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Richard Hillestad, James Bigelow, Anthony Bower, Federico Girosi, Robin Meili, Richard Scoville, and Roger Taylor Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs Health Affairs, September/October 2005; 24(5): 1103-1117. [Abstract] [Full Text] [Figures Only] [PDF] [Technical Executive Summary] [Reprints & Permissions]

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Realism in Health Care Savings

David P. Lawton, PhD   ( 28 September 2005 )

Realism in Health Care Savings 28 September 2005
David P. Lawton, PhD, Health Surveillance Administrator Nebraska, Health and Human Services Send comment to journal: Re: Realism in Health Care Savings david.lawton{at}hhss.ne.gov David P. Lawton, PhD	There is no doubt that use of IT in health care will bring about savings related to effeciency and improvements in quality. What is unique in the case of health care as compared to other industries is who will benefit from the savings and who will pay for the savings. Whenever cost savings are mentioned, we must realize that some individual and group of individuals will be losing to provide the savings for the rest of us. In the case of health care, those who are in the funding chain of duplicating tests (radiology, and lab) or those who benefit from poor care requiring extended hospitalization (pharmacy, hospitals, doctors, and nurses) will lose income. Many will lose employement. Eighty-one billion dollars represents a lot of workers, taxes, and investments. Those who will gain will be those who pay for health care (consumers, insurers, businesses, and eventually, all American consumers). There will always be a balance. Health care is unique in that those who benefit from ineffeciencies are highly skilled and educated. They are members of large voting blocs and have enormous combined influence and wealth. We need to think differently about how we approach this problem and its implementation. Quality has never been an adequate motivator to improve care and drive fiscal constraint. It should be, but it is not. The health care industry operates on a profit basis. Therefore, incentives will not motivate change, unless the incentive exceeds the loss. A public resolve and political voice is required if we are to change this industry to once again serve the public interest.