Here is the backdrop for open source medical software in the U.S.: A moderately-sized "academic medical center" (usually meaning a medical school and its associated hospital(s)) in the Mid-West has just contracted with Cerner corporation to purchase Cerner's entire suite of record keeping software for the next ten years for the sum of... Well, now that I've got your attention, let me add a few things before I give the price. The sentence above is very carefully worded. What is being bought is *Cerner's* entire suite of applications. At present, this suite does *not* include fundamental pieces of an integrated hospital information system: pharmacy for example. Cerner promises that they will provide this functionality in the future. In addition, what is being bought will be developed and designed by Cerner, not by the purchasing institution. They want something different from what Cerner offers them, they can just whistle. Okay, so here's the price: $65 million over ten years. That's $6.5 million per year. That's a lot of money to spend to prove how completely passive and empty-headed you are. One can hire nearly a hundred Java programmers for $6.5 million. So that's a hundred programmers working for ten years. But of course, there's only one of the striking contrasts with open source: with open source you get far more than a hundred programmers for free. But who wants that...
