View from the Hill: Will America Awaken from Its Deep Sleep on Healthcare?


March / April 2008

View from the Hill

Will America Awaken from Its Deep Sleep on Healthcare?

I cannot imagine an issue more important to anyone than his or her health. Our present and future are dependent upon our health — our ability or inability to act on our thoughts, desires, and ideas.

However, in February nearly half of Americans listed the economy as the most important problem facing the country, according to Gallup. The economy is extremely important. However, we must make the connection between the economy and healthcare. They are directly related and should not be mutually exclusive in budget, policy, and regulatory discussions.

The facts are clear. National healthcare spending is expected to exceed $2.7 trillion in 2010, nearly a trillion dollars more than we collectively spent last year. Health insurance premiums have leapt 73% in just the past 5 years. Healthcare costs are rising five times faster than inflation and four times faster than wages. And, finally, according to the Institute of Medicine, more than 100,000 people die each year due to medical errors.

Healthcare affects all budgets — government, business, individuals, and families. Year after year, employers and employees are forced to dig deeper into their pockets to fund healthcare. The aging of the population and increased longevity that new technologies and medicines facilitate will place additional financial burdens on the system.

U.S. health spending is projected to increase from 16% of GDP in 2006 to 20% in 2016 — from $2 trillion to $4 trillion. Meanwhile, the number of uninsured Americans also continues to rise.

Discussions on healthcare must include the economic costs as well as opportunities lost as we continue to allow our current system to fester. Opportunities lost include the lack of widespread use and implementation of health information technology, as well as patient safety and quality measures.

All Americans need to understand that our healthcare system will not be transformed unless they begin to individually demand that their political leaders support the widespread adoption of health information technology and patient safety and quality measures. As a nation, we have our challenge clearly laid out before us in the upcoming 2008 Presidential election and beyond.

Regardless of the healthcare plan and/or candidate you support, you must demand planning and funding for information technology and patient safety and quality measures from your elected officials. Sitting quietly on the sidelines won’t work. As we sit and ponder the economy, international issues, and healthcare, the United States is falling further and further behind in healthcare and most other important fiscal indicators.

The International Context Isn’t Any Better
The Commonwealth Fund 2006 International Health Policy Survey of more than 6,000 primary care physicians in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States reveals that primary care physicians in the U.S. do not have the tools or support to provide the best care possible to patients.

In fact, the U.S. primary care system trails other countries in several areas including implementation of health information technology, computerized physician alerts for adverse drug interactions; access to resources to manage chronic care; and after-hours care.

America leads the world in innovation and development of health information technology, but most of it is used in other countries. For example, only about a quarter of primary care doctors in the U.S. (28%) and Canada (23%) use electronic medical records, compared with a large majority of primary care doctors in the Netherlands (98%), New Zealand (92%), the U.K. (89%), and Australia (79%).

Less than a quarter of U.S. primary care doctors (23%) receive computerized alerts for adverse drug interactions. By contrast, 93% of primary care doctors in the Netherlands, 91% in the U.K., 87% in New Zealand, 80% in Australia, and 40% in Germany have computerized alert systems. Among the surveyed countries, only in Canada (10%) do primary care physicians make less use of computerized alerts than do U.S. primary care physicians. Almost half (47%) of U.S. primary care physicians have no system — computerized or manual — for alerting them to potential drug-related hazards.

The U.S. primary care system also trails other countries in several areas in its ability to offer care to patients outside of working hours, which can prevent unnecessary emergency room visits. Statistics vary from a high of 81% in the U.K. to lows of 29% to 32% in the U.S., Canada, Australia, and New Zealand.

Ultimately, healthcare is a fiscal, physical, and mental policy that impacts all of society.

America, it’s time to take a fresh breath of reality and wake up to the truth that our health — fiscal, physical, and mental — is in jeopardy. Our health is at the base of our existence. Other countries recognize this and spend far less than America on healthcare by using information technology and patient safety and quality methods to improve care delivery and decrease cost.

The question remains: Are we willing to awaken immediately from our deep sleep, accept the economic, physical, and mental realities of healthcare, and change our current course?

Dave Roberts is vice president of government relations for the Healthcare Information and Management Systems Society (HIMSS) and senior executive of HIMSS’ Office of Advocacy & Public Policy in Arlington, Virginia. Formerly a professional staff member for both the U.S. House Appropriations Committee and the U.S. Senate Health Subcommittee on the Handicapped and a civilian financial analyst for the U.S. Air Force, Roberts now resides with his family in Solana Beach, California, where he is an elected member of the City Council and deputy mayor. He is a member of the Editorial Advisory Board for Patient Safety and Quality Healthcare and may be contacted at