Obama Signs Economic Stimulus Measure Into Law

President Obama on Tuesday in Denver signed into law a $787 billion economic stimulus package that includes a number of health care provisions, the New York Times reports (Stolberg/Nagourney, New York Times, 2/18).

During a speech in which he discussed the benefits of the stimulus package, Obama said, "We have done more in 30 days to advance the cause of health care reform than this country has done in an entire decade" (Fletcher, Washington Post, 2/18). He added that the stimulus package provides "the biggest increase in basic research funding" for NIH, with an additional $10 billion for biomedical research and facility construction (Hall/Jackson, USA Today, 2/18).

White House Press Secretary Robert Gibbs also said that Obama might consider a second stimulus package, although no plan currently exists for such a package (Stolberg, New York Times, 2/18).

Meanwhile, Families USA Executive Director Ron Pollack praised the provision in the stimulus package that will provide states with $87 billion in additional federal Medicaid funds but criticized the elimination of a provision in an earlier version of the package that would have allowed low-income workers who lost jobs that did not include health insurance to apply for Medicaid through 2010. He said, "The absence of temporary Medicaid coverage for unemployed workers represents a regrettable lost opportunity to help families during their period of greatest need" (USA Today, 2/18).

Effect of Unfilled Cabinet Department Positions
In related news, the Times on Wednesday examined how "virtually no one is in place" in Obama's Cabinet departments, such as HHS, to distribute about $180 billion of the economic stimulus package that "will be spent at the discretion of government officials." Obama lacks an HHS secretary, as well as two other Cabinet members, and only two of the 15 Cabinet departments have deputy secretaries confirmed. According to the Times, as a result, the "very departments charged with executing one of the largest spending projects in American history are operating largely with career stand-ins without the authority of political appointees" (Baker, New York Times, 2/18).

Letters to the Editor

• James Rohack, Wall Street Journal: A Feb. 11 Journal editorial cited the potential benefits of electronic health records, and those potential benefits have prompted the American Medical Association to support the health care information technology provisions in the economic stimulus package, AMA President-elect Rohack writes in a Journal letter to the editor. According to Rohack, the provisions will establish national health care IT interoperability standards, which "are essential to achieve the promise HIT holds to help increase patient safety, improve care coordination and reduce unnecessary paperwork." He writes, "As is true in other industries, basic standards will provide the essential foundation on which the private sector can build innovative commercial products," adding, "Competition and innovation are bedrocks of America's economic system, as they should be in health care." The health care IT provisions in the stimulus package "maintain this vision, while building on existing federal efforts to encourage HIT adoption," according to Rohack. He writes, "The bill also provides physicians with significant financial assistance" for health care IT, adding, "This critical support is needed so that physicians can make HIT purchases, and patients can then begin to reap the benefit" (Rohack, Wall Street Journal, 2/17).
  
  
• Scot Silverstein, Wall Street Journal: The Feb. 11 Journal editorial indicated that the "true political goal" of Democrats is "socialized medicine facilitated" by health care IT and that the "public is being deceived, as the rules behind this takeover were stealthily inserted in the stimulus bill," but "it is the government that has been deceived" by the "industry and its pundits," as the Obama "administration is deluded about the true difficulty of making large-scale health IT work," Silverstein, a biomedical informatics faculty member at the Drexel University Institute for Healthcare Informatics, writes in a Journal letter to the editor. According to Silverstein, the "beneficiaries will largely be the IT industry and IT management consultants." He writes, "I'm far more concerned about a mega-expensive IT misadventure than an IT-empowered takeover of medicine." The "stimulus bill, to its credit, recognizes the need for research on improving" health care IT, but "this is a tool to facilitate clinical care, not a cybernetic miracle to revolutionize medicine," Silverstein writes. He adds, "The government has bought the IT magic bullet exuberance hook, line and sinker," and "I can only hope patients get something worthwhile for the $20 billion" (Silverstein, Wall Street Journal, 2/17).
  
  
• Bill Novelli/John Tooker, Washington Times: A Feb. 11 Washington Times editorial "grossly misleads about two health components of the economic recovery package -- health information technology and comparative-effectiveness research -- that are critically important for improving the quality of health care for Americans of all ages," AARP CEO Novelli and American College of Physicians Executive Vice President and CEO Tooker write in a Washington Times letter to the editor. They write that comparative-effectiveness research "could save lives by giving doctors and patients better, more objective information to make important health care choices." In addition, health care IT "is important because it gives health providers and patients real-time information that can reduce errors, save time and improve care," the authors write. They add that health care IT "funding in this economic recovery package will help establish a system focused on two things: setting standards to make sure different systems in doctors' offices are compatible with one another and protecting patient privacy." According to the authors, "Until those standards exist, hospitals and doctors won't modernize, and health IT will not advance." They write, "We are confident that the American people will see through this fear-mongering propaganda," adding, "We can't let the same scare tactics that have stopped health reform in the past stop it again" (Novelli/Tooker, Washington Times, 2/18).

Broadcast Coverage
CNN's "Lou Dobbs Tonight" on Tuesday included an interview with Michigan Gov. Jennifer Granholm (D) about the potential effect of the economic stimulus package for the state (Dobbs, "Lou Dobbs Tonight," CNN, 2/17). A transcript is available online.

WBUR's "On Point" on Tuesday reported on the potential effects of the stimulus package on state budgets. The segment includes comments from Los Angeles Times Sacramento Bureau Chief Evan Halper; Scott Pattison, executive director of the National Association of State Budget Officers; Wisconsin Gov. Jim Doyle (D); and Menzie Chinn, a professor of public affairs and economics at the University of Wisconsin (Clayson, "On Point," WBUR, 2/17).