With the well past
due retirement of America Online’s Instant Messenger, I thought about interconnectivity concerns in light of AOL’s
market dominance. Years ago, advocates
worried that AOL could bolster its market share simply by refusing to interconnect
its networks and large subscriber base with market entrants. The AOL-Time Warner merger provided a basis
for the federal government to impose some connectivity requirements that in
retrospect appear unnecessary.
Currently,
I am experiencing the consequences when health networks do not interconnect and
no government agency has legal authority, or the inclination to require connectivity. My Primary Care Physician and all specialty
doctors I see have an affiliation with Medical Practice Group One. This Group is affiliated with the only
hospital in town. My employer has its
own Medical Practice Group Two which predictably cannot share medical
information, including blood tests, with other Groups. Additionally, my employer has negotiated
quite attractive blood test prices with an unaffiliated Large Diagnostic
Facility which predictably has no direct document links with either Medical
Practice Groups.
In
this “balkanized” environment, test results do not get delivered to physicians
and the Medical Practice Groups cannot share results. With repeated prodding, the Large Diagnostic
Facility will use 1960s facsimile technology to send results to the Medical Practice
Groups.
I
can reduce, if not eliminate the prospects for non-delivery of results if I opt
to use the Local Diagnostic Facility affiliated with both the local hospital
and Medical Practice Group One. This
option typically costs 300-400 percent more.
Would
you pay the premium to reduce or eliminate hassles, uncertainty and
anxiety? For many months I resisted and
have paid the consequences. However, I
cannot help thinking that intentional “unconnectivity” serves business
interests at the expense of consumers.
Economists can explain the situation in terms of network effects and
externalities, but they do not seem to factor in higher consumer costs for
joining the dominant network.
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