Can Obama's Economic Plan actually stimulate health care?

Jeff - great point, and one that has not fallen on deaf ears. Obama has heard you loud and clear and proposes to use a portion of the stimulus package to health care jobs stimulation.

When you dive into the stimulus package - it seems to break down currently into the following buckets:

• $39 billion in subsidies to health insurance for the unemployed; providing coverage through Medicaid
• $90 billion to shore up state Medicaid programs
• $20 billion for health-information technology systems
• $4 billion for preventative care

Infusion of capital into the insurance markets will help preserve jobs, but I think the real jobs creation is in the $20bb for HCIT. The question is how does a technology solution that conceivably kills jobs (less need for transcriptionists, filing and admin support) create other types of jobs?


Halamka - the CIO and an ED doc from the BI has outlined how his organization has created jobs through EMR implementation . The link is here

The Health Care Blog: Electronic Medical Records and Obama's Economic Plan

The meat of the post is as follows:

"In 2009, we will implement 150 physicians in 75 practices, or 13 physicians in 6 practices per month. The direct staff we'll need are:

Massachusetts eHealth Collaborative: 6 FTEs (5 practice consultants plus a project manager)

Concordant: 9 FTEs (5 on-site assessment/design/deployment/support, 2 technical lead/system architect, 2 project management)

eClinicalWorks: 4 FTEs (3 on-site trainers, plus part of a product specialist and a project manager)

At BIDMC, the project is run by 3 FTEs (Project Director, Technical Lead, Senior Practice Consultant)

Thus we've created 22 jobs for the rollout and support of our EHR project. Multiply this by the number of clinicians needing EHRs in the country and you'll see that the Obama plan will create tens of thousands of new high tech jobs."

I don't disagree with the numbers of people required. At approximately $25K / physician install costs, with ongoing annual service costs of approximately $8k - $20bb will not cover the remaining 86% of physicians who do not have an EMR office solution. Also, part of the reason that EMR hasn't taken off (in addition to a whole host of reasons I'll post at some point) is that the install process requires too many people and disrupts the office operations to an unacceptable degree. So for EMR install gain acceptance, we will need to find solutions that require less people. That means engineering jobs to develop the lower footprint install. But will the stimulus go directly to providers or to HCIT vendors?

Anyways, not a structured argument - but essentially I think Obama's proposed jobs creation program should theoretically focus on health care - but it's not really clear that the program will really create jobs directly.

Regardless, the stimulus is the right steps towards increasing access to health care while driving down costs and raising quality.