Friday, March 13, 2009

Elegant Exercises In Wishful Thinking

One of the big hitters in President Obama's new health care proposal is his plan to push for use of electronic medical records throughout the system. He claims this will save $80 billion a year and result in better efficiency for providers and better care for patients.

On the surface, this seems like a no-brainer. But, as we're coming to discover about many of Mr. Obama's grand plans, when you start looking into the details you find that things don't quite add up.

Dr. Jerome Groopman and Dr. Pamela Hartzband did a little digging to find out exactly how electronic medical records would save $80 billion a year and penned a piece in yesterday's WSJ called Obama's $80 Billion Exaggeration:

Last week, President Barack Obama convened a health-care summit in Washington to identify programs that would improve quality and restrain burgeoning costs. He stated that all his policies would be based on rigorous scientific evidence of benefit. The flagship proposal presented by the president at this gathering was the national adoption of electronic medical records -- a computer-based system that would contain every patient's clinical history, laboratory results, and treatments. This, he said, would save some $80 billion a year, safeguard against medical errors, reduce malpractice lawsuits, and greatly facilitate both preventive care and ongoing therapy of the chronically ill.

Following his announcement, we spoke with fellow physicians at the Harvard teaching hospitals, where electronic medical records have been in use for years. All of us were dumbfounded, wondering how such dramatic claims of cost-saving and quality improvement could be true.

The basis for the president's proposal is a theoretical study published in 2005 by the RAND Corporation, funded by companies including Hewlett-Packard and Xerox that stand to financially benefit from such an electronic system. And, as the RAND policy analysts readily admit in their report, there was no compelling evidence at the time to support their theoretical claims. Moreover, in the four years since the report, considerable data have been obtained that undermine their claims. The RAND study and the Obama proposal it spawned appear to be an elegant exercise in wishful thinking.

So we have a theoretical study backed by no compelling evidence whose conclusions have since been questioned by follow-up data. Seems like a rock solid foundation to base your claims on, no? This appears to be another case where Mr. Obama has already decided what the policy will be and almost as an afterthought tries to line up the facts to support it.

Before you dismiss this as nothing more than the latest distortion from the neo con wing nuts who frequent the WSJ's editorial pages, consider how the doctors close their piece:

We both voted for President Obama, in part because of his pragmatic approach to problems, belief in empirical data, and openness to changing his mind when those data contradict his initial approach to a problem. We need the president to apply real scientific rigor to fix our health-care system rather than rely on elegant exercises in wishful thinking.

Elegant exercises in wishful thinking. That has to be the most apt description of the Obama Administration that I've yet come across.

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