Why healthcare in US is so expensive. From the perspective of a software developer.

I just wrapped up a programming contract at one of the largest hospital chains in the US. Can’t tell you which one, but if you google Top Hospital Chains in US, it’ll be right there. It gave me a very small glimpse into why US healthcare is so freaking expensive and is likely to remain that way regardless of what reforms are enacted in the years to come.

When I started the contract I was struck by how few IT employees the hospital had relative to the army of people that the multiple contracted consulting companies brought to bear. Which makes sense: software development is not the native expertise of the hospital —treating patients is. However, that has a cost.

The consulting companies write “consulting company” code. What does that mean? It means that the code base is complex for the sake of complexity. Which means that the consulting company will be needed to stick around (and extract fees) to maintain the code with a ton of resources.

Let me give you an example. Logging. And mind you, this isn’t logging for some life saving medical device, which is important. We are just logging to record an API call for some minor action on the hospital website.

If I was paying for development out of my own pocket, I’d receive the action, hand it off to a logging library like Log4Net or Serilog and let it dump the data into storage of some sort. Easy, reliable and mission accomplished. How does a consulting…