It often takes decisive presidential leadership to tackle a significant challenge. As a student of history, President Obama has spoken often about looking to his predecessors for guidance. When it comes to modernizing healthcare through information technology, he has taken a page from our 34th President, Dwight D. Eisenhower.
In the mid-20th century when he envisioned a nationwide interstate highway system, Eisenhower faced many of the same problems that we face in building a modern, electronic healthcare system. While a highway system had long been a dream, it was Eisenhower who made it a reality when he proposed, and then in 1956, signed the Federal-Aid Highway Act, beginning the construction of more than 41,000 miles of interstate highways.
Prior to the highway system, Eisenhower described the nation’s roads as “an appalling problem of waste, danger, and death.” This is an apt description of healthcare today. Presidential leadership can change this, and President Obama is applying the same lessons that Eisenhower did more than a half century ago to achieve success.
First, President Eisenhower made a significant financial commitment. In 1956, Congress appropriated $25 billion for highway construction, which was a vast sum of money considering that total federal spending in 1956 was $70 billion. Hundreds of billions of dollars were eventually spent, making it one of the nation’s highest priorities.
President Obama will invest $20-30 billion to put information technology in the hands of doctors and providers. The primary vehicle for this investment is through incentive payments from Medicare or Medicaid—more than $60,000 per physician—for the “meaningful use” of certified technology. This will tie incentives to clinical performance measures.
Second, President Eisenhower created an interconnected system. One of the most important components of the highway system was its adherence to uniform standards of construction. According to the Federal Highway Administration, common standards included 12-foot lane widths, standard shoulder widths, a minimum of two travel lanes in each direction, and speed limits. This avoided each state building their own highways with their own unique specifications. They built a true ‘system.’
We must do the same in healthcare. If billions are spent to equip doctors and hospitals with technology that cannot communicate with each other, we will have laid a lot of track that does not connect. The administration is helping to narrow the technology standards or specifications of how to exchange electronic information.
Third, President Eisenhower created a true collaboration between the private sector, states, and the federal government through highway construction. Even though the federal government paid 90 percent of the costs of building the highway system, the states were responsible for managing the construction, and the private sector did the actual work.
Building upon the leadership and progress from the Bush Administration, President Obama has made public-private collaboration a cornerstone of his efforts.
Eisenhower’s leadership created a wave of productivity and prosperity that we continue to ride today. It opened new markets through interstate commerce, created a national sense of community, brought the modern world to rural America, enabled families to move and travel over long distances, and drove innovation from coast to coast. We can experience that same level of transformation in healthcare through information technology.
With even more difficult challenges upon us, this must be the
first of many priorities where Republicans, Democrats, and Independents can
join together to solve the problems we face. It has happened before, and
it must happen again. Our country and our future depend on it.
Tom Daschle is a former U.S. Senator from South Dakota and former U.S. Senate Majority Leader. Newt Gingrich is Founder of the Center for Health Transformation and former Speaker of the House of Representatives from 1995-1999.