Neal Peirce / Syndicated columnist
Health-care Rx: information

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BOSTON — Delivering his acceptance speech here this week, Sen. John Kerry is all but sure to make a pitch for radical improvement in America's health system.

Indeed, how could any serious candidate miss the issue? The medical industry constitutes a fifth of the national economy, $1.6 trillion or more yearly, with costs going up four times more rapidly than wages and threatening to imperil U.S. global competitiveness.

But while we lead the world in per capita medical spending, our life expectancy is about the same as Cuba's and well behind nations ranging from France to New Zealand, Spain to Singapore.

And there's alarming sloppiness in our practices. In the cyber age, most prescriptions are still written by hand, constantly subject to errors. Independent studies show proven best medical practices are disregarded in alarming proportions. Hospital and physician errors are taking up to 98,000 American lives a year.

Kerry's headline plan — cutting back on tax cuts for the wealthy to subsidize states and employers to expand coverage to reach 95 percent of Americans — is high on heart. And on target: our 44 million uninsured Americans constitute a prime national scandal.

But what will be the incentives to achieve greater medical quality, accuracy, accountability and, just maybe, less-alarming cost increases? In Kerry's own backyard, Harvard's internationally recognized Michael Porter has waded into health care, urging big breakthroughs in collecting and disseminating information on the outcome of specific medical procedures. Porter's ideal: that patients know enough so they can make intelligent choices among doctors and hospitals.

No Pitts Leonard Pitts Jr. is taking a break. His column will return in August.

Porter believes today's market dynamic — in which health plans, hospital groups and doctors too often hoard information, limit access to care and try to shift costs onto one another — inevitably leads to constantly rising prices and preventable medical errors.

Porter's prescription is transparency, radically expanded information. Which begins, interestingly, to sound much like the idea of former U.S. House Speaker Newt Gingrich — that Americans have their individual medical records on secure individual Internet pages that permit them to track trends in their weight, height, blood pressure or other conditions, share information with health providers they authorize, and make informed decisions on any needed treatment.

Sen. Hillary Rodham Clinton has a similar idea for "personal health records." Kerry does too, claiming they'll cut back on redundant and unnecessary tests and dramatically reduce serious medical errors. President Bush is on the same wavelength — he's urging a quick switch to computerized prescriptions.

But the politicos' chosen route to the new technology is shaky — layering subsidies on a medical industry that has already proved its disinterest in rapid shifts to computerized record-keeping.

More will be needed. For evidence, check Boston. With three medical schools and 16 teaching hospitals, renowned universities, a pre-eminent biotech industry and $1.5 billion a year in federal medical-research funding, it's a medical mecca of global import.

But my colleague Curtis Johnson and I, in dozens of Boston medical-sector interviews for a regional study, found these institutions famously turf-conscious, engaged in an arms race for the most advanced equipment, jealous of each others' star surgeons and research grants. They couldn't even agree, we heard, on a common claims form or a process to check insurance eligibility.

But if a single computer can track hundreds of airliners hurtling through American skies at a single moment, why can't a nationally accessible medical database be created, and despite the admittedly massive technological challenges, perfected over time?

Some of the country's major hospitals and health plans are now engaged in serious experiments to see if information technology can make our medicine more effective and safer. And maybe, just maybe, one day, less numbingly expensive.

The problem is that it is tough for monks to reform the monastery. Without strong outside pressure, the reforms are in constant danger of stalling out. The ticket here isn't just money or laws. It's leadership. It's a president willing to meet directly with varieties of medical sector leaders. Eye to eye, the national chief needs to convey the message that America's economy — and long-term health — depends on radically expanded medical-information systems. And not later, but now.

Neal Peirce's column appears regularly on editorial pages of The Times. His e-mail address is nrp@citistates.com