Tom Munnecke the designer of VA’s Mailman has a remarkable article with some fascinating history of VA’s Mailman, what the future for Health ITcould hold and some warnings of unintended consequences: ‘…Beware Stimulating the Perversity of the Health Care system. Their are huge perverse incentives are “baked in” to our Disease Industrial Complex. The commodity of this industry is disease, not health. Regardless of the good intentions and expectations of individuals, the system forces them into less-than-virtuous behavior. The current stimulus effort runs the risk of unintended consequences of stimulating the perversity of our system rather than the virtues we seek. For example, it would appear that the greatest financial value derived from a universally available health record would be increased malpractice suits, because they would be able to program scanners that could automatically scan historical records with 20/20 hindsight and find some instance of an activity that in retrospect was the wrong path to take. This in turn will lead to an even greater emphasis on defense medical practices…’