Like many protective laws, the HIPAA law covering the protection of your medical records comes with a small business exemption.

The exemption works both ways. Small businesses who fund their own plans don't have to comply. Neither do medical providers who don't computerize. As an NFIB alert on the law states, "Health-care providers -- such as doctors, nurses, on-site clinics, etc. -- are exempt from these regulations if they do not transmit electronically, but this exemption applies only to providers, not to group health plans." (Boldface is mine.)

The result of this is that small practices now have a major incentive not to computerize, and not to transmit anything electronically. Thus, they don't.

Instead, they hire staff, gatekeepers who stand between doctor and patient, with little or no medical training, capable of doing great damage at a single dropped message.

Now that all the HIPAA compliance deadlines have passed, the smart thing to do would be to eliminate this exemption, eliminate the incentive to stay in Lud, and to let my modems go between me and my doctor.

Think that's going to happen?

And do you think we can do anything serious to reduce medical costs otherwise?