OCT 11, 2012 4:58pm ET

Meaningful Use Held Hostage … By Ignorance


As a 45-year resident of Michigan and former state political reporter, I remember Republican U.S. House Reps. Dave Camp and Fred Upton when they were young, bright, informed legislators who worked across party lines, found compromise, and actually governed.

But they long ago became appeasers to a base of their party that celebrates, indeed advocates, ignorance in the 21st Century. Ideologies are supposed to be rooted in ideas. But today, to not know what you’re talking about is actually a badge of honor.

The lawmakers have risen high; Camp is chair of the Ways and Means Committee and Upton chairs the Energy and Commerce Committee, two of the most expansive and powerful committees in Congress. They recently co-authored a letter with their health subcommittee chairs, Rep. Wally Herger at Ways and Means and Rep. Joe Pitts at Energy and Commerce, calling on HHS Secretary Kathleen Sebelius to halt--and then rehaul--the electronic health records meaningful use program.

Read that letter and you’ll wonder how much the two committee chairs know about the health care industry. You’ll be amazed at how little the subcommittee chairs know. They contend that 4 1/2 years into the meaningful use program (actually about 3 1/2 from the time the law was signed for those who know basic math) “it is safe to say that we are no closer to interoperability in spite of the nearly $10 billion spent.”

They actually expected the nation’s largest, most fragmented and complex industry to fully automate, integrate and share data within a few years--faster than most other industries, if not all of them, were able to do the same. And they have no idea what meaningful use has done to change the entire mindset of an industry toward information exchange.

The legislators contend that the Stage 2 rules in some respects are weaker than in Stage 1. For instance, they say the proposed Stage 1 rule set a 75 percent threshold for electronic prescriptions and 80 percent for medication reconciliation during a transition of care, which is far higher than the thresholds in Stage 2. True. Except that proposed rules aren’t real rules--don’t you think these veteran congressmen should know that? The proposed thresholds in Stage 1 were changed after the government listened to those being governed and made the thresholds more plausible in the final rule, to be complied with in the real world. That’s what real governing looks like.

Further, the final Stage 2 rule strengthens the e-prescribing and medication reconciliation thresholds. These guys and their staffs couldn’t even bother to read the rules they criticize. Or maybe they didn’t understand the rules but decided that wasn’t important. Again, ignorance doesn’t make good governing.

Seriously, Camp and Upton once were good legislators.

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