According to the major media outlets, the healthcare portion of President-elect Obama's economic recovery plan is targeted at information systems for hospitals and large healthcare systems in order to reduce overhead costs. This is admirable and it is likely that the plan may actually save the taxpayers of the U.S. at least $1 for every $1 spent.
Been in a top hospital lately or a major medical clinic (I have great health insurance -- as do the other employees of the company my partner Lisa Melchior and I own -- and am 57 years old so I am at health providers much too often these days)? EMRs (electronic medical records) are everywhere and in emergency rooms interns and residents and nurses spend more time in front of the computer screen than in front of the patients' beds. For 3 or 4 years my primary care internist has been talking to me while cradling a small footprint notebook computer.
The healthcare problems of poor people who get beat up by their family members, heroin addicts and other drug abusers, the chronic (and even intermittent) mentally ill, those with HIV/AIDS or those performing behaviors that will make them acquire HIV, alcoholics, those who do not speak English fluently enough to be understood in the healthcare system, and many others are not going to be solved, or even changed very much, by fancy new computer systems. Yes, we need better information systems to manage cases more efficiently and bill public and private sources more efficiently but we mostly need more and better trained healthcare providers who will treat junkies, crazy people, those who smell when they come into the clinic, those who do not speak English or Spanish, those who just got beat up, those in acute withdrawal, and those who are "clueless" about how to access care.
We need more physicians (especially geriatricians), more nurses (primarily gerontological specialists and nurse practitioners to replace physicians), more social workers (especially those specializing in elder populations), and more counselors and therapists for mental illness and behavioral health problems. We need to train current healthcare workers better about how to provide superior care as well as how to use information system technology.
The accounting and health economics approach to healthcare did not work the last time Hillary and Bill Clinton tried it 16 years ago with many of the same players scheduled to be in the Obama Cabinet or Obama White House Advisors, and this is still not the answer to healthcare reform.
The economic recovery plan needs to include a lot of funds for more treatment programs and more and better providers. And a little for new computers and sofware. Many of the members of Congress know this; hopefully the new inhabitants of the Executive Branch will learn from this.
And keep Hillary and Bill and their friends out of healthcare reform this time.
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