Anyone watching the presidential address this evening has no doubt that Obama will be known as one of the "great communicators" among American presidents. His speech was forceful, uplifting, emotional and at times, tearful. One topic of interest to me was related to the process of healthcare reform.
Previously, the promise was for universal healthcare. Now the promise is for healthcare reform. The post election Obama/Biden plan is now posted on the White House website here . The WH website rehashes what Obama/Biden were promoting during the election. The concept was touched upon during the speech this evening, but with much less detail. One aspect Obama did touch upon was the development of electronic health records as a way to reduce costs and medical errors. Is that really the best we can do?
I have spoken to many physicians whose hospitals have all electronic data entry including progress notes, laboratory reports, nursing notes, radiology and pathology reports and the like. What they tell me is that because of the "templates" used (pre-formatted outlines for ease of entry) it is much easier to document a patient's information but it is also easier to make mistakes. Let me explain to you how that works.
During a patient's stay a progress note is completed each day. The template automatically imports vitals signs from the nursing notes, lab data from the laboratory, etc. What it also does is pull up your previous days note in it's completed form for you to review and modify for the current day. If you're in a hurry, you can simply leave it the way it is and submit it for that day's note with no changes, even if there may have been changes that should have been addressed and recorded. This can be done day after day, with no change in the note but with significant changes in the patient's condition. So, did the expensive electronic medical record save money, provide better quality of care or increase efficiency?
Some of the concepts of the Obama plan are sound, should save money and extend healthcare to more people. Importation of safe drugs, more stringent scrutiny of the insurance companies, increased competition among them will all help to control, and even decrease, costs. But unless the government looks within to trim waste and corruption, they will never be able to eliminate it elsewhere.
By making the waste inherent in any government endeavor the first and most public target, Obama will provide much needed credibility to further his efforts out into the private sector. Everyone respects a person who admits and overcomes their faults and shortcomings. If they can conquer their own, maybe they can help me with mine? Absolutely.
Just as Obama stated there would be open accounting of the cost of the war in Iraq, he should offer an open accountability of the waste in Medicare and Medicaid. Let all of us see just how our tax dollars are being spent by the very people who are asking us to trust them with even more of our money.
Mr. President, put our money where your mouth is!
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