From The Editor | November 18, 2011

If Not Obamacare, Then What?

Ken Congdon, Editor In Chief of Health IT Outcomes

By Ken Congdon, editor in chief, Health IT Outcomes

As the title would indicate, I’m about to write another one of those politically charged opinion columns that always seem to get me in hot water with a large portion of our readership. The topic? Healthcare reform.

As we enter into a new election year, healthcare reform will undoubtedly be a pivotal topic in the presidential debates. Republican presidential aspirants are united in wanting to repeal the healthcare reform act (commonly referred to as “Obamacare”). And, a Gallup poll released on November 16 showed that much of the nation is of the same mindset. According to the poll, 47% of Americans want to do away with healthcare reform, while only 42% want it kept in place. These findings are similar to an October Gallup poll that showed 48% of the nation in favor of repeal, and 40% of Americans backing the legislation.

Furthermore, all around the country, the negative feelings documented by these polls are manifesting themselves in protests where angry Americans hoist signs that read “Hands Off My Health Care!” These protests have been second only to the ‘Occupy Wall Street’ demonstrations taking place throughout the nation.

As I’m presented with all of this data, I prepare myself for the very real possibility that a Republican will be elected President next November and our country will begin the process of repealing healthcare reform. I think about this and I am disheartened.

I am disheartened not because I am an Obama-loving democrat. Truth be told, I am a registered Independent and I have taken issue with much of what President Obama has done (or hasn’t done) during his term as Commander-In-Chief. I am disheartened because I believe repealing the healthcare reform act would be a step back for the healthcare industry and our country.

While I am a conservative when it comes to many political topics, healthcare is one area I don’t feel our country can afford to approach conservatively. As much as people balk at the thought of government-run healthcare, I feel it has become necessary for the government to intervene because it can no longer afford to foot the bill for maintaining the healthcare status quo. Healthcare costs under our current system account for more than 17% of our GNP and continue to rise rapidly. With our economy in shambles, we need to gain control over our healthcare expenditures, and we can’t afford to wait.

The healthcare reform act provides a plan (an albeit imperfect plan) to reduce wasteful healthcare spending, while potentially improving patient care. It intends to accomplish this by changing the reimbursement model and holding the provider community accountable for patient outcomes, while ensuring that every American has an affordable health insurance option.

I understand why this plan has been met with such drastic opposition. It’s a significant, even scary, change that will have major implications for healthcare providers, payers, and patients alike. However, if it’s evident that the current system of healthcare delivery isn’t working, then I ask: What’s the better alternative to Obamacare that is going to allow us to control healthcare spending, keep health insurance costs affordable for the majority of American citizens, and allow us to preserve the integrity of our current healthcare model? I have yet to see a plan that meets this criteria from any opponents of healthcare reform. And, as mentioned, I don’t think we have the luxury of time to go back to square one and start the debate process all over simply to land on another imperfect healthcare reform package that party lines will inevitably disagree on.

The IT Implications Of Reform Repeal

As a journalist that covers the healthcare IT space, the talk of reform repeal also causes me to consider the potential impact this action could have on IT adoption in healthcare. I’m certain that IT adoption in healthcare will continue to grow with or without healthcare reform. But, will new IT systems be implemented at the same pace if Obamacare is repealed? My guess is probably not. While healthcare facilities throughout the country are beginning to realize the benefits of IT tools such as EHRs, HIE, business intelligence dashboards, e-prescribing, medication administration solutions, clinical decision support tools, mobile solutions, telemedicine, and more, there’s something to be said for new government mandates and incentives driving this IT adoption activity. The healthcare market has been historically slow to adopt IT, and therefore lags woefully behind other industries (e.g. finance, retail, etc.) in terms of automation. There’s no denying that IT adoption in healthcare began to pick up some steam when the HITECH (Health Information Technology for Economic and Clinical Health) Act was passed in 2009. This trend has continued as a result of healthcare reform, as providers and payers alike work to establish the IT infrastructures necessary to successfully function as Accountable Care Organizations (ACOs). My fear is reform repeal will wipe out a key driver for IT adoption, and the industry will fall back into its old laggard ways.

As the Gallup poll results indicate, my opinions are likely to be wildly unpopular with the majority of folks that read this column. Please note, that these opinions are mine alone and not the opinions of Health IT Outcomes. I encourage you to comment on this article and share your own opinions and thoughts on this topic with me and the Health IT Outcomes audience. (Please ensure your comments are thoughtful and considerate, and not just hate mail.) In the meantime, I will brace myself for your backlash.