On Wednesday morning, Nov. 7, Sharon Canner, the senior director of advocacy programs at the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), spoke with HCI Editor-in-Chief Mark Hagland, to share her perspectives on the implications for healthcare IT initiatives and policy, in the context of the elections in the United States Senate and House of Representatives and the presidential election. Below are excerpts from that interview.
As of 9 a.m. eastern time this morning (Nov. 7), NBC is projecting a net pickup of eight Democratic seats in the House, and a few in the Senate. There’s so much that has to be resolved, in terms of healthcare policy and spending issues. What will happen now?
You could say it’s going to be more of the same, to some extent. But the more positive thing would be to look at the structure that’s been created by the HITECH Act [the American Recovery and Reinvestment Act/Health Information Technology for Economic and Clinical Health Act], and meaningful use, and the certification process. So the election results reaffirm all that work, and that we’ve laid a really good base [in terms of the HITECH Act, etc.]. In a few minutes, the HIT Policy Committee will talk about proposed suggestions for Stage 3 and I’m headed off to that meeting. And there will be information placed in the Federal Register soon. And so my contention is that [President Barack] Obama’s reelection has reaffirmed the very solid foundation that’s been created for IT.
Would the Republicans have taken down HITECH, had they achieved control of the White House and both houses of Congress?
I don’t think that they would have taken HITECH down, but they would have moved to take back some of the funding, and that would have come through a legislative initiative. However, there would have been a pushback from the healthcare industry, especially the hospitals, with regard to the funding. And there’s a multiplier effect related to jobs in the community that [people are aware of]. And for example, Mike Leavitt [Michael O. Leavitt] was his transition person on healthcare; he was Secretary of Health and Human Services under President Bush; and he appreciates the value of healthcare IT.
Now, Congress and the President face the looming “fiscal cliff,” as well as the “SGR problem.” What might happen now?
If you look at the fiscal cliff and what Obama has to do to get folks off the dime, first, you could say, well, the Republicans still have the majority in the House. But it’s important to understand that Obama is now a seasoned president, and understands a lot of the aspects that have been used by the House majority. Meanwhile, there’s got to be a higher learning curve on the part of the Republican Party. What has the Republican Party learned from this election. And if you look at some of the candidates who won, there’s some interpretation that, as Americans, we want our lawmakers to cooperate. And I think there was a considerable discrediting of the Grover Norquist approach. So perhaps there was a learning curve for the President, but also for the Republican Party.
Is there any way that the members of Congress can avert the physician Medicare cut in the short term, per the SGR?
I don’t know, but as I recall, CMS can do some sort of short-term maneuver to keep the payments coming, and I don’t know what the technical term is for that. There was something that they did earlier, but that only lasts for a short time.
Is there any chance of that?
Well, when members of Congress want to work on something, they can move quickly if they want to. And the election takes considerable relief and uncertainty off some things. And there are a number of proposals out there about how to do the long-term SGR fix; but that takes some negotiation.
So you don’t see it happening in the next two months?
To come to all the details that have to be managed, I just don’t see it happening, though perhaps there could be a short-term administrative fix.
One of the points I’d like to make about the election is that there were significant retirements off the Senate Finance Committee; Conrad and Kyl [Kent Conrad, D-ND, and John Kyl, R-AZ] are gone, and they were both experienced. We’ve kept Debbie Stabenow [D-MI], who has a really keen understanding of health IT, and has been a leader on that. Amy Klobuchar [D-MN] has won, and she [while in the House] formed a coalition with Sen. Scott Brown [R-MA] last year, though he’s gone. So we should watch the level of experience of some committee leaders. Who else is gone? Sadly, Olympia Snowe [R-ME]; also Jeff Bingaman [D-NM]. From CHIME’s perspective, we’ve got a huge education hurdle [with regard to newer members and their staffers]. Obviously, for those new to positions in the Senate, and of course, a massive effort in the House, will be necessary, to really build an understanding of the accomplishments of IT; and we hope to work with bipartisan champions of this.
Another point to add: as far as ONC and CMS [the Office of the National Coordinator for Health IT, and the Centers for Medicare & Medicaid Services], they can point with pride to the fact that $7.7 billion is out the door [already disbursed to qualifying hospitals and clinicians under HITECH]. They have a task to really describe and raise the visibility of, what this money has accomplished, and set a preempt to House leadership who might put to doubt what this has accomplished So ONC and CMS have a public relations task ahead of them.
So you will be busy?