February 2005

Intelligence Quest

No matter how much we might want to roll the dice in the evening, when we wake up we want the sun to be rising in the east, we want energy equaling mass times the speed of light squared and we want our compasses pointing north. No matter how much we want the government off our backs, we demand that government protect the safety of our food, drugs, air and water.
But at a time when government and private employers offer us membership in “the ownership society” and the right to make unknowable decisions about how to spend the first $5,000 of our annual health care bills or how much of our Social Security we want to gamble on, old certitudes are decaying into a swamp of conflicting or nonexistent data.

Historically, we attributed to our doctors, our financial planners and investment advisers the wisdom to make the many of these decisions for us. But it turns out that neither the Drug Companies, nor your doctor, nor the FDA, nor the EPA, nor the weatherman can offer the safety assurances we want. And the hallmarks of an ownership society formally place responsibility for assessing risk — physical and financial — directly on us. We are on our own.

Is this a good idea? Maybe so, because in an “ownership society” health is the most precious thing one can own.

In the health domain, millions of Web sites and nonstop coverage in the news media feed the convenient illusion that we can easily find out what we need to know in order to make accurate judgments about our health risks and the health care we need.
I am not confident that this is true.

A friend in the benefits consulting business uses this simple guide: “Data” are facts and observations. “Information” consists of those facts when they are organized in a way that leads to useful insights — about the role of cholesterol in developing heart disease, for example. “Intelligence,” however, is the information we need that helps us weigh all the relevant information and personalize it to help make a specific decision.

Information is of limited value when applied at the wrong time; for instance, finding out that you shouldn’t have had your kidney removed once you have been stitched up.

What we need as consumers is the same thing that soldiers in the field need — intelligence; the right data organized in the right way at the right time. While health intelligence is in the public interest, it is in no one’s individual or corporate interest to provide it. It seems to me, then, if we have to be owners of our own health, we will need an owner’s manual. Who is going to write it?

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