HIT POLICY the new system along in the form of higher charges and utilization rates for all of IS, the same way they pass along the unfunded mandate of caring for the unin sured in the ER. This unfunded mandate, however, represents health system prog ress, a collective investment in a better health care system, rather than a grinding away at the safety net of the current one New equilibrium prices would be estab lished, the installation costs would eventually be recouped as the efficiencies crue to the providers, and the new systems would take root. We can, quite often count on the marketplace to work just fine These ideas will no doubt meet with fierce resistance not only from the obviou lobbies, but from health care's outsized Greek chorus of professional naysayers and nitpickers. The absurdity of the industry debate that will accompany this(or any)federal IT proposal has already been presaged in the editorial pages of Modern Healthcare in its criticism of the nascent, benign, and as yet barely funded activities of Brailer,s Office of National Coordinator of Health Information Technology ONCHIT). The trade journal's managing editor, Todd Sloane, muses that the fed eral call for an interoperable health care system is a way of enabling, electronically, President Bush's agenda to decouple health insurance from employment status, enabling portable insurance and health savings accounts. 3 In the same pages, gina Herzlinger excoriates the movement as a left-wing conspiracy that will in evitably usher in a single-payer system. The symmetry of these paranoid political observations is probably the best indication that it is a good idea Knee-jerk criticism from health care's usual tear-down artists notwithstand ing,the time to fix this problem is now. The market has failed, and the only other option is policy-based and one supported by real political muscle. President Bush has included an HIT system on his national agenda and maintained both Brailer and McClellan in their pre-election positions, with the obvious goal of getting this job done. Both have bipartisanship support because they are committed to the pri macy of public health over political philosophy, to a belief in the power of better formation and better iT to fix what ails health care. And there is a third impor tant actor on the political stage. William Frist(R-TN), the current Senate major ity leader and a physician from what can safely be called a health care family dy nasty, is often mentioned as a Republican front-runner for the White House. For the kind of health care system that Frist envisions, we need look no further than his essay, "Health Care in the Twenty-first Century. While he marvels predict ably at the impact of genomics and breakthrough medical technologies, Frist also describes similar miracles of HIT, including a hospital that"transmits the com puterized information about [the patients] treatment, seamlessly and paperlessly to [his] insurer for billing and payment. 40 A good first step toward getting there is serious consideration of the proposals introduced in this paper September/October 2005H I T POLIC Y the new system along in the form of higher charges and utilization rates for all of us, the same way they pass along the unfunded mandate of caring for the unin￾sured in the ER. This unfunded mandate, however, represents health system prog￾ress, a collective investment in a better health care system, rather than a grinding away at the safety net of the current one. New equilibrium prices would be estab￾lished, the installation costs would eventually be recouped as the efficiencies ac￾crue to the providers, and the new systems would take root. We can, quite often, count on the marketplace to work just fine. These ideas will no doubt meet with fierce resistance not only from the obvious lobbies, but from health care's outsized Greek chorus of professional naysayers and nitpickers. The absurdity of the industry debate that will accompany this (or any) federal IT proposal has already been presaged in the editorial pages of Modern Healthcare in its criticism of the nascent, benign, and as yet barely funded activities of Brailer's Office of National Coordinator of Health Information Technology (ONCHIT). The trade journal's managing editor, Todd Sloane, muses that the fed￾eral call for an interoperable health care system is a way of enabling, electronically. President Bush's agenda to decouple health insurance from employment status, enabling portable insurance and health savings accounts.^^ In the same pages, Regina Herzhnger excoriates the movement as a left-wing conspiracy that will in￾evitably usher in a single-payer system.^^ The symmetry of these paranoid political observations is probably the best indication that it is a good idea. Knee-jerk criticism from health care's usual tear-down artists notwithstand￾ing, the time to fix this problem is now. The market has failed, and the only other option is pohcy-based and one supported by real political muscle. President Bush has included an HIT system on his national agenda and maintained both Brailer and McClellan in their pre-election positions, with the obvious goal of getting this job done. Both have bipartisanship support because they are committed to the pri￾macy of public health over political philosophy, to a behef in the power of better information and better IT to fix what ails health care. And there is a third impor￾tant actor on the pohtical stage. Wilham Frist (R-TN), the current Senate major￾ity leader and a physician from what can safely be called a health care family dy￾nasty, is often mentioned as a Repubhcan front-runner for the White House. For the kind of health care system that Frist envisions, we need look no further than his essay, "Health Care in the Twenty-first Century" While he marvels predict￾ably at the impact of genomics and breakthrough medical technologies, Frist also describes similar miracles of HIT, including a hospital that "transmits the com￾puterized information about [the patient's] treatment, seamlessly and paperlessly, to [his] insurer for billing and payment.'"'" A good first step toward getting there is serious consideration of the proposals introduced in this paper. September/Octobe r 2005