Something I’ve been thinking about is whether the current technological landscape, through positive and negative pressures, can enable a revival of small-scale production. Basically, making more of what you consume at home, in your neighborhood, etc. I think “human scale” technologies can help mitigate some of the more nightmarish horizons of the technological society we inhabit, though, obviously, neither completely…
I'm a physician and I've thought a lot about this in the context of the US healthcare system. Step foot in a hospital and the first thing you notice is that everything is single-use, thousand-dollar widgets. I've been into the idea of open-source medical hardware and software for a while. The unfortunate reality, however, is that the obscene cost of getting FDA approval for even the simplest medical device makes thes…
EHR is sort of similar. To me, the roll-out of that was a disaster, and pushed what was in-house in most cases to being managed by EPIC and other EHRs out of the hospital. The mandates were a big mistake in my opinion, as it forced hospitals to scramble to use something being offered by outsiders, instead of collaborating to produce something open-source, or growing EHRs more organically from within the organization.
I personally blame the rise of hostageware in hospital settings partially on this trend.
My broader point is that although I think there's a lot of potential with open source hardware, software, and things like 3D printers, prevailing economic forces are pushing in the opposite direction. Consolidation and mergers, streamlining everything that doesn't contribute to increasingly dense profits as you go up the administrative chain. In this schema, better to outsource everything you can to trim costs. I don't agree with it, as I think it leads to a lot of hidden costs and hidden but lost benefits, but that's the idea.
Unfortunately, the combination of overregulation and profit-driven hierarchical management is creating pressures against in-house, from the bottom up creation of goods and medical services. The talent is there, it's just pushed out from the top.
Sometimes I feel like healthcare and the biomedical area is today driven more by the interests of profiteers than patients/clients/customers.