Bush tells federal agencies to gather and share data on health quality and cost

President George Bush has signed an executive order requiring four federal agencies to collect and share data on healthcare quality and costs and make the data available to users, such as people enrolled in health plans operated or supervised by the federal government.

Although the president's order called for improvement of the quality and efficiency of health care, it said federal agencies should not incur additional costs for the government. Agencies must begin complying with the order by January 2007.

The president has often recommended that consumers shop for quality health care at the best price. Mike Leavitt, head of the Department of Health and Human Services, said, “Every American should have access to a full range of information about the quality and cost of their healthcare options.”

The agencies to share information are the Department of Health and Human Services, which oversees the Medicare health insurance scheme for elderly and disabled people, and Medicaid, the scheme for poor people; the Department of Defense, which provides health care for the military; the Department of Veterans Affairs, which operates the Veterans Administration healthcare system; and the Office of Personnel Management, which oversees healthcare programmes for federal employees.

Health economists have estimated that US spending on health care will rise from the current 16% of gross domestic product to 25% by 2030. The federal government pays for about 40% of US health care.

The new system must be interoperable, said the president. The president's order said that it must be possible “to communicate and exchange data accurately, effectively, securely, and consistently with different information technology systems, software applications, and networks in various settings and exchange data such that clinical or operational purpose and meaning of the data are preserved and unaltered.” The secretary of health and human services will be responsible for developing standards for the system.

In a fundraising meeting for Republican candidates in Minnesota, President Bush said it was necessary “to use information technology to wring the costs out of medicine—and yet be able to deliver good quality care to our citizens.” He estimated that electronic medical records could reduce medical costs by 25% to 30%.

He encouraged the use of health savings plans, in which people set aside money, free of tax, to pay for routine health costs and purchase health insurance to cover major health costs. “If that's the goal then it makes sense to make sure that consumers have got rational data from which to make choices. And that's not the case today in medicine,” he said. People are not concerned about health costs, he said, “because somebody else is paying the bill” (such as an insurance company or the government).

The American College of Physicians, responding to earlier discussions about transparency, said, “Price, alone, is a poor proxy for determining the total cost of care and informing consumers' choice of physician.”

President Bush's announcement is at www.whitehouse.gov/infocus/healthcare.