Hillary Rodham Clinton: Let evidence lead the healthcare reform fight

Former Secretary of State Hillary Rodham Clinton gave the keynote address at the HIMSS 2014 conference in Orlando, FL. (Photo courtesy of HIMSS)The “hyper-politicized debate” about healthcare reform needs to shift to a thoughtful dialogue about evidence and data, according to former Secretary of State Hillary Rodham Clinton.

In addressing thousands of health information technology professionals at the recently concluded HIMSS 2014 conference in Orlando, Florida, Clinton called on healthcare thought leaders to let evidence guide decisions and development to improve quality and reduce cost of the American healthcare system.

“I am a believer that good data helps to make good decisions,” Clinton says. “It’s true in medicine; it’s true in business; it’s true in government, and it’s true in life…. Unfortunately, the hyper-politicized debate about the Affordable Care Act (ACA) has been often more about ideology than data.”

Clinton called on policymakers and healthcare professionals to debate ways to improve the U.S. healthcare system.

“I want us to have a healthcare debate where our differences are fully aired," Clinton says. "We don’t have a one-size-fits all; our country is quite diverse. What works in New York City is not necessarily going to work in Harrison, Arkansas or Albuquerque. We do need to have people who are looking for ways to use evidence but leave their blaming, their gaming, their shaming, their point scoring at the door.”

There are many reform provisions in the ACA that attempt to improve the system, Clinton says. Some examples include:

• measuring outcomes,

• covering preventive care,

• shifting from fee-for-service to rewarding quality and value,

• building pricing transparency,

• using comparative effectiveness research,

• opening up access to healthcare coverage to millions of Americans who were previously uninsured,

• allowing children to stay on their parents’ coverage until they are 26,

• “liberating employees” from staying in jobs solely to access health insurance because a family member has a pre-existing or chronic health condition.

“There are many provisions embedded in this act that most Americans, if asked, would support,” Clinton contends. And there are just as many challenges facing the system.

“What happens when us Baby Boomers double the number of Medicare beneficiaries from 40 million to 80 million people?" Clinton asks. "How do we prepare for that dramatic increase? How could we improve coordination and communication among all healthcare providers responsible for a patients’ well-being? Will advances in technology combined with comparative effectiveness research continue providing patients and providers with more and better information about what works and what doesn’t in ways that will reduce cost and improve outcomes? How might we replace, once and for all, our fee-for-service model (with a system) that provides provider-led, community-wide care?”

The case for electronic health records

The challenges facing healthcare are also calling for its modernization through technology, Clinton says.

The need for digitizing medical records was clearly evident following the devastation of Hurricane Katrina in 2005, which decimated parts of New Orleans and other areas on the Gulf Coast.

Millions of pages of medical records were lost during that storm.

“I saw firsthand when I went to meet with survivors and refugees from Katrina. People were just totally bewildered. Elderly people didn’t know what medicine they were taking. They couldn’t explain what that little blue pill was they took 3 times a day. We know how important this is. When you are in the middle of a medical emergency, accessing information can literally make the difference between life and death,” Clinton says.

Squeezing healthcare costs

Technology will ultimately lower healthcare costs to Americans, Clinton says. And this country has made some progress. “Healthcare costs are growing at the slowest rate in 50 years, just around 4%. That has significant implications for our economy going forward.”

“There is a lot of misinformation and a lot of anxiety (about healthcare reform),” she says. “(People) are worried about what they might lose. We need to clear the smoke, and figure out what is working and what isn’t. It would be a great tragedy, in my opinion, to take away what has now been provided to the millions of people who now have Medicaid or a health insurance plan for the first time.”

Clinton was one of four keynote presenters at HIMSS 2014, which drew more than 37,000 healthcare IT professionals. Other presentations were delivered by Mark Bertolini, CEO of Aetna; Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services (CMS), and Karen DeSalvo, MD, MPH, Office of the National Coordinator for Health Information Technology.

More HIMSS 2014 coverage:

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