Where Angels Fear to Tread?

Feb. 1, 2009

Less than 48 hours ago, President-elect Obama announced his bold “new” vision for healthcare: Electronic health records (EHR) for every American within five years. Already, I’ve received dozens of e-mail invites to attend seminars or interview executives to learn “how” he plans to achieve his lofty goals. Did I miss something? I don’t recall hearing a “plan” — just a list of priorities. At the moment, how he will perform this miracle is anyone’s guess, but that doesn’t stop the barkers from selling tickets to the show.

Less than 48 hours ago, President-elect Obama announced his bold “new” vision for healthcare: Electronic health records (EHR) for every American within five years. Already, I’ve received dozens of e-mail invites to attend seminars or interview executives to learn “how” he plans to achieve his lofty goals. Did I miss something? I don’t recall hearing a “plan” — just a list of priorities. At the moment, how he will perform this miracle is anyone’s guess, but that doesn’t stop the barkers from selling tickets to the show.

According to the CIA’s 2008 World Factbook, there were 303,824,640 Americans in July 2008. Simple math shows that at least 166,479 records per day would have to be digitized for 1,825 days (five years) to cover the population back then. Considering the speed at which the government’s wheels turn, someone needs to get started because the population is bigger today and growing.

So, how does this bode for the healthcare IT industry? It should be huge. According to several recent studies by independent organizations, including the RAND Corp. and the Commonwealth Fund, the cost could be as high as $100 billion. That much money could certainly shore up a struggling IT infrastructure, and retain or hire thousands of current and future employees. Sort of a mini-bailout for healthcare, if it works.

But is it good for all Americans? The government taxes its citizens to pay for these programs, which means Americans will have less to spend on other areas of their lives, including preventative healthcare, which promises to be the true source of lowered costs. Hopefully, President Obama will follow through on his pledge to pay for the program through tax cuts.

Can Americans opt out? Massachusetts’ universal healthcare model seems to be a test bed for a future national healthcare industry, so it’s probably safe to assume that some form of the state’s “play or pay” approach (whereby citizens or employers who do not purchase health plans in a timely manner are fined or pay increased taxes) will find its way into Obama’s plan as well. We may not be offered a choice, and considering the recent rash of healthcare data thefts, it’s imperative that the early focus be on finally securing our private medical data; however, it should not be accomplished overnight.

EHRs for all could truly revolutionize delivery of healthcare in America. Something this important should not be rushed for political expediency.

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