Dancing to the Music, or Listening to the Words?

March 13, 2009
Mike Hennessy

Slowly but surely, President Obama's plan for radically shifting our economy from a private sector-led enterprise to a public-led state is beginning to take shape. Because the President is eloquent and confident, the exact message he is delivering often seems obscured by his skill in delivering it.

Slowly but surely, President Obama’s plan for radically shifting our economy from a private sector-led enterprise to a public-led state is beginning to take shape. Because the President is eloquent and confident, the exact message he is delivering often seems obscured by his skill in delivering it. The result, as I see it, is a headlong shift away from the values that most Americans share. With the bailout package and with the President’s just-released budget plan, we’re moving rapidly in the direction of economic policies that were an epic failure the first time they were trotted out.

Though the President’s approval rating is high—60% in a recent Wall Street Journal/NBC poll—a majority of 49 economic leaders are “dissatisfied” with the administration’s economic policies, according to an article in the March 12 edition of the Journal. Nearly half of the respondents gave the President a failing grade. Among other concerns, the economists cited delays in enacting key parts of the bank bailout provisions and an overall level of vagueness in the administration’s policies.

Investors have seen the writing on this wall, and so far the verdict has been mixed, with new lows for all the major stock indices until the most recent bear-market rally. The editorial in Tuesday’s Journal opened with the sobering thought that recent deal-making in the pharmaceutical industry, most recently in the form of the normally hesitant-to-deal Merck’s joining forces with Schering-Plough—isn’t a sign of “creative destruction,” which typically happens prior to a period of market growth. Rather, the editors wrote, “More likely it is the industry’s way of anticipating, and building insurance against, the coming era of government-run healthcare.”

The coming era of government-run healthcare. It’s a frightening combination of words, to pair the inefficiency of government with the complexity of healthcare. As a brief example, let’s take a closer look at one of the claims from President Obama’s recent healthcare summit in Washington. According to an article in the Journal, “the flagship proposal presented by the President at this gathering was the national adoption of electronic medial records—a computer-based system that would contain every patient’s clinical history, laboratory results, and treatments. This, he said, would save some $80 billion a year, safeguard against medical errors, reduce malpractice lawsuits, and greatly facilitate both preventive care and ongoing therapy of the chronically ill.”

Sounds great, except that the co-authors of the article, Jerome Groopman, MD, and Pamela Hartzbrand, MD, say those savings are a mirage. Though they tout the benefits of EMRs, the physicians question the study on which the President is basing that $80 billion number: “The basis for the president's proposal is a theoretical study published in 2005 by the RAND Corporation, funded by companies including Hewlett-Packard and Xerox that stand to financially benefit from such an electronic system. And, as the RAND policy analysts readily admit in their report, there was no compelling evidence at the time to support their theoretical claims. Moreover, in the four years since the report, considerable data have been obtained that undermine their claims.”

This is one of many examples where the distance between the rhetoric and the facts is wide. Later in their article, which is a must-read for physicians, Drs. Groopman and Hartzman close the article with the following passage:

“We both voted for President Obama, in part because of his pragmatic approach to problems, belief in empirical data, and openness to changing his mind when those data contradict his initial approach to a problem. We need the president to apply real scientific rigor to fix our health-care system rather than rely on elegant exercises in wishful thinking.”

While many are dancing to the music, it seems like too few are listening to the words of the song. But the words are what matter. Long after the music has stopped, the words will be translated into policy, and the policy into governance.

The $80 billion savings President Obama is touting is little more than a red herring. The real motivation driving the shift in EMR policy is to set the stage for the inevitable attempt at universal healthcare. Such a shift would introduce massive new inefficiencies into an already flawed system, and would be detrimental to physicians’ inability to treat patients as individuals, rather than as a class of disease-sufferers.

The more the public learns about the President and his policies, the more they may come to question such “elegant exercises in wishful thinking.” As a concerned public (and, for you as a physician who will be impacted by changes to healthcare policy), it is our responsibility to question the “facts” as they’ve been presented to us. In many cases already, the facts are not facts at all.

Mike Hennessy is Chairman and CEO of MJH & Associates. Click here for more Hennessy's Highlights