Myth 4: Infant mortality is lower in other countries because they have “universal” tax-funded medical care, and the U.S. does not.

July 3rd, 2009

A number of countries report lower infant mortality than the U.S., but it has nothing to do with the source of payment for medical care.

In Japan, which has the best statistics (3.3 die per 1,000 live births), the national system does not cover normal childbirth—or prenatal, postnatal, and postpartum care (Your Health Matters by Gregory Dattilo and David Racer, Alethos Press, 2006).

In the U.S., mortality is only 3.0 per 1,000 for full-term babies weighing at least 5.5 lbs (ibid.). Premature, low-birth-weight babies, who have a much higher risk of early death, have a better chance of survival in the U.S. than anywhere else, because of the excellent medical care they receive here.

The incidence of prematurity and low birth weight is relatively high in the U.S.; one reason is ethnic composition. Black American mothers give birth before 37 weeks twice as often as whites, and 3.8 times as often before 28 weeks (Future of Children, Spring 1995).

Predictors of premature birth include socioeconomic factors such as age under 20, single marital status, being on welfare, and not having graduated high school (Lieberman E, et al. N Engl J Med 1987;317:743-748) ; chronic health problems such as diabetes, hypertension, or clotting disorders; certain infections during pregnancy; use of cigarettes, alcohol, or illicit drugs (CDC); and prior abortions (Rooney B, Calhoun BC, J Am Phys Surg 2003;8:46-49). Increasing Medicaid coverage for pregnant women had no effect on birth outcomes (Ray WA, et al. JAMA 1998;279:314-316).

Many nations do not count very small babies as live births. Hence, they don’t count as deaths either. In France and Belgium, for example, babies born before 26 weeks are automatically considered stillborn, states Bernardine Healy.

In the U.S., all our babies count, even if they make our statistics look worse. The tiny ones we now save could be the first casualties of “reform.”

“[A question] that assumes even greater significance as we contemplate the finances of health care reform [is] how much capital are we willing to invest to save the lives of the most extremely preterm infants?” (Future of Children, op. cit.)

Additional information:

Posted in health care reform, mythbusters, single payer health care, socialized medicine, universal care | No Comments »

Deliveries available for $2,300

July 2nd, 2009

The typical cost for a vaginal delivery without complications is $9,000 to $17,000 in the U.S., depending on geographic location, and whether there is a discount for uninsured patients. A Caesarean section runs $14,000 to $25,000. The baby usually gets a separate bill: $1,500 to $4,000 for a healthy full-term baby.

Tucson Medical Center (TMC) in Tucson, Arizona, however, offers a special package—and it’s not for a drive-by delivery. The cost is $2,300 for a normal delivery with a two-day hospital stay, and $4,600 for an uncomplicated Caesarean section with a four-day stay. Included are exams for the newborn, and a massage for the mother. The childbirth package is one of a number of pre-paid deals offered to affluent Mexican nationals who like the amenities of American medical care—as well as to other self-paying patients.

“These are families with a lot of money, and some (women) arrive on private jets,” said Shawn Page, TMC’s administrator of international services and relations (Mariana Alvarado, Arizona Daily Star 6/21/09).

The practice of wealthy Mexican women coming to the U.S. to give birth has gone on for generations, and occurs at all Tucson hospitals. TMC is said to be the only one actively soliciting this business. While legal, it offends advocates of tougher immigration standards, because babies born here automatically receive U.S. citizenship. The automatic citizenship is a feature of U.S. federal law, and hospitals are required by the federal Emergency Medical Treatment and Active Labor Act (EMTALA) to provide maternity services to illegal aliens who just walk in and do not pay.

The newspaper story garnered more than 180 reader comments, many expressing anger about “anchor babies.”

But one commenter asked a key question: “It costs less than 5,000 for a C-section? If it’s that cheap why do people even worry about getting insurance?”

The prices quoted for the package deals do not include fees for the anesthesiologist, surgeon, or physicians who interpret tests.

“Packages are offered to self-pay patients only, not to patients covered by insurance. To receive package program rates, full payments must be received before services are performed, otherwise full charges will be billed.”

Additional information:

Posted in Uncategorized, consumer driven medical care | 5 Comments »

Myth 3. Americans are going bankrupt, and American companies are noncompetitive, because we don’t have “universal health care.”

July 2nd, 2009

For years, advocates of “single payer health care” have been warning that middle-class Americans are only “one serious illness away from bankruptcy”—even if they have insurance. Obama has claimed that medical costs cause a bankruptcy in America every 30 seconds. Divided We Fail claims that “millions” go bankrupt every year because of medical costs.

American companies are also going bankrupt and losing out to global competition, allegedly because they are having to bear workers’ high health costs.

Both problems would be solved, say proponents of a government takeover, if the U.S. adopted a universal tax-funded medical system, which would purportedly drive down expenditures, while imposing them on taxpayers instead of individuals and employers.

The facts are these:

  • The actual number of “medical bankruptcies”—by the single-payer advocates’ definition—fell by 220,000 between 2001 and 2007.  There were a total of 822,590 bankruptcies filed in 2007.
  • According to Ning Zhu of the University of California at Davis, author of a study of 2003 bankruptcies in Delaware, only about 5% were caused by medical problems. If this percentage holds, (.05) (822,590) or about 41,000 were caused by medical costs—far from Obama’s 30/sec or 1,051,200.
  • The mean net worth for “medically bankrupt” households was          –$44,622, while their average out-of-pocket medical costs came to $17,943. Single-payer advocates attribute bankruptcy to medical reasons if the debtor reported uncovered medical bills exceeding $1,000 in 2 years, or lost at least 2 weeks worth of income because of illness or injury. Bankruptcy is caused by debt, and a loss of the income needed to service it.
  • Many companies are in trouble, especially if they have acceded to union demands for unsustainable “gold-plated” benefits that encourage overconsumption of medical services. But American industry as a whole also faces an increasingly hostile business environment of taxation, regulation, and litigation, as well as high wages compared with the developing world.

Universal tax-funded medical care only compounds the bankruptcy problem. The existing single-payer systems in America—Medicare and Medicaid—are themselves unsustainable and on a course to bankrupt both federal and state treasuries. The price controls they impose on physicians and hospitals lead to cost shifting to private insurers and self-paying patients.

European social welfare systems are even more financially challenged than those in the U.S. Spending growth is about the same in the U.S. and other developed countries.

The entire world is in an economic crisis. “Universal health care” is much more likely to be a contributory cause than a solution.

Additional information:

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Posted in health care reform, mythbusters | 11 Comments »

Pelosi rams through $0.8 trillion tax increase, calls it a “jobs bill”

June 30th, 2009

On June 26, a narrow margin of 219 to 212, the U.S House of Representatives passed a “cap and trade” bill, H.R. 2454, the American Clean Energy and Security Act of 2009, or Waxman-Markey bill.

The 1,200-page bill is said to “literally save the planet,” while creating “millions of green jobs.”

In closing debate, Speaker Nancy Pelosi (D-CA) said, “Just remember these four words: Jobs, jobs, jobs, and jobs.”

The goal is overall reduction of U.S. greenhouse gas emissions by 17% from 2005 levels by 2020, and 83% by mid-century (Wall St J 6/27/09).

It was not possible for Congress to know the true impact of the bill, if enacted and implemented, especially as it was reportedly not possible to find the 1,200-page version of the bill, including the 3 a.m., 300-page amendment, by the time of passage.

The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) estimated that federal revenues would increase by about $846 billion over the 2010-2019 period, starting slowly at $0.9 billion in 2010 and growing to $132 billion in 2019 (CBO Cost Estimate 6/5/09). There would, however, also be direct expenditures of $821 billion over the same period, so that the bill could only reduce the budget deficit by $24 billion.

This would fall far short of the $646 billion windfall hoped for by 2019 to cover the “down payment” on health care reform (AAPS News of the Day 3/2/09).

The bill would affect every aspect of American life, and impose massive reporting requirements on energy generators and users—including clinics and hospitals. “Every aspect of our lives must be subjected to an inventory in order to battle global warming and reduce our carbon footprints,” said Pelosi in May (Marc Morano, Climate Depot 6/26/09).

The lowest cost estimate is Obama’s—the cost of a postage stamp per day. “It’s paid for by polluters who currently emit dangerous carbon emissions” (AP 6/27/09). The CBO estimate is $175/yr for the average household, after tax credits and rebates, but not counting effects on employment or gross domestic product. Taking the Obama Administration’s estimate of $650 billion from auctioning carbon permits, and “knowledgeable” estimates of $2,000 billion for impact on consumers, and dividing by the number of households and 10 years, the Science and Environmental Policy Project (SEPP) calculates $650 to $2,000 per year per household. (The Week That Was 6/27/09).

The net reduction in jobs, according to Charles River Associates International, would be between 2.3 million and 2.7 million per year, as manufacturing is outsourced to China and India.

In the House Energy Committee, three Republican amendments were defeated during the few days in which debate was allowed: to suspend the program if gasoline prices hit $5/gal, or electricity prices increased 10%, or unemployment rates hit 15% (Wall St J 6/26/09).

If the emissions reductions goal were met—reducing carbon dioxide emissions to 1907 levels, when the primary mode of transportation was horses—the largest possible effect on temperature by the end of the century would be 0.2 degrees Fahrenheit, according to a climate modeling study by Chip Knappenberger (ibid.) Obama called the initial targets set by the House bill “modest” (NY Times 6/28/09).

As the House was voting on the biggest tax increase in history on 100% of Americans, the Obama Administration attempted to suppress a report by EPA scientists that “completely blows apart the scientific underpinnings of the endangerment finding that the EPA administrator made on CO2” (NY Times 6/26/09).

Alan Carlin and John Davidson were ordered, in emails obtained by the Competitive Enterprise Institute (CEI), not to communicate to the public their conclusion that the global warming theory is bunk, because the Administration had decided to go ahead with “the endangerment finding.” CEI has posted the report.

Obama pulled back an address on the urgency of health care reform, substituting a message focusing on the House “climate victory.” He is already turning up the pressure on the Senate, where the “cap and tax” energy-rationing proposal faces stiff opposition (NY Times 6/28/09).

Voting against the bill were 44 Democrats, and voting for it were eight Republicans: Mary Bono Mack (R-CA), Mike Castle (R-DW), Mark Steven Kirk (R-IL), Leonard Lance (R-NJ), Frank LoBiondo (R-NJ), John McHugh (R-NY), Dave Reichert (R-WA), and Chris Smith (R-NJ).

Additional information:

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Myth 2: A public plan could save enough on administrative costs to provide coverage to all.

June 29th, 2009

It is frequently asserted, especially by groups such as Physicians for a National Health Program (PNHP), that a “single payer” (government) system could “save” enough money on administration to buy coverage for all the uninsured.

The basis for the assertion is the claim that Medicare spends only 2% to 3% of its outlays on administration, compared with private plans’ alleged costs of 20% to 25%.

In fact, data from the Congressional Budget Office (CBO) shows that insurance companies spend at least 50% less on administration than government does on its health programs. (The Congressional Budget Office Reports: Comparing health care admin cost: who’s less costly?)

CMS (Centers for Medicare and Medicaid Services ) divides spending data into care (paid to doctors, hospitals, pharmacies, and others for patient care) and non-care (everything else). For 2009, CMS projects spending on care at $2.13 trillion, and non-care at $424 billion or 16.7% of total spending.

Of the $879 billion projected to be paid in 2009 by private insurance, CMS estimates $128 billion for non-care—12.7%. For all public programs except Medicare, the comparable percentage is 26%, without adjustment for the taxes and assessments paid only by private insurers. Unlike Medicare, other public programs—Medicaid, SCHIP, Veterans Administration, and military programs—are internally administered.

Medicare is externally administered by private companies; its non-care costs are 5.7%. If it were administered like other government programs, administrative cost would increase by $1 trillion over the next 10 years.

There are many reasons why private companies have higher non-care costs for their private plans than for Medicare:

  • Private insurance plans must pay government taxes and assessments up to 5% of premiums. When these are factored out, the real net cost of private administration is less than 10%.
  • CMS excludes the cost of its own employees who enroll recipients, perform outreach and education, handle customer service, and do auditing and other functions. Private plans include these in overhead.
  • Private plans have on average a higher number of claims to process for a given amount of expenditure.
  • Insurance companies have to collect premiums. The IRS does that for Medicare.
  • Private companies do underwriting; their premiums have to cover their costs. Medicare deficits have to be covered by taxpayers.
  • The cost of servicing the public debt is not included in Medicare costs—and Part B is 75% subsidized by general revenues, not beneficiary premiums.

Greg Dattilo and Dave Racer conclude: “Though one has to dig for the truth, the CBO report makes the case: Competition in a private health insurance market saves tens of billions each year that government agencies would waste on administrative cost.”

Benjamin Zycher of the Manhattan Institute for Policy Research also notes that it costs the economy more than a dollar to send a dollar to Washington (Wall St J 10/29/07). The lowest plausible assumption for the excess economic cost of the tax burden, 20%, would raise the cost of delivering Medicare benefits to at least 24% to 25% of Medicare outlays, and a more realistic estimate to about 52%, or four to five times the net cost of private insurance.

Other facts to remember about Medicare administration:

Additional information:

Posted in health care reform, mythbusters | 4 Comments »

Myth 1: An electronic medical record could save your life in an emergency

June 29th, 2009

Information technology does not stop bleeding, start IVs, defibrillate the heart, or put in a breathing tube. In an emergency, those are the things that save your life. If you need them, the doctor does not have time to look at your EMR.

In an emergency, the doctor needs to know your blood sugar NOW, not what it was 6 months ago. Ditto for your chest xray. If the test needs to be done STAT, the old results are probably irrelevant, and if it doesn’t need to be done STAT, there’s time to make a phone call and ask for a faxed report.

The most important information in an emergency is what just happened to you, and that will not be in your EMR.

If you have a serious allergy or other problem that your doctor needs to know in an emergency, wear a MedicAlert bracelet or something else attached to your body. In a bad emergency, your ID may be lost, the computer may be down, or the power may be off.

The EMR is being promoted for the convenience of bureaucrats and lawyers, and for the profits of vendors. Sometimes it helps doctors; sometimes it’s a hindrance. Only the doctor can decide.

The EMR costs a huge amount of money, and the costs never stop. It might save a few dollars in preventing unnecessary tests for people who have bad memories or can’t keep track of paper records.

The whole record could be destroyed by a power surge (especially if it’s an electromagnetic pulse or EMP). Or it could become unreadable; tapes, disks, and other media become obsolete and are not necessarily durable. On the other hand, it can be nearly impossible to extirpate errors.

The EMR may prevent some errors, but introduce others, especially ones caused by identity theft, sloppy data entry, poor typing skills, confusing software, dry-labbed information entry by macro, and failure to check data once entered. It could even kill you.

EMR systems are a nonconsented experiment, the results of which may be kept secret by the vendors.

If you’re desperately ill or critically injured, you need a doctor, not a computer. Your doctor needs to be able to keep his records in a way that works for him, and to choose his own tools, computers included.

Additional information:

Please send suggestions for other mythbusters to jane@aapsonline.org or post them below.

Posted in information technology, mythbusters | 8 Comments »

Where is the money for “health care reform”?

June 28th, 2009

At a Tucson “tea party” on June 22, Steven Knope, M.D., opened the discussion with the remark that the U.S. just doesn’t have the money for the proposed “change” in American medicine—or anything else.

This is becoming increasingly clear to foreigners, if not to Americans. The U.S. was told “no” when it requested to attend the June 15/16 meeting in Yekaterinburg, Russia, as an observer. The six-nation Shanghai Co-operation Organisation was discussing ways to challenge American economic hegemony.

Member nations are Russia, China, Kazakhstan, Tajikistan, Kyrgyzstan, and Uzbekistan. Iran, India, Pakistan, and Mongolia have observer status.

“If China, Russian and their allies have their way,” writes Michael Hudson, the “world’s largest debtor” will no longer be able to “live off the savings of others” (Financial Times 6/15/09).

Some believe that the U.S.—or “Wall Street”—has been propping up the dollar by temporarily smashing the prices of commodities such as gold and crude oil. Having been thwarted in its efforts to buy an important stake in Western commodity firms such as Unocal or Rio Tinto, China has been directing its dollar reserves toward hedge funds, writes Jim Willie. He views this as part of an encirclement strategy, which will deprive the U.S. of a key method of supporting the dollar.

“China commands the Great Wall of Money that will eventually cascade onto world markets. That cascade could be more important as a factor in generating U.S. price inflation than the buildup and spillover of the USFed balance sheet” (Goldseek.com 6/18/09).

Chinese students recently laughed at U.S. Treasury Secretary Timothy Geithner when he told them that Chinese dollar assets were safe. Former Chinese central bank advisor Yu Yongding referred to the Federal Reserve as the “world’s biggest junk investor.”

If one counts private debt, official government debt, off-budget obligations, and internal commitments, America owes 100 times as much as Weimar Germany. And it just keeps borrowing more. In 2009 alone it will borrow $1.3 trillion, “just shy of the debt that sank the Weimar Republic,” writes Bill Bonner (LewRockwell.com 6/22/09).

The Federal Reserve is adding bank reserves at a rate that allows the money supply to expand geometrically, at a rate of 4,500%. Any normal bank that did that would be closed down immediately, Bonner states.

In 1923, Karl Helferich, Chairman, Central Bank of Germany, wrote: “To follow the good counsel of stopping [the inflation machine] would mean…that in a very short time the entire public, factories, mines, railways and post office, national and local government, in short, all national and economic life would be stopped.”

Some argue that hyperinflation will not occur—because the inflation machine simply will not work any more. Deflation is inevitable, they say, because of continuing debt collapse. Open market paper, instead of growing as it had in almost every prior quarter in history, is collapsing at an annual rate of $662.5 billion. The only major player borrowing money in big amounts is the U.S. Treasury, sopping up $1,442.8 billion of the credit available, leaving less than nothing for the private sector, writes Mish Shedlock (Mish’s Global Economic Trend Analysis 6/24/09).

Would more regulation work? Richard Maybury writes that instead of being restrained by a free market (contracts, courts with informed juries, and competition), all financial entities, no matter how incompetent or dishonest, are now under the same massive regulatory umbrella, so it is impossible to distinguish good guys and bad guys. Regulations are providing camouflage for crooks. Massive malinvestments in the U.S. economy are not being corrected. Huge injections of money are simply not being circulated. (Daily Bell 6/7/09).

The current version of “regulatory reform,” in any event, amounts to handing dictatorial control of the entire U.S. economy over to the Federal Reserve, said Congressman Ron Paul, M.D. (R-TX).

Paul concludes, in his June 22 weekly address, that the apparent goal of the Administration and Congress, with the continuing round of “stimulus” packages, is to bring about the total economic collapse of the United States.

“Bank robbers rob banks because that’s where the money is. Similarly, governments tax producers because that’s where the money is,” observes Robert L. Hale (Reactionary Utopian 5/20/09). Compared with the other five-sixths of the economy, how well off is medicine? Is it likely to be the sink for redistributed money—or the source?

Additional information:

Posted in Uncategorized, health care reform | 5 Comments »

Kennedy bill breaks Obama’s promises

June 22nd, 2009

In his campaign speeches and recent talk to the AMA, Obama promised that all Americans would “be able to get the same kind of coverage that members of Congress give themselves.”

The proposed Kennedy bill, the Affordable Health Choices Act, however, specifically exempts members of Congress and other employees from being pushed into stingy plans with HMO-type controls (section 3116), notes Betsy McCaughey (Wall Street Journal 6/16/09).

Contrary to what many seem to believe, the Federal Employee Health Benefits Program (FEHBP) is not a public plan. Rather, it offers a wide range of private plans, paid for by the employer—the federal government. Those plans include low-cost, high-deductible plans coupled with health savings accounts.

Ordinary Americans would have to enroll in a “qualified” plan—or else be tracked down and fined (sections 3101 and 6055). We won’t know all the requirements until after the bill gets passed and the Secretary of HHS writes the rules. The language suggests that the plan will require a “medical home” (sections 3101 and 2707). That is likely to be this decade’s version of the HMO gatekeeper, writes McCaughey.

The “payment structure” will be based on “incentives” to “provide the best care, rather than more care.” In other words, an incentive to get paid more by doing less.

Both Obama and Kennedy promise that if you like your plan you can keep it. The question is, how big a fine will you have to pay? The bill sets no limit, but says it will be enough to “accomplish the goal of enhancing participation in qualifying coverage” (section 161).

Obama also promises people that they can keep their doctor. Assuming, of course, that he’s still available on the patient’s plan. Or still in practice at all, after automatic, across-the-board Medicare spending cuts are triggered by failure to meet cost-cutting targets, as proposed by Senator Baucus.

Additional information:

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Alert: for physicians not opted out of Medicare

June 20th, 2009

CMS asks that you share this important information with all of your association members and State and local chapters. 

Scam Alert

CMS has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC).  The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments.  The fax may have  the CMS logo and/or the contractor logo to enhance the appearance of authenticity.

Medicare FFS providers, including physicians, non-physician practitioners, should be wary of this type of request.  If you receive a request for information in the manner described above, please check with your contractor before submitting any information.  Medicare providers should only send information to a Medicare contractor using the address found in the download section of the  CMS.gov website found at

http://www.cms.hhs.gov/MLNGenInfo/ or

http://www.cms.hhs.gov/MedicareProviderSupEnroll .

Mary Case for Valerie A. Haugen, Director
Division of Provider Information Planning & Development
Provider Communications Group, CMS
(410) 786-6690
Valerie.Haugen@cms.hhs.gov

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Digital panacea is fiscally disastrous, clinically dangerous

June 19th, 2009

While advances in technology—eagerly adopted by doctors and hospitals—are often blamed for high medical costs, there is one type of technology that will supposedly save billions once we “invest” billions in it and force it on supposedly recalcitrant, technophobic doctors and hospitals: health information technology (HIT), including the electronic medical record (EMR) and computerized physician order entry (CPOE).

“Faith-based cost control” is the term used by Dr. Jon Oberlander in a “Perspective Roundtable: Health Care and the Recession,” offered by The New England Journal of Medicine in January, 2009.

The “stimulus” package provides between $44,000 and $64,000 for physicians who acquire an EMR and demonstrate “meaningful use.” However, “the price is dwarfed by the problems [an EMR] causes the office,” stated Evan Steele, CEO of SRS Soft, which provides a less complex alternative. If a specialist who bills $750,000 a year loses 5% of her productivity dealing with the computer system, she loses $162,000 over 5 years (Physicians Practice, April 2009).

Even the vaunted Veterans Administration system has major problems. An 8-year, $167 million project was not able to develop acceptable scheduling software. The military’s AHLTA system is so slow, unreliable, and cumbersome that clinicians spend 40% of their time inputting data, causing a “near mutiny” (CPR #172, 4/3/09).

For ₤12.7 billion the UK still does not have a national health information technology system, but rather an HIT quagmire, some of it caused by U.S. HIT vendors, writes Dr. Scot Silverstein to the Wall Street Journal.

The province of Ontario just created a new agency, eHealth Ontario, to replace Smart Systems for Health Agency, which spent $647 million without showing any noticeable results. The new agency is supposed to provide EMRs for all citizens by 2015. The province has just hired a consultant to examine whether eHealth Ontario is spending too much money on consultants (Canada Free Press 6/9/09).

In the U.S. also, “most big health IT projects have been clear disasters,” says Dr. David Kibbe, senior technology advisor to the American Academy of Family Physicians. And it’s not just the money.

One U.S. pharmaceutical data base found 43,372 medication mistakes, or about 25% of the total reported in 2006, that involved computer technology: flaws in data entry, inadequate software, and confusing screens. In 2006, Children’s National Medical Center in Washington, D.C., found an eightfold increase in dosage errors for high-risk medications (Terhune C, et al., Business Week 4/23/09).

A 2005 study by University of Pennsylvania sociologist Ross Koppel found 22 circumstances in which the software boosted the probability of error. Doctors also suffered from “alert fatigue” from endless false alarms about minor drug interactions.

“If drug companies sold products with this quality level,” states Dr. Scot Silverstein, “it would be a scandal” (Forbes 5/11/09).

HIT vendors shift liability to users and insert contract language that keeps them from learning of serious faults (Koppel R, Kreda D, JAMA 3/25/09).

“There is a dearth of data on the incidence of adverse events directly caused by HIT overall” (Joint Commission. Sentinel Events Alert, Issue 42, 12/11/08). Among many potential problems are “dangerous workarounds” necessitated by counterproductive technology.

Potential benefits have been greatly exaggerated. Large randomized controlled studies in both the U.S. and Britain have found that EMRs with computerized decision support “did not result in a single improvement in any measure of quality of care for patients with chronic conditions including heart disease and asthma” (Washington Post 3/17/09).

As a direct consequence of the EMR and pay for performance (P4P), the veracity of the clinical record is compromised, write David J. Gibson, M.D., and Jennifer Shaw Gibson (“The Case Against the Electronic Medical Record,” MedicalTuesday.net). Reported data may be “dry-labbed,” and, once entered, data are rarely checked for accuracy.

There are good reasons why only 1.5% of U.S. acute-care hospitals have a comprehensive EMR (Jha AK, et al. N Engl J Med 4/16/09).

Obama’s estimate of savings is an $80 billion exaggeration,” write Jerome Groopman and Pamela Hartzband (Wall Street Journal 5/12/09).

Additional information:

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