Thursday, February 12, 2009

The Progress Report: Misinformation On Health Information Technology

The right is raising the specter of health care rationing to fight the economic stimulus package and comprehensive health care reform. What does the stimulus bill really say about electronic medical records and how they'll be used?

by Faiz Shakir, Amanda Terkel, Stayam Khanna, Matt Corley, Benjamin Armbruster, Ali Frick, and Ryan Powers, for The Progress Report

Late last month, the House passed an economic recovery package containing $20 billion for health information technology, which would require the Department of Health and Human Services to develop standards by 2010 for a nationwide system to exchange health data electronically. The version of the recovery package passed by the Senate yesterday contains slightly less funding for health information technology ("health IT"). But as Congress moves to reconcile the two stimulus packages, conservatives have begun attacking the health IT provisions, falsely claiming that they would lead to the government "telling the doctors what they can't and cannot treat, and on whom they can and cannot treat." The conservative misinformation campaign began on Monday with a Bloomberg "commentary" by Hudson Institute fellow Betsy McCaughey, which claimed that the legislation will have the government "monitor treatments" in order to "'guide' your doctor's decisions." McCaughey's imaginative misreading was quickly trumpeted by Rush Limbaugh and the Drudge Report, eventually ending up on Fox News, where McCaughey's opinion column was described as "a report." In one of the many Fox segments focused on the column, hosts Megyn Kelly and Bill Hemmer blindsided Sens. Arlen Specter (R-PA) and Jon Tester (D-MT) with McCaughey's false interpretation, causing them to promise that they would "get this provision clarified." On his radio show yesterday, Limbaugh credited himself for injecting the false story into the stimulus debate, saying that he "detailed it and now it's all over mainstream media."

McCAUGHEY GETS THE FACTS WRONG: In her commentary, McCaughey writes, "One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective." But the fact is, this isn't a new bureaucracy. The National Coordinator of Health Information Technology already exists. Established by President Bush in 2004, the office "provides counsel to the Secretary of HHS and Departmental leadership for the development and nationwide implementation" of "health information technology." Far from empowering the Office to "monitor doctors" or requiring private physicians to abide by treatment protocols, the new language tasks the National Coordinator with "providing appropriate information" so that doctors can make better informed decisions. As Media Matters noted, the language in the House bill, on which McCaughey based her column, does not establish authority to "monitor treatments" or restrict what "your doctor is doing" with regard to patient care. Instead, it addresses establishing an electronic records system so that doctors can have complete, accurate information about their patients. The Wonk Room's Igor Volsky pointed out that "this provision is intended to move the country towards adopting money-saving health technology (like electronic medical records), reduce costly duplicate services and medical errors, and create jobs."

HEALTH I.T. BELONGS IN RECOVERY PACKAGE: Projected to create over 200,000 jobs, the funding for health information technology in the recovery package is both an important stimulus and a down-payment on broader health care reform. Speaking in Ft. Myers, FL, yesterday, President Obama said that investment in health IT was "an example of using a crisis and converting it into an opportunity." "We are going to computerize our health care system, institute health IT," said Obama. "That creates jobs right now for people to convert from a paper system to a computer system, but it also pays a long-term dividend by making the health care system more efficient." Currently, fewer than 25 percent of hospitals, and fewer than 20 percent of doctor's offices, employ health information technology systems. Researchers have found that implementing health IT would result in a mean annual savings of $40 billion over a 15-year period by improving health outcomes through care management, increasing efficiency, and reducing medical errors. Investing in health would also help primary care physicians -- who often bear the burnt of tech implementation without seeing immediate benefits -- afford the infrastructure for expansion. The Congressional Budget Office has estimated that one-third of $2 trillion spent annually on health care in America may be unnecessary due to inefficiencies in the system such as excessive paperwork. Investments in infrastructure like health IT will help improve the quality of America's health care.

MCCAUGHEY'S POISONING HEALTH REFORM AGAIN: Responding to her Bloomberg commentary, the New Republic's health care writer Jonathan Cohn noted that "Elizabeth McCaughey is up to her old tricks again." "Not content to have poisoned one major health care debate, she seems determined to poison this one, too," wrote Cohn. In 1994, McCaughey published a "viciously inaccurate" article on the Clinton health care plan in the New Republic, which is credited with having "completely distorted the debate on the biggest public policy issue of 1994." McCaughey's article claimed that there would be "no exit" from the Clinton plan, and individuals would be prevented from "going outside the system to buy basic health coverage" that they preferred. But, as the Atlantic's James Fallows pointed out after the Clinton plan was defeated, McCaughey ignored "the first provision of the bill," which clearly said: "Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services." Just like in 1994, McCaughey's latest Bloomberg commentary provides page numbers from the legislation to give her claims the aura of credibility. But just as in 1994, McCaughey's assertions are not supported by the language of the bill she cites

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