Obama’s Surprising Answer on Which Part of Obamacare Has Disappointed Him the Most

There was this moment, about 50 minutes into our interview with President Barack Obama last week, that genuinely surprised me (and surprised other health care journalists, like David Nather, too). My colleague Ezra Klein had asked the president a question about which part of the law had overperformed his expectations, and which part of the law had underperformed. The president gave a surprisingly frank assessment of something his administration has tried, and failed, to do: Get doctors off paper and on to digital medical records.

“We put a big slug of money to encouraging everyone to digitalize and catch up with the rest of the world here,” President Obama told us. “And it’s proven to be harder than we expected.” Obama then went on to analyze why this had been so hard — why in a world where, in the president’s words, “you can basically do everything off your phone,” the medical system remains buried under “mountains of paperwork.” His answer is worth reading in full: 

We put a big slug of money to encouraging everyone to digitalize and catch up with the rest of the world here. And it’s proven to be harder than we expected, partly because everyone has different systems, they don’t all talk to each other, it requires retraining people in how to use them effectively, and I’m optimistic that over time it’s inevitable it’s going to get better because every other part of our lives, it’s become paperless. But it’s a lot slower than I would have expected; some of it has to do with the fact that it’s decentralized and everyone has different systems...