System Overhaul

The Hospitalist. 2009 February;2009(02):

February 1, 2009 | The Hospitalist

Within the first few months of his administration, Obama also plans to push for investment in health information technology as a way to modernize the healthcare system and spur the economy, says Judy Feder, PhD, a professor and former dean of Georgetown University’s Public Policy Institute and a two-time Democratic congressional candidate who campaigned on a healthcare platform almost identical to the president’s.

Obama says he would like to direct $10 billion a year over the next five years to help the nation’s hospitals and healthcare providers install electronic billing and medical record systems.

“Somebody’s got to help set those up. We’ve got to buy computer systems and so forth. That’s an immediate boost to the economy…but it’s also laying the groundwork for reducing our healthcare costs over the long term,” Obama said in November upon naming Peter Orszag, an economist who regards rising healthcare spending as the nation’s top fiscal threat, director of the Office of Management and Budget.

Hospitals and hospitalists can benefit from IT advancements, but the technology should be slowly phased in to give users time to adjust, which may run counter to the quick economic stimulus Obama is trying to achieve, says David Meltzer, M.D., Ph.D., a professor in the department of medicine at the University of Chicago who has conducted considerable research in hospital medicine.

“The point is, health IT takes years to implement,” Dr. Meltzer says. “Just giving grants to buy and set up the equipment isn’t enough. You also want to give grants to prepare people on how to use it effectively.”

Key Points Of Obama’s HealthCare Plan

President Obama and Secretary of Health and Human Services Tom Daschle want to lower healthcare costs and provide all Americans with affordable, accessible health coverage. Here’s how they plan to do it:

CHANGE THE HEALTH INSURANCE SYSTEM

Require insurance companies to sell to everyone, regardless of health problems.
Create a national health insurance exchange, which would set a minimum level of benefits for health plans, give tax credits to any person or business that can’t afford premiums, and allow people to keep their plan when they change jobs.
Offer a new public health plan similar to federal employee benefit plans.
Expand eligibility for Medicaid, Medicare, and the State Children’s Health Insurance Program.
Require all children—and possibly all adults—to have health coverage.
Eliminate subsidies to Medicare Advantage plans and pay providers what it would cost to treat patients under regular Medicare.

PREVENTIVE CARE AND PATIENT SAFETY INITIATIVES

Invest $10 billion annually over the next five years in health information technology.
Pay providers based on quality of care, not quantity of services.
Promote disease management programs and medical-home-type models for people with chronic conditions.
Create an independent board to compare the effectiveness of drugs, medical devices, and procedures so that doctors and their patients have accurate, objective information. The board could decide the therapies that public and private insurance plans cover.
Promote preventive-care initiatives, such as vaccinations, health screenings, exercise programs, and healthful foods in schools and workplaces.

INCREASE PRESCRIPTION DRUG COMPETITION

Allow people to get their medications from other countries, provided the drugs are safe and cheaper than those in the U.S.
Allow Medicare to negotiate with pharmaceutical companies for cheaper drug prices.
Prevent pharmaceutical companies from keeping generic drugs off the market.

Sources: Obama-Biden Healthcare Plan; Critical: What We Can Do About the Health-Care Crisis, by Tom Daschle, Jeanne M. Lambrew and Scott S. Greenberger.