HIMSS: IT can empower people, says Bill Clinton

NEW ORLEANS—“You all know that information technology and how we manage information technology is critical to an effective healthcare system in the 21st Century,” said Former U.S. President Bill Clinton, delivering a keynote address on March 6 at the Health Information and Management Systems Society (HIMSS) annual convention. Clinton’s talk covered his foundation’s efforts to improve healthcare and education globally, his thoughts on the current political atmosphere and how information technology can improve the U.S. healthcare system.

The political, social and healthcare impacts of the Patient Protection and Affordable Care Act have yet to be fully determined because it all depends on how it’s implemented, he said. With the issues surrounding the national debt, “the most dire scenarios are premised on an assumption that healthcare costs will continue to increase at three times the rate of inflation mostly because of population shifts.” The real problem, he said, is that if the fix for the budget is to take healthcare costs out of the government’s budget and put them into the private sector, the real people affected will be asked to move from a less expensive system to a more expensive system. “The burden of fixing America’s budget problem might be entirely on them.”

In this maelstrom, information technology will become very important, he said, because it helps stakeholders learn more about how to hold costs down and it can serve as a tool that gives millions of “little” people—those with little economic and political clout—huge collective clout to affect markets. For example, the median donation for victims of the 2004 tsunami was $56, Clinton said. That was the first natural disaster that involved internet giving.

Information technology can help improve the quality and cost of healthcare delivery but it also can help improve the quality and cost of healthcare utilization and access. “We need to be thinking about both things. The revolution in information technology is finally empowering consumers to get more value at lower costs in a way that will increase productivity.”

The process is about building systems, Clinton said. “When we build systems, we don’t always get it right.” U.S. healthcare developed on the financial side. He cited Lyndon B. Johnson’s knowledge that he didn’t have the support to let America join every other advanced country in the world that would insure everybody so he allowed for Medicare and Medicaid and “we’ve been tacking on ever since.”

There are “no devils in this,” however, he said. But, a country that spends 17.8 percent of its gross domestic product on healthcare is the most expensive by far. “No other country in the world is above 12 percent of its gross domestic product. There is about $1 trillion difference between 17.8 percent and 11.8 percent.” As much as 30 percent of our healthcare costs are either wasted money to due to overcharging and mismanagement. “What lies before us is the necessity to reform.”

Clinton discussed his foundation’s efforts to work with soft drink and juice companies to reduce the consumption of high calorie beverages in U.S. schools. The companies agreed to make adjustments such as getting rid of all full-sugar drinks and offering smaller portions. He cited an independent study that found last year that with no taxes and no federal rules, in the past five years there has been a 90 percent reduction in calories consumed through drinks in 90 percent of the country’s schools. “A lot of this stuff may not sound very high tech but if we’re not feeding the system as many sick people, that lowers costs for the rest of the people.”

“You should be optimistic for a lot of things,” he told the audience. For example, “I spent $3 billion of your tax dollars [on genomic sequencing], and it was worth every penny. It’s already creating tens of millions of dollars in economic activity.”

This is an exciting time to be alive, Clinton said. “Life expectancy will continue to rise but don’t you want that for everybody?”

The whole promise of information technology is that “we can manage data better than ever before to see what the in the heck we’re doing. It’s quite chilling when you realize how the absence of technology in part means consumers have no way of knowing what they’re going to be charged and what their options are.”

“We need to think about the role of information technology in empowering people to have a bigger impact on the healthcare market and to take better care of themselves and to know what is going on. That is really, really important.”

I’ve told you all these troubling things but you can fix it. We cannot allow a lack of transparency and a disempowering environment for ordinary people to stop you. Over a 10-year period we can get American healthcare costs in line.”