By Neil Versel, contributing editor

November 11, 2008 | WASHINGTON—The election of Barack Obama as president and the solidification of the Democratic majority in Congress clearly will have an effect on the national health care agenda for 2009, but some of the reasons might not be so obvious.

Something remarkable happened during the heated, seemingly interminable campaign that culminated Nov. 4: After Obama put forth a health care reform proposal, his opponent, Sen. John McCain (R-Ariz.) did more than simply pick apart the Obama plan. He issued a detailed plan of his own, something that does not always happen during a presidential race.

“It shows a coming of age of health care as an issue,” according to David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital and Partners HealthCare System in Boston. Blumenthal, a longtime health-IT advocate, was a senior advisor on health care issues to the Obama campaign.

However, Blumenthal said here at the American Medical Informatics Association annual symposium that even though health care may have been the No. 2 concern among voters in exit polls, it trailed economic worries by nearly 6-to-1.

Of course, the weak economy, of course, stands to have a major effect on health policy in the near future. “The uninsured are likely to dominate the health care debate early in ’09,” said Washington lobbyist Douglas Peddicord, a member of the AMIA Public Policy Committee.

But so might the issue of privacy, which has held up many a health-IT bill in the past, and there is a good possibility Congress could seek to strengthen federal health privacy rules. “We are very much in HIPAA Round 2,” Peddicord said.

Much could depend on whether consumers start to embrace personal health records. PHRs, according to Peddicord, are “beginning to change the landscape” as a whole new constituency starts handling health care data. News like last week’s disclosure that pharmacy benefits manager Express Scripts was the target of an extortion attempt by someone who broke into the St. Louis-based company’s electronic patient files did nothing to soothe public jitters.

Obama has called for a five-year, $50 billion federal investment in health-IT to boost the move to electronic health records and construction of the National Health Information Network, but he recently said that stabilizing the economy and reforming the tax code would be his first priorities as president. To date, the president-elect has not indicated whom he might pick to lead the Department of Health and Human Services, much less the Centers for Medicare and Medicaid Services and other HHS agencies.

“The campaign is over,” Blumenthal said, “and campaigning and governing are two different modes.”

Two key federal health-IT advocates, Office of the National Coordinator for Health Information Technology leader Robert Kolodner, and Agency for Healthcare Research and Quality director Carolyn Clancy are career HHS employees, and could stay on in the new administration.