Forum: IT raises health care quality and costs
The major-party presidential candidates have endorsed the expanded use of health information technology as a means of containing the country’s medical costs, but experts say there is little evidence that the approach will curb spending on health care.
That was the consensus reached by a panel of health care experts at the National Press Club June 3 in a forum sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation. They gathered to talk about “putting the brakes on health care costs.”
However, the greater use of health IT will increase the quality of health care, panelists said.
“It’s one thing to be in favor of health IT becoming a more important factor in the delivery of health care,” said Paul Ginsburg, president of the Center for Studying Health System Change. “Will it contain costs? Very uncertain.”
By almost any measure, the United States spends significantly more on health care -- 16 percent of the gross domestic product in 2005 and a projected 20 percent of the GDP by 2016 -- than do other developed countries.
Testifying before the Senate Finance Committee earlier that day, Ginsburg said,
“The overall quality of health care in the United States is uneven at best.” He noted that rates of infant mortality and preventable deaths are higher in this country than in other countries. “The enormous amount of money spent on medical care in the United States does not appear to buy us outstanding health,” he said.
Citing a report from the Congressional Budget Office, Mark McClellan, director of the Engelberg Center for Healthcare Reform, said even though health IT has the potential to “help us close that gap” on costs and even reduce them, getting there is elusive.
“Technological innovation can theoretically reduce costs and, for many types of goods and services, often does,” CBO wrote in the report, “Technological Change and the Growth of Health Care Spending,” released earlier this year. “Historically, however, the nature of technological advances in medicine and the changes in clinical practice that followed them have tended to raise spending.”
Panelists agreed that reining in costs will require lawmakers to look at fundamental ailments in the health care system that are beyond the scope of IT to cure.
Uwe Reinhardt, the James Madison Professor of political economy at Princeton University, suggested that a highly complicated system of pricing and delivering health care undermines the efficacy of market forces that otherwise would serve to contain costs. The cost of a colonoscopy, he said, can range from $800 to $13,000 in some regions.
“Most U.S. policy keeps the demand side splintered and weak,” Reinhardt said, noting that the powerful health care industry “springs into action” whenever laws or policies are proposed that would increase transparency or otherwise put consumers on a more equal footing with suppliers.
The health care industry usually gets its way, said Reinhardt, who characterized its members as the “largest shareholders in the U.S. Congress.”
About the Author
John Pulley is a freelance writer based in Arlington, Va.