All Parties Ignore the One Way to Reduce Health Care Costs: Single-Payer

Computer vendors' promises of cost savings by eliminating paperwork have also flopped. In a previous study of 3,800 hospitals, we found that computerization actually increased hospitals' administrative costs. Make no mistake: we support clinical computing. It's an essential tool for improving medical care. One of us directed clinical computing at a Harvard hospital for more than a decade. And a handful of hospitals have developed computer systems that have improved care and may even cut costs.

But these successful systems were custom-built by clinicians on the ground and focused on meeting patient care needs. In contrast, business managers are the decisionmakers about computer purchases in most hospitals and large practices, and they're choosing off-the-shelf software that gives priority to maximizing billings and addressing management's needs. As our studies show, these management-led systems have increased health costs.

Yet politicians across the political spectrum - from Barack Obama to Newt Gingrich - continue to push computerization as a health care cure-all. Citing consultants' estimates (in reports mostly funded by computer firms), they promise that the billions invested under the Health Information and Technology for Economic and Clinical Health (HITECH) Act will soon yield hundreds of billions in savings.

It's not just vendors and consultants who fuel politicians' delusions. The cost savings promised by computerization may be vaporware, but they're painless. The realistic alternatives for medical cost control are not.