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President Promotes Switching To Electronic Medical Records

Bush Says Paperless System Would Cut Costs, Improve Care

By Michael Fletcher
Washington Post Staff Writer
Friday, January 28, 2005; Page A07

CLEVELAND, Jan. 27 -- President Bush called on doctors and hospitals Thursday to move their medical records from paper to electronic files, a change that he said would improve medical care while shaving significant sums from the nation's spiraling health care bill.

Speaking at the Cleveland Clinic, Bush quoted health analysts who said that the efficiencies wrought by electronic medical records could reduce medical costs as much as 20 percent. Electronic records can "help change medicine and save money and save lives," he said.

President Bush discusses electronic medical records during an appearance at the Cleveland Clinic. (Kevin Lamarque -- Reuters)

_____Health Care Debate_____
Text: Kerry's Comments
Bush Promotes Health Savings Accounts (The Washington Post, Jan 27, 2005)

Friday's Question:
It was not until the early 20th century that the Senate enacted rules allowing members to end filibusters and unlimited debate. How many votes were required to invoke cloture when the Senate first adopted the rule in 1917?

The clinic is helping to develop an information technology standard for medical records. Bush and other proponents say electronic records liberate doctors and other medical personnel from the crush of paper that contains most patient information. Electronic files give doctors instant access to potentially lifesaving information such as patients' medical histories, lab test results and the list of medications they have been prescribed. In addition, proponents say, electronic records reduce administrative costs and the chance for medical errors that occur when information is written down inaccurately or illegibly.

The records also invite patients to become more involved in their medical care by making lab tests and other records available to them over the Internet, and providing them with electronic links to more information about their medical conditions.

In his 2004 State of the Union address and during the presidential campaign, Bush called for the nation to eliminate paper medical records within a decade. On Thursday, the White House said it wanted to double funding for that effort to $100 million in the current fiscal year and would ask for $125 million in the fiscal 2006 budget that Bush will submit to Congress on Feb. 7.

The Department of Health and Human Services has begun the process of helping to develop a "medical Internet," which would allow the confidential transmission of medical records across the country. Some civil liberties groups have raised concerns about the confidentiality of the records, but proponents say privacy can be preserved.

Bush's appearance here marks the second consecutive day that he has highlighted his policies for expanding access to health care and controlling its skyrocketing costs through market forces, rather than government action.

"The fundamental question facing the country is can we have a health care system that is available and affordable without the government running it?" Bush said here. "I happen to believe the best health care system is one where the consumers, the patients, make the decisions."

About 45 million Americans have no medical insurance. Many of them work for small businesses struggling to contain the costs of their health plans or for firms that offer no benefits. Congressional Democrats have criticized Bush's policies as inadequate, saying the nation's health care crisis has deepened on his watch.

Bush has countered with plans that would put more health care decisions in patients' hands. He reiterated on Thursday that health savings accounts, which allow workers to save for medical expenses in tax-sheltered accounts, offer an appealing answer to rising health costs. The accounts are used to pay for medical expenses up to a certain deductible. An insurance plan then pays for any costs that go beyond the deductible, which is typically several thousand dollars.

Some experts question whether much money will be saved either through electronic records or health savings accounts. David Cutler, a health economist at Harvard University, said the savings accounts could "make things worse" by making the nation's health care system more bifurcated than it is now -- with the affluent and healthy receiving one level of care, and the poor and infirm another.

Cutler explained that people who lead healthful lifestyles are most likely to choose health savings accounts, leaving traditional medical plans heavily weighted with the poor and the infirm. Also, he said, the plans might discourage people from seeking routine medical screenings in an effort to hold money in their accounts.

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