What Health IT Wont Do

Opinion: It is policy, not just technology, that is needed to cure U.S. health care ills.

Health information technology promises better care at lower costs, but it cant fix a broken system. Giving doctors more access to computers wont, by itself, give the underinsured more access to doctors. The Department of Health and Human servcies provides a steady drumbeat of health IT projects: coordinating standards, providing seed money, laying the groundwork to share and protect patient information. Its easy to forget that that all this work must solve issues in health care, not just health IT.

"We need IT, but its not going to solve the problem of the health care crisis," said Pat Schoeni, Executive Director, National Coalition on Health Care. "If you fix one thing and dont fix the other things that need to be done, you can be exacerbating the overall problem."

The U.S. has 46 million uninsured people. It also leads in the fraction of its citizens who forgo care to save money, according to a study by the Commonwealth Fund that surveyed thousands of "sicker adults" across six developed countries. Americans who do get care pay more. Thirty-four percent of U.S. patients surveyed had spent more than a thousand dollars; no other country aproached this rate. Australians and Canadians came closest, with 14 percent paying as much.

As far as health care dollars go, we are doing less with more. We spend about 15 percent of our GDP on health care; thats twice as much as the UK and 1.35 times as much as Germany, according to the Organization for Economic Co-operation and Development (OECD).

Despite this spending, the U.S. has worse metrics for longevity and infant mortality than many other developed countries. In the Commonwealth study, the U.S. scored the highest on all seven measures of patient-reported medical, medication, and lab error rates, though not all differences were statistically significant. Americans even have to wait longer to get a regular doctors appointment. (We come in a close second to Germany for the shortest wait times for specialist appointments and for elective surgery.)

Costs are getting worse, particularly for individuals. Employer health insurance premiums went up by 11.2 percent last year , up 59 percent from five years ago, and family premiums are now approaching a years salary for a fulltime worker earning minimum wage, according to the Kaiser Family Foundation. The automotive and airline industries are threatened with bankruptcy partly because of health care costs for retired workers.

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