Maybe we should tax the fax

The Fax Machine: Technology That Refuses to Die, in today’s New York Times, reports that “the fax persists as a mockery of the much-predicted paperless society.” Sales of fax machines are rising.

The main businesses I encounter that still rely on faxing are doctors’ offices and pharmacies, and sure enough there was a mention of this in the article. The author and a CVS spokesman put this use in a positive light, touting the benefits of faxed prescriptions compared with telephoned or hand-carried prescriptions. Faxes provide a written record and reduce security issues associated with email, they say.

Think about these claims in relation to the financial services or airline industries and you will realize how far behind the times medicine is. Remember when you had to write out withdrawal slips by hand and wait in line for a bank teller? ATMs have been in place since the 1970s –with security and documentation controls that are more stringent than for pharmaceutical dispensing. Remember when your travel agent used to write out airline tickets using red carbon paper? Those days are long gone.

Even physicians who use “electronic” prescribing often print out the prescription and fax it in or hand it to the patient, eliminating most of the benefit. Change is under way, led by governmental and private payer e-prescribing programs, and enabling initiatives such as Rx Hub, but it’s slow going.

In the meantime, maybe we should consider a tax on faxed prescriptions to discourage their use and to speed adoption of 20th (or even 21st) century technologies.

March 27, 2005

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