Whitehouse spoke of “a tsunami of health care cost” sweeping down on the nation and explained to colleagues why more active federal support for I.T. adoption, quality improvement measures and supportive reimbursement policies are imperative. Health I.T., Whitehouse said, “is a baseline platform necessary to even try to respond humanely to the looming crisis.” Following is the full text of his speech:
"Mr. President, today I want to speak for some moments on health care, and recognize the extraordinary work that four members of this body have done to promote an integrated, interoperable health information technology infrastructure in this country. Senators Kennedy and Enzi on the HELP Committee, Senators Hillary Clinton, Senator Hatch, along with their talented staffs, have balanced a tremendous number of interests to put forward a very promising first step in our long journey toward reforming our ailing health care system. I commend their tremendous effort in drafting the Wired Act. I look forward to working to see strong health information technology legislation passed in the Senate, in the House, and signed into law by the President.
"Adoption of health information technology is a vital part of saving lives and lowering costs in our health care system. The RAND Corporation estimates – in its most conservative estimation – that a national, interoperable HIT system could save $81 billion per year. And as Senators Kennedy, Enzi, Clinton, and Hatch are so aware, America’s health care information infrastructure is decades behind where it should be. We are losing billions and billions of dollars – I sound like Carl Sagan: ‘billions and billions of stars’ – billions and billions of dollars to waste, inefficiency and poor-quality care as a result of that failure. Ultimately, and most tragically, lives are lost to preventable medical errors because health care providers do not have adequate decision support for their determinations on medical treatment, medication, and so forth.
"I am an enthusiastic supporter of health I.T. as one mechanism for fixing our broken health care system. In fact, one of the first bills I introduced as a U.S. Senator was the National Health Information Technology and Privacy Advancement Act (S. 1455), in which I proposed a national not-for-profit entity with presidential appointment subject to advice and consent of the Senate, possessing rulemaking power to set national standards under the Administrative Procedures Act, and with the ability to set licensing and access fees to raise capital for necessary investments, outside the federal budget process. I still believe that is the best and most effective kind of authority. But I also recognize that there are many good ideas out there. But time is short. We cannot just snap our fingers and be in an I.T.-enabled health care environment. Development, testing, build-out, and adoption will all take time. And we don’t have much time.
"A tsunami of health care cost is sweeping down on us, inevitably, as baby boomers age and costs increase. The Comptroller General of the United States has warned us of what he called ‘unprecedented stormy seas ahead that threaten to swamp the ship of state,’ and he testified ‘we’ve never seen anything like what we’re headed into.’ Never in our history. Our present federal health care liability, if nothing changes, is $34 trillion dollars. That’s a 34 with twelve zeros behind it, and it comprises the bulk of the $53 trillion in federal liabilities we are presently obliged to pay in coming years. Now, now, is the time to get started in humane ways to avert this fiscal crisis. And health I.T. is a baseline platform necessary to even try to respond humanely to the looming crisis.
"Unfortunately, in moving toward our ultimate objective, we must realize that health I.T. adoption alone will not stop the tidal wave of health care costs. As I think we all know, our health care system is broken in more ways than one. Just look at the signs of its failure. The number of uninsured Americans is climbing and will soon hit 50 million. Despite the best doctors, the best nurses, the best equipment and procedures, and the best medical education in the world, as many as 100,000 Americans are killed every year by unnecessary and avoidable medical errors. Life expectancy, obesity rates, and infant mortality rates are a cause for national embarrassment by most international measures. The annual cost of the system exceeds $2 trillion and is expected soon to double. We spend more of our country’s GDP on health care than any other industrialized country – 16 percent – double the average of the European Union. More American families are bankrupted by health care costs than any other cause. There is more health care than steel in Ford cars, and more health care than coffee beans in Starbucks coffee. Hospitals are broke, doctors are furious, and paperwork is choking the system. This thing is crying out for reform.
"I believe that comprehensive restructuring of our health care system must rapidly address three critical issues. As I have already said today, the first is the development of a national, interoperable, secure health information technology infrastructure. But there are two other equally important issues: one, the American health care system must invest properly in quality and prevention, promising areas where better care actually lowers cost. And two, the way we pay for all this, the way we pay for health care sends perverse price signals that drive market behavior away from the public interest. That drive behavior away from what we want. So, these are three critical issues at the core of the health care crisis in this country: Inadequate health information technology; inadequate attention to quality and prevention; and a perverse price signal system.
"Let us look first at how improved quality of care could lower cost. That intersection, improved quality of care that lowers cost, should be our national Holy Grail in health care. And the Keystone Project in Michigan shows how effective this can be. It went into a significant number of Michigan ICUs – not all of them, but a significant number – to improve quality and reduce things like line infections and respiratory complications. Between March 2004 and June 2005, the project saved 1,578 lives, in just that year and two months. It saved 81,000-plus patients days they otherwise would have spent in the hospital, and over $156 million. It’s a win-win.
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