A few years ago, I did some health IT stuff (implemented 5 RHIOs which included 80 hospitals plus various partners comprising roughly 300 data feeds).

I played with VistA. Thought maybe I could steal some of their fire. At the time, the VA was getting a lot of props for turning their act around and VistA was considered no small part.

MUMPS.

I will never willingly work on MUMPS.

I had to do a bunch of Intersystems' Cache, Ensemble, ObjectScript work. Inspired by MUMPS (the communities overlap). Complete garbage. Remember how a coding error can bork (brick) a SmallTalk runtime? Welcome to Intersystems. But without the benefits of a debugger, undo, version control, real database, an actual grammar and compiler, or rational people creating and supporting the product.

I mention Intersystems because as bad as it is, MUMPS makes it look slick.

Please understand that I am completely, utterly committed to universal healthcare with a single payer in the USA. Medicare/VA for all.

But if it means the infrastructure running VistA + MUMPS, I'll probably vote against it. (And I don't know if I'm joking.) I just can't imagine an IT migration to VistA finishing before the heat death of the universe.