Robert Graboyes

SLIPPERY ROCK — Could your smart phone or tablet be the key to a new way of managing health care services?

For many people using services like tele-medicine, it already is.

But a patchwork of competing financial interests and an entrenched system that prizes risk management over advancement and innovation may stand in the way of more widespread innovation in health care.

Robert Graboyes, an economist and senior research fellow at George Mason University’s Mercatus Center, told a panel at Slippery Rock University June 3 that the key to breaking the logjam lies in confronting what we think we know about the health care system: that it’s immune to normal economic rhythms, that patients can’t take an active role in their own care, and that we’re even all talking about the same thing when we say “health care.”

Graboyes’ comments came at the annual Pennsylvania Economic Association conference where he addressed academics and business owners.

For Graboyes, who has spent decades studying health care systems in countries around the world and the last several years observing political turmoil surrounding landmark health care events, such as the Affordable Care Act, political disagreements are just red herrings when it comes to health care.

“The real philosophical divide is not between the left and the right,” he said. “The whole ACA debacle ... they’re all arguing a zero-sum game.”

The ACA debate, Graboyes said, is more about health insurance — how the system distributes financial risk and the costs of medical care — than about the delivery of that care.

What often gets lost in the shuffle, Graboyes argues, is the fact that we should be looking for “absolute gains” from our health care industry. Not just for the professionals — doctors, nurses and hospital administrators, who have been talking about the money-saving prospects of digital record-keeping and other efficiencies for years — but for a vast population America’s health care industry tends to marginalize: patients.

“We have eliminated the patient by a paternalization that basically says: ‘you must remain ignorant,’” Graboyes said.

But information technology — which empowers inventors and rewards risk-taking in the same way health care strives to mitigate risk and preserve the status quo — is changing much about that arrangement. In fact, Graboyes said, we’re closer to a brave new world of medical care than ever before.

Dozens of smart phone apps offer telemedicine services, fitness tracking — even printable electrocardiograms and eye exams — to patients on a scale never before seen.

Small-time inventors are revolutionizing fields like prosthestics and driving costs from the tens of thousands of dollars into — literally — the tens of dollars.

‘We now have the ability, to a certain extent, to be our own doctor,” Graboyes said. “The question is, how do we unleash innovation like this?”

Part of the question is whether or not the American health care system actually wants to unleash it at all, Graboyes said. And that answer is fraught with competing interests — from state medical boards that guard physician licensing requirements, to the federal government’s often-hapless direction of medical research and development.

Graboyes believes it should if for no other reason than the current system flies in the face of the way we treat almost ever other industry in America. Health care behaves differently not because it’s immune to the economy, but because it is treated as a special case.

“We need to rethink what institutions will maximize safety and efficacy, and get the costs down to the place we want,” Graboyes said. “The conventional wisdom — that the laws of economics don’t apply to health care — is as false as the notion that gravity doesn’t operate when I lift up my foot.”