New Democrat Update

STICKING TOGETHER

U.S. Rep. Mark Udall has opposed President Bush on the Iraq war from the very start. He was against giving the president authority to invade and was among the first in Congress to demand an exit strategy. As a member of the House Armed Services Committee, he has grilled administration officials at every opportunity. Just recently, he supported a funding measure that required troop redeployment timelines.

After President Bush vetoed that bill, Udall backed an override, which failed because almost all Republicans stuck with the president. Refusing to give up, the congressman plans to introduce legislation to implement the bipartisan recommendations of the Iraq Study Group, which calls for a phased redeployment by next March.

Despite a long track record of opposing this president’s policies on Iraq, Moveon.org and other antiwar groups have publicly blasted Udall for his recent vote to fund the war. They are missing the bigger picture.

The antiwar community must realize that the current fight within the Democratic Party is not one over principle, but one over tactics - where reasonable people should be able to disagree. In addition, there are genuine national security concerns - even among those who have always been opposed to the war (like Udall) - over the pace of redeployment. Folks who argued against haste before the invasion should not be supporting it now.

Cutting off the funding does not mean that American soldiers will be left defenseless on the battlefield but the American people’s deep ambiguities about Iraq have led them to believe otherwise (a majority is now opposed to the war but worries about the aftermath of a withdrawal). Those who have the responsibility of governing must deal with the world as it is, not as they wish it would be. For now, torn public opinion, combined with a president who seems to despise bipartisanship on anything, gives the administration all the cards on Iraq.

Changing the course of a war from the legislative branch is always difficult work. Ending the Vietnam War - another very unpopular conflict - required four years. That occurred with a Congress that was much more dominated by Democrats than it is today.

The debate on Iraq is far from over - it has only been postponed. The funding bill signed by the president includes a requirement to consider redeployment in September.

The momentum right now is clearly with the war’s critics. By the fall, more Republicans in Congress may well have defected from the president. Indeed, that is the main point - this president will consider the alternatives only after enough of his fellow party members force him to change course.

Democrats meanwhile, regardless of how they feel about the war, should be sticking with their friends. Antiwar activists should realize who their true allies are and focus on getting more converts. Addition always trumps subtraction in a democracy.

There is simply much too much at stake - the Iraq war and everything else.

SMARTER HEALTH CARE

It is easy to forget how information technology has so thoroughly revolutionized the way we work, play and live. Activities like getting cash from an ATM, telecommuting, shopping from home, corresponding by email, talking on cell phones and accessing all kinds of information on the Internet are now part of our daily routine. Productivity - both personally and on the job - has jumped considerably.

Strangely enough, this revolution has hardly touched the health care industry. Most doctors still handwrite prescriptions, different personnel within the same hospital often ask patients the same questions over and over again and many service providers, to this day, keep patient records on paper in many different places. The complete picture about an individual’s health is incredibly difficult to get, if not impossible.

As a result, health care professionals and emergency service providers are making treatment decisions based on incomplete information at the point of care. Instead, they must rely on the incomplete scraps of information they can obtain from patients or family members.

Patients, who are used to Information Age-type services in other parts of their lives, sense this huge disconnect. According to a survey conducted by Markle Foundation late last year, over 80 percent of Americans want real time, online access to their personal health information because they see it as a very valuable tool to improving the quality of their care and managing their medical expenses.

They also correctly conclude that automation will reduce medical errors and increase efficiencies by reducing unnecessary and repeated tests and procedures. The RAND Corporation, a nonprofit think tank, estimates that for every dollar invested in such a system, patients and taxpayers will get five dollars back.

At the same time, the public is very concerned about patient privacy and identity theft. They want government to establish tough rules and protections around the access and use of their personal health information.

Securely wiring the many players in the health care business (including information for Medicare and Medicaid patients) will require significant private-public sector collaboration. Thankfully, through the efforts of State Senators Bob Hagedorn and Brandon Shaffer, a governor-appointed task force will soon begin working on a plan to build such a health information infrastructure.

In a report just released, David Kendall of the Progressive Policy Institute offers a roadmap on how to make that infrastructure a reality. He calls for “a networked system that allows medical service providers to securely feed those disparate pieces of information into a single electronic history that is owned and controlled by the individual patient, and that represents the patient’s complete medical record,” along with strengthened patient privacy rights.

That goal can be accomplished by developing a marketplace of independent health record trusts (IHRT) responsible for maintaining patients’ electronic medical records. “Patients’ accounts would contain a complete digital copy of their records from all sources. Physicians and other providers would continue to keep their own records and send copies to patients’ EHR accounts. These accounts would be issued by independent, government-certified health record trusts that can perform administrative functions similar to the ones credit card companies perform.”

In addition to working well with existing information infrastructures, IHRTs will empower consumers with control over the exchange of their personal medical information. A recent evaluation by the Washington State Health Care Authority concluded that such a system, properly designed, will provide timely and secure access to information and protect patient privacy. Competition among IHRTs will also spur new, innovative and convenient ways of making health information available when and where needed, while overcoming the mistrust of Big Brother-like single-entity control.

A high-level state commission is currently looking at four comprehensive health care reform proposals to expand coverage and reduce costs. Governor Bill Ritter and the legislature will get its recommendation later this year.

Clearly, there is no better time to get started on a health care information infrastructure than right now.