presidential candidates and health care

Presidential Candidates and Health Care Information Technology: Where Do

They Stand?

Election day is more than twelve months away, but the contest for

president of the United States is already shaping up to be a fierce

one. Many presidential candidates have either released or announced

their intention to release a comprehensive plan for health care

reform. Following is an attempt to summarize each candidate's position

on health care information technology such as e-prescribing and

electronic medical records. You are encouraged to visit each

candidate's Web site on your own, as their positions may change in the

future.

Joe Biden (D): His home state of Delaware is a leader in adopting new

health information technology, and the candidate notes the Delaware

Health Information Network (DHIN) is a state-wide health information

and electronic data interchange network for public and private use.

Biden says the potential savings to the health care industry from full

adoption of electronic medical records is substantial. He notes that

researchers at the RAND Corporation estimated that full adoption of

electronic medical records could save $77 billion annually. RAND also

determined that by 2004, 15 to 20 percent of U.S. physician offices

had adopted electronic medical records systems.

To get to 100 percent adoption of EMR/EHR software, Biden says he

would invest at least $1 billion dollars per year in moving to

electronic health records systems, provide grants to states to develop

electronic medical records and other health IT systems, and assist

hospitals, medical facilities and doctors in upgrading to electronic

record systems and implementing them in their practice.

Electronic Medical Records Information and Resources

Sam Brownback (R): Brownback advocates for lifetime electronic medical

records. On his Web site, he notes that he is " ... the sponsor of a

bill that would offer patients both ownership and control over their

personal health information and ensure that personal health

information is not used by third parties without the consent of the

patient. This proposal would also offer patients debit-like cards

containing their private and portable personal health information."

Hillary Clinton (D): In her comprehensive plan for health care reform,

Clinton pledges to ensure that all health care providers and insurance

plans use privacy-protected information technology. She says her

proposal will give doctors financial incentives to adopt health

information technology and facilitate adoption of a system where high

quality care and better patient outcomes can be rewarded. Clinton also

notes on her Web site that the Business Roundtable, SEIU and AARP

estimate that "widespread adoption [of such IT reforms] raises the

potential savings to $165 billion annually."

Chris Dodd (D): In his plan, Dodd says health insurance premiums will

be affordable based on leveraged negotiating power, spreading risk,

reduced administrative costs and incentives for adoption of

information technology and savings from better care. He implies that

technology such as electronic health records and practice management

software systems will help integrate clinical information tools,

monitoring technologies and care management such that chronic diseases

are kept under control.

John Edwards (D): Edwards advocates for universal health care, and

healthcare information technology will be critical to ensuring his

model delivers high quality care without breaking the bank. On his Web

site, the presidential candidate notes: "Many insurers and hospitals

still rely on cumbersome paper systems and incompatible computer

systems. The outdated 'paper chase' causes tragic errors when doctors

don't have access to patient information or misread handwritten

charts. It creates needless administrative waste recreating and

transporting medical papers, performing duplicative testing, and

claiming insurance benefits. Edwards will support the implementation

of health information technology while ensuring that patients' privacy

rights are protected."

Edwards pledges to support new technologies, such as handheld devices

and electronic medical records, to give doctors the latest information

at their fingertips. Edwards also promises to support public-private

collaborations that reduce medical errors through electronic

prescribing (e-prescribing).

Rudy Giuliani (R): Giuliani has pledged to invest in health

information technology to reduce medical errors, improve efficient and

detect health threats, noting that thousands of hospital deaths each

year are attributed to preventable medical errors. He sais

public-private partnerships to improve and set standards for health IT

but without overbearing regulations can play a major role in improving

quality of care and reducing health care costs.

Mike Gravel (D): It does not appear that Gravel has a position on the

role of information technology in health care reform; if he does, we

were unable to find it.

Mike Huckabee (R): Huckabee is famously known for losing 100 pounds

after being diagnosed with diabetes, and for his steadfast support for

preventive health care. He has not released a comprehensive plan for

health care reform, but he does note that health care can be made more

affordable by adopting electronic record keeping, among other

strategies such as medical liability reform and health insurance

portability.

Duncan Hunter (R): There's no mention of health care on his Web site,

let along discussion of electronic medical records.

Kucinich's proposal is for universal, single payer health care plan

completely funded by the government.

Dennis Kucinich (D): Kucinich has proposed a universal, single payer

health care plan completely funded by the U.S. government, called the

United States National Health Insurance Act (H.R. 676). In his

proposal, he calls for the creation of a "standardized, confidential

electronic patient record system in accordance with laws and

regulations to maintain accurate patient records and to simplify the

billing process, thereby reducing medical errors and bureaucracy," and

that "notwithstanding that all billing shall be preformed

electronically, patients shall have the option of keeping any portion

of their medical records separate from their electronic medical

record."

John McCain (R): He says that reforms to federal health care policy

and programs should focus on enhancing quality while controlling

costs, but we were unable to find any references to health care

information technology in his campaign materials.

Barack Obama (D): In his Plan for a Healthy America, Obama calls for

lowering costs through investment in electronic health information

technology systems, acknowledging that paper-based medical records

make it difficult to coordinate care, measure quality and/or reduce

medical errors. He also says processing paper claims costs twice as

much as processing them electronically.

Obama pledges to invest $10 billion a year over the next five years to

move the U.S. health care system to broad adoption of standards-based

electronic health information systems, including electronic health

records. He will also phase in requirements for full implementation of

health IT, and promises to "commit the necessary federal resources to

make it happen." He also pledges to ensure that these systems are

developed in coordination with providers and front line workers,

including those in rural and under served areas.

Ron Paul (R): He's a Medical Doctor, but he has not proposed a plan

for health care reform, and makes no mention of electronic medical

records in his campaign materials.

Bill Richardson (D): To achieve health care for all, Richardson

proposes streamlining health care administration by using "21st

Century Health Care Bonds" to invest in health information technology,

thereby saving the system $22 billion per year.

Mitt Romney (R): In August, Romney shared his health care reform plan

with physicians in Florida, where he underscored the importance of

bringing market dynamics and modern technology to health care. In his

presentation, Romney supported the idea of federal incentives to

foster more widespread adoption of electronic medical records

technology.

Tom Tancredo (R): He has announced a very basic plan for reform, but

there's no mention of electronic medical records or other types of

information technology.

Fred Thompson (R): Thompson says he is committed to a health care

system with five key attributes. One of those five guiding principles:

"Modernized delivery and administration of care by encouraging the

widespread use of clinical best practices, medical information

technology, and other innovations."

For more information on each candidate's health care ideas, visit the

Association of Health Care Journalists.