Opinion Piece Addresses OMB's 'Unwillingness To Embrace Change,' Recommends Overhaul

Main Category: IT / Internet / E-mail
Also Included In: Public Health
Article Date: 30 Jan 2008 - 10:00 PDT

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The Bush administration "has made health information technology a high priority," but "because of petty turf battles, or a genuine belief in the paper-based status quo, [Office of Management and Budget] bureaucrats deny reality and have fought any and all federal investments in health IT," former House Speaker Newt Gingrich (R-Ga.), founder of the Center for Health Transformation, and David Merritt, project director of the center, write in a Roll Call opinion piece. According to Gingrich and Merritt, "By directly undercutting the president ... they make his words on modernizing health care ring hollow," adding, "This is not some arcane policy debate. OMB's intransigence has serious consequence for real people, including suffering, injury and death."

Gingrich and Merritt continue, "The most egregious example is from New Orleans," where HHS recently extended a three-year, $100 million grant to a network of primary care clinics that serve low-income and uninsured residents. Former administration officials said that OMB staff "were 'adamant' that not a single penny of this grant be spent on hardware, software or information technology of any kind," Gingrich and Merritt write, adding, "We have visited these clinics. OMB's prohibition sentences the citizens of New Orleans to receive an archaic delivery of care, with all of its dangers and inefficiencies."

"OMB's power to block smart federal spending is not limited to health information technology," as it "tried to slash the health services research budget at HHS by 50%," Gingrich and Merritt write. They note that OMB also "estimated the cost of the Medicare drug benefit but not its savings," adding that the office "did not have the ability or was unwilling to acknowledge that with drug coverage, seniors can control their chronic conditions with medication, reduce hospitalizations and utilization, and improve their health."

Gingrich and Merritt state, "It must change, and Bush can do it," adding that the president should lift the technology prohibition on New Orleans and that the "bureaucrats" who imposed the ban should be fired. In addition, "budget models should incorporate modernized, independent tools that are capable of estimating long-term savings," and "the long-term budget window should be extended to 15 years" to "allow for investments to show their rightful return," Gingrich and Merritt write. They conclude, "This unwillingness to embrace change coupled with their power to undercut the president's agenda makes transforming health exceedingly clear: Real change in health starts -- and may end -- at OMB" (Gingrich/Merritt, Roll Call, 1/29).

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