Health IT Bill Needs Work, Says Ways and Means Subcommittee
Legislation to speed adoption of electronic health records needs strong privacy and record-keeping provisions, House Ways and Means Subcommittee members said Thursday at a hearing. Chairman Pete Stark, D-Calif., said he plans soon to introduce a bill promoting adoption of a national health record system ensuring strong privacy protection for patient records. He and other subcommittee members said the House Commerce Committee bill (HR-6357) passed Wednesday by Commerce (CD July 24 p3) doesn’t offer a complete plan but is a start.
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Stark wants an interoperable federal health IT system, incentives that encourage Medicare providers to adopt health IT and protections for patient privacy. He criticized the Bush administration for lagging in pursuit of its 2004 goal of a national health IT system. That year the Health and Human Services Department created an office on the subject.
No one disputes the need for change, but “considerable attention placed on privacy and security” could slow Hill efforts, said ranking member Dave Camp, R-Mich. Camp’s HR- 6179, introduced in June, would create a public-private entity to set federal interoperability standards. That bill includes tax incentives to encourage the shift and asks for a study on privacy protections. “We must be cautious” that delivering legislation “we do not limit the ability of health care workers and facilities to actually provide health care,” he said at the hearing.
Camp hoped Stark would work in a bipartisan manner, he said, praising such efforts in the Commerce Committee. To illustrate the system as it is, Stark hoisted a staffer’s medical records, a sheaf he said weighed five pounds and which had to be copied and moved among physicians’ offices. “This is the only way he could get his records from one doctor to another because they are not stored electronically.”
A mandate that the government buy health IT systems probably would “induce nearly all providers to adopt it at a small cost to the government,” cutting health costs, Congressional Budget Office Director Peter Orszag told the subcommittee. To promote “cost-effective” health IT, Congress should pass some “version of a requirement or an explicit or implicit penalty” for those ignoring the standards, he said.
Health IT systems are too costly or cumbersome, which is why many providers haven’t switched, Orszag said. There is no business case to invest, said Yul Ejnes, an internist speaking for the American College of Physicians. Ejnes said he got an electronic records system two years ago, thinking it would help his patients. But mandating health IT use without enough incentives could drive providers out of business, he said. Rep. Rahm Emanuel, D-Ill., questioned whether revenue from spectrum auctions could go to pay for health IT. Orszag said the idea was “good,” adding that “all sort of assets” could be tapped.
A comprehensive federal mandate on privacy is needed for health IT technologies to see wide use, according to Center for Democracy and Technology testimony. The “right mix” of privacy policies protecting consumers would not discourage investment, it said. Lawmakers are split on how to deal with privacy, with some criticizing the Commerce bill for not defining privacy.
Health IT legislation should consider the needs of people not comfortable using technology, said Rep. Stephanie Jones, D-Ohio. CBO’s Orszag agreed that’s a “huge issue that has received far too little attention.”