Thursday, November 29, 2012

The US ‘Fiscal Cliff’ Might Make A Mess Of E-Health In The US. Could Be Ugly.

This appeared a few days ago.

The Fiscal Cliff and Meaningful Use: Be Very Afraid

NOV 16, 2012 8:11pm ET
During the congressional tax/budget debate coming very soon, someone in the Republican Party is going to demand another $20 billion or so cut from an entitlement program or another government program that is near and dear to the Democratic Party. Someone in the Republican Party will mention that boondoggle health information technology initiative in the hated stimulus bill, and someone in the Democratic Party will decide that’s where another $20 billion in savings can come from. Whatever federal funds are left to support electronic health records meaningful use, health I.T. workforce training, health information exchanges, best practices dissemination, regional extension centers and anything else in the HITECH Act will be gone.
Don’t believe all the talk of how health I.T. has bi-partisan support. Nothing but the most sacred cows will be considered sacred in the upcoming budget battle. Since health I.T. doesn’t pass the sacred test, the spigot is in danger of running dry unless the nation’s physicians and hospitals rise up en masse and scare the hell out of their congressional representatives and senators.
Yes, AMA, you have to stop whining about ICD-10 and focus elsewhere on the real here and now. Yes, AHA, all of your hospitals are spending millions of dollars on EHRs and soon won’t be getting those rebate checks, unless you also turn them loose to fight for what they were promised. Yes, insurers and employers, if you want to have any government funding for information systems that will support bending the cost curve and moving to payment models better than fee-for-service, you also have a lot of work to do. And you all need to do it now.
More here:
The US ‘fiscal cliff’ is a series of taxation measures and spending cuts which have already been legislated and which begin to bite come January 1, 2013. The net effect on US GDP will be a contraction of the order of 4% of GDP next year - and given the fact US growth is only about 2% presently, this - if unchanged - may turf the US back into recession according to the non-partisan Congressional Budget Office.
There is going to have to be some serious ‘horse trading’ to avoid this cliff given the political divide we have in the US. At present the President rather has the upper hand in getting some concessions as he has a veto over any legislation that might prevent tax rises.
As the article points out there is a very large Health IT incentive program and you can bet those who want some spending cuts will want to wind that back big time.
We live in pretty interesting  times as, if the US does not sort this out - as most expect - we will also be hit down under.
I am reminded of Winston Churchill’s comment on the Americans - ‘They will always do the right thing - after having exhausted all other possibilities’ We can but just wait and watch.

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