As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Thursday, December 11, 2008

Health Care "This Year"

In between fielding another pointless round of questions on Rod Blagojevich, Barack Obama used today's press conference to introduce Tom Daschle as the next Health and Human Services Secretary and to signal that he would move early in his term to reform health care.

"Some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question -- I ask how we can afford not to....If we want to overcome our economic challenges, we must also finally address our health care challenge [...] This has to be interwoven into our economic recovery program. This can't be put off because we're in an emergency. This is the emergency!"

It's a very important way to look at the health care crisis, which is destroying both American families and American business with its twin outrages of soaring costs and reduced care. The key point, as Ezra Klein notes, is that Obama said he would seek to reform the system "in my first year." That suggests he is determined to move quickly on health care, which is exactly what is needed to secure passage. There are going to be a lot of neo-Hooverists out there calling for delay, but if Obama sticks with his solid rhetoric, he should parry those calls pretty easily. It's amazing what you can accomplish if you take the long view of the subject. If health care costs continue to expand at their current rate, today's recession will look like a small bump in the road.

Nobody really knew what Obama would spend his political capital on early in his term. If it's health care, I'm very pleased.

By the way, Daschle wasn't the only appointee on stage.

He also introduced Jeanne Lambrew's appointment as Daschle's deputy. Lambrew is an incredibly talented and knowledgeable health wonk, and her involvement should cheer liberals. Unlike during the campaign, when Obama's health care team seemed heavy on relatively cautious academics, Lambrew has long White House and executive branch experience, and comes to health care as a crusade as much as a topic of study. As Jon Cohn says, the importance of her presence "goes beyond the fact that she happens to know a heck of a lot about health care. She, too, has a strong commitment to what you might call the 'social justice' side of the debate."

More from Jon Cohn and Robert Pear at the NYT. a side note, one of Obama's core ideas to lower health care costs is electronic medical records. Ezra spells that out pretty nicely here. You wouldn't think that you could achieve as much savings just by putting health records online, but it turns out that the Veteran's Health Administration has gone electronic, and they save $33,000 a year per nurse practitioner, according to this study. That's pretty amazing. And we're finally at a moment where we can swallow the up-front costs:

But the problem is the upfront costs are quite high. Around $50,000 per physician. And that's not to include the time it takes to learn the system, or a doctor's preference for the way he's always done things. Which is why fewer than 20 percent of physicians have adopted the technology. At this point, it's clear you'd need some coordinating authority to help pay some of the upfront cost, and ensure standards and interoperability among systems. An authority like...the government. Even Kevin MD, as free market as they comes, agrees. "The ball is in the government's court. If universal electronic records are the happen, they have the ability to make it so." And now the government, under Obama, is planning to make it so, including real money for health information technology in the stimulus package. This is how the stimulus should be used: To make necessary and needed investments that will have lasting beneifts.


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