I was called by the LA Times for a comment on whether increasing access would increase cost. After giving my standard lament about how no one talks about the real underlying problem of practice variation and waste (or at least about the political realities of dealing with it) I thought I should spend a bit of time seeing if that was true. And the answer is that, if you read deep into his plan, Obama does talk about that—although he doesn’t go after a solution quite yet. He instead proposes some intermediate solutions. more disease management, better care coordination, and more spending on health IT. In fact, a lot more spending on health IT:
Obama will invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems, including electronic health records. He will also phase in requirements for full implementation of health IT and commit the necessary federal resources to make it happen.
All you need to know is that health IT is roughly a $30 billion market now. Obama wants to pump it up another 25%. I assume Neal, Judy, Pam Pure et al have their checkbooks out! And now I know why Glen Tullman is such a big fan (Just kidding, Glen!)
Actually to suspend my cynicism, I’m now among the converted and I think that this type of national program is a good idea, so long as it’s done in conjunction with a significant change in incentives. We’ll see how it shakes out as these proposals all develop.