By Jane Sarasohn-Kahn

First Posted at Health Populi on 3/7/2013

Jane Sarasohn-Kahn, Host of Health Populi

Jane Sarasohn-Kahn, Host of Health Populi

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected.

President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star.
Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the far back of the room. Seats in the lobby area outside of the main stage were already beginning to fill up to watch the speech live on wide screen TVs.

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Before the former President was introduced on the big stage, we took in a video on the Clinton Health Initiative which is promoting health for all around the world and in the U.S. Clinton is passionate about many things, and the health of all – especially children, one of Hillary Clinton’s shared passions — is evident in the work he does tirelessly.

The fact he’s turned vegan is perhaps helping conserve his energy and drive along this productive journey.

Clinton quickly got to another topic for which he is passionate: the U.S. economy and especially the budget. “I hate the debt,” he repeated several times throughout his talk. He noted the fact that health spending is the long term debt driver in the U.S. economy, which drains productivity, corporate profits, and consumers’ wage increases.

He also noted the irony that if Medicare enrollees are moved to private sector health plans, spending will actually increase, further exacerbating the deficit, as Medicare is a much more cost-effective payor. In doing so, “health care costs go to the private system, moving people from a less expensive system to a more expensive system,” he declared.

IT becomes more important in health care: as a tool, Clinton asserted, it can give millions of “ordinary people huge collective clout….it can lower costs,” he said, calling out the role that the Internet has played in crowdsourcing funds post-disasters like the great tsunami and post-Katrina storms.

IT can help the health system “get more value at a lower cost,” Clinton believes. But only for people who are empowered, he warned. “If you’re left out of the [patient] empowerment movement, you’re screwed,” he criticized. But IT in health care when done strategically can address health disparities. He cited work done by the Clinton Health Initiative overseas in developing countries where text messaging and negotiations for cheaper drugs treating HIV/AIDS and malaria have transformed health outcomes and mortality for the better in very low income nations.

Especially affecting in this energetic, empathetic speech was when he asked the audience who had seen Steven Spielberg’s film, “Lincoln,” starring Daniel Day-Lewis as the iconic president. Clinton said that while Day-Lewis’s portrayal of that President was stunning, that wasn’t the best reason to see the movie. The most important aspect of the film, Clinton believes, is its message of compromise: that nothing can be accomplished in advancing policies that better citizens when politicians don’t find ways to reach across the aisle, one lawmaker at a time, to come to a meeting of the minds. He called compromise “a decent moral imperative.”

President Clinton then described “where we are” in the political economy of health care. He cited the recent USA Today analysis of the health care cost-employee wage trade-off, Steve Brill’s all-issue piece on “Bitter Pill” in TIME magazine, and the need for transparency in price and quality. He also recognized the Blue Button initiative which now covers 80 million Americans, a line which got applause.

He repeated his budgetary mantra: “I hate this debt. You can’t get blood out of a turnip,” adding that the U.S. should not go down Europe’s austerity path of dramatic budget cuts. “No country can sustain an economy if any player takes too much like housing, consumer spending and finance have in the U.S.,” warning the HIMSS audience that no economy should be so tied to any one sector.

Even with this cautionary message, Clinton implored us to “be optimistic. Look at human genome sequencing,” he pointed out. “I spent $3 billion to do that and it’s worth every penny to you, our kids and grandkids,” with an ROI of billions of dollars, he calculated.

Still, he warned HIMSS folks, all of whom work in the health industry, about health disparities and public health threats of obesity, smoking (especially noting growing smoking rates among women), and higher death rates from prescription drug overdoses, saying that two young men in his social circle recently died from overdosing meds.

In addition, the epidemic of health industry stakeholders not being transparent further threatens the industry’s ability to move forward to improve quality, lower costs, and empower U.S. health citizens to be more engaged in health.

Health Populi’s Hot Points:  President Clinton called for the health IT industry, every one of us, to play a role in transforming health and health care. He emphasized the the only way to achieve the Triple Aim – to reduce costs, improve quality, and expand access — was indeed through leveraging health IT as other industries have done. Given the long standing ovation the President received before and after he came on stage, HIMSS conference attendees drank the Kool-Aid on the role of health IT. Now, to the heavy lifting of making transformation in health care happen. I hope this message will stay with each of us who were transfixed by President Clinton’s engaging, informative, and passionate speech. This was a major HIMSS moment for me in my near-20 years of attending the conference. Thank you, VMware, for sponsoring President Clinton’s keynote. Money well spent!