This person, in describing the environment and attitudes on the list made note of fact that much had been discussed and there would eventually be splintering along the standards boundaries. I mention this for two reasons. Also, I think we need to realize that even in opensource there will not be ONE standard for a long long time. What it will take is for two projects to collaborate to a successful end. Then add a third, fourth etc.
Critical mass is there somewhere.
Then we will have an open source healthcare standard. Or something totally different. It's scary to think of the resources expended on developing these 'standards' and to have them be so different. Each with it's own strengths and weaknesses too. The personal and capital resources spent by people on projects this large cause them to be defensive about their work.