When Martin Wygod (pictured from when he was named to the Del Mar racetrack board), the dark lord of medical computing, took control of WebMD back in 2001, I cheered.

Wygod has been handling medical claims for ages.

I first ran into him when he sold his Medco Containment (a drug sales firm) to Merck, long before the Web was spun. WebMD had been an airy-fairy Web boom dream company, based in my own hometown of Atlanta, and had spent years drawing admiring glances from the media without doing anything more but put up a bunch of me-too Web pages. Founder Jeff Arnold built himself a big house with the proceeds, but nothing much else happened.

Marty will straighten their hash, I figured.

Marty did. He blew 'em all out is what he did. And he dropped the outgo steadily, aiming to match the income, all the while taking care of number one, Marty Wygod.

Sure it's robber baron stuff. But think of it as evolution in action.

I've drawn a lot of flack for trying to "flack" WebMD, but my eyes were wide open. I just didn't see a Web business there. What I saw, what I continue to see, is an opportunity for saving money in health transactions.

But that depends on more than one company can provide. It depends, in large part, on government mandating efficiency. It depends on reliable identity, an infrastructure that lets you give your identity to any health care provider and then allows that provider to get the records they need without requiring you to fill out forms, hand over credit cards, to do anything.

Most of the money lost in medicine today is lost in the front office. Look at it, next time you go to the doctor. Even if you're going to a one-man practice, you'll likely see three people out front, pushing papers (papers!) and trying valiantly to keep up.

The HIPAA law could have solved this mess, by pushing providers into a more efficient structure. It would have, had it been followed up by quiet talks among major providers (including WebMD, health insurance carriers, and hospital chains) about such things as standards for identity, for authentication, and for processing.

Instead, HIPAA's requirements were just piled on top of everything else, no money was provided for implementation, and Marty Wygod sat on his hands.

Now he's being hammered for it. And I can understand the case against him. But a solution won't come from New Jersey. It can only come from Washington. And right now Washington ain't interested.

Until you make Washington get interested in the right issue (efficiency), nothing will change for the better.