysis.

The level of data collection possible is astounding.  For example, pressure sensors can be placed under rugs or cushions recording normal walking and sitting movements.  Researchers extrapolate that with computer assisted analysis the data can differentiate between walking and limping.   In the kitchen, placing sensors on cookware and utensils are intended to provide indicators to the ‘main frame’ that they are being used for regular meal preparation.

Sensors on doors can track the traffic patterns of residents entering and leaving their homes; placed in mattress they will assess changes in a person’s body weight over time.  This Orwellian thinking includes directly monitoring individuals by sensors placed in bracelets or contained in ‘jewellery’ to track data like blood pressure. 

The reference to embedding Intel’s cutting edge research tools in ‘jewellery’ is perhaps predicative of the income group where such healthcare technologies will most likely be applied in order to optimize the  ‘maximization of healthcare resources.’

Undoubtedly, as a care giver or family to someone suffering from such degenerative diseases as Alzheimer’s these technological tools offer a sense of protection from in home dangers as well as providing an elaborate tracking system intended to ensure well-being.

But, what happened to home care services?   Where are the investment interests in enhancing care systems that involve people? Rather than acknowledging a huge shift in age based demographics and directing healthcare resources to recruit, train and employ people to work with our elders – Intel and healthcare researchers are investing in computer chips and main frames.

The application of ‘smart home technologies’ as it is being called, has a variety of applications like security and surveillance. Researchers are thinking about applying it to as a large a market group as possible.   Dr. Eric Tangalos, a professor of medicine and the Director of the program on aging at the Mayo Clinic in Rochester, Minnesota notes “these technologies are already creeping into our environment – making our lives better by making our environments easier to navigate.”  After all he says, “don’t we all want a VCR that resets itself after the power goes off?” 

The visionary researchers imagine the embedded network of sensors being so ubiquitous that if a person forgets to take their medication on time, there will be a computer based technological reminder–a digitized voice already dubbed a  ‘personal health assistant’ emanating from a home computer system, or PDA reminding the forgetful soul to take their prescription. 

The growing convergence between healthcare systems and information technologies is revealing. To Intel, perhaps the fact that 80% of the world’s population has yet to even hear the sound of dial tone in their homes, or that less than 2% of the population is connected to the Internet are indicators of market potential for their research project.  

Intel may also be thinking that if they play their cards right, it might be able to cash in on public monies to advance their own research agendas for profit making.   Consider that Intel has spent $12 billion dollars in the past two years (2001-2003) getting ready to move into new kinds of manufacturing technologies.

Ironically, the same day the Globe and Mail reported on the ProActive Health Research venture for Intel, they also reported in a separate section that Intel was leading a number of major technology stocks downward!

The reason cited for the share price plummet was that investors were responding to a company warning that it was cutting its 2003 capital budget.  Andy Bryant, Intel’s Chief Financial Officer offered inquiring financial analysts assurances that “what we are really trying to do is manage the company very cautiously.”

Of course shaving off nearly a billion dollars from its capital spending plans would fit most CFO’s definition of cautious management. 

 

But looking into the not too distant future, it might be possible for IT corporations like Intel to build a field of dreams from our rapidly growing aging population and support their venture with publicly funded investments in smart home technologies. 

Cognitive decline, may be inevitable as we age, but until it takes hold it will be important for healthcare activists to sharpen our remaining faculties on the future plans of IT companies leering at the public healthcare purse.

Karl Flecker is the Education Coordinator with the Polaris Institute.  May - 2003.

References:

Building on Values: Final Report Commission on Future of Health Care in Canada

From outsourcing to health care, tech’s allure gets stronger J. Kapica Globe and Mail Jan 16.2003

Intel creating smart system to keep old folks at home, G. El Baroudi Globe and Mail Jan 16.2003

Intel leads tech stocks down, D. Akin Globe and Mail January 16. 2003

Losing Ground Bit by Bit www.news.bbc.co.uk November 1, 1999

Profit is not the Cure: A citizen’s guide to saving Medicare, Maude Barlow,2003

Research at Intel http://www.intel.com/research/prohealth/

Waiting in the Wings: How for-profit health corporations are planning to cash-in on the privatization of Medicare in Canada.  Darren Puscas & Tony Clarke. 2003