By John Russell

Feb. 26, 2008 | ORLANDO, FL – Former U.S. Senator Bill Frist (R, Tennessee) mixed politics, humor, and a call for health-IT advocacy in his opening keynote to HIMSS 2008 yesterday. Not surprisingly, he also championed market-oriented solutions to the current health care problems. More than 20,000 health-IT professionals are expected to attend the annual conference being held this week in Orlando.

“Politics matter,” he told the audience. Frist said he thought Senator Barack Obama (D, Illinois) would face Senator John McCain (R, Arizona) in the general election — “though I’ve changed my mind two or three times up to now” — and suggested their alternative visions for health care and voter reaction to those views will be important in determining who wins the general election.

Frist, the first practicing physician elected to the Senate since 1928, rose to become the Republican majority leader and was a vigorous force behind the Medicare Modernization Act of 2003. He served two terms before stepping down, as he’d announced he would when first elected.

Appearing far more relaxed than he usually did in the Senate, Frist delivered his synopsis of the troubles facing the U.S. health care system — and took a swipe at entitlements generally — attempted to characterize what he believes are the key differences between the Democrats and Republicans on approaches to health care, and then pitched a market-based approached. Democrats emphasize expanding coverage while Republicans emphasize controlling costs, he said.

This, of course, is a familiar refrain. To his credit, Frist didn’t escalate rhetoric. Indeed he was an engaging speaker, and argued attendees should all decide for themselves whose vision they support, and having done that, take an active role in advancing it. Despite the call to action, he said, “I don’t think we’re going to see major federal reform.”

Frist noted the U.S.’s poor showing among other well-developed countries on key indicators such as infant mortality rates and life expectancy. But he also argued the relative impact of various factors on life expectancy is often contrary to what many think. He said genetics contributes 30 percent; socioeconomic status, 15 percent; environmental factors, 5 percent; personal behavior, 40 percent; and health services, just 10 percent.

The bulk of his comments were on the burgeoning costs and growing burden of health care with sizeable dollops of health-IT thrown in. Many of the cost figures, of course, are well known. Health care is around 18 percent of the GDP and is growing substantially faster than the GDP. He argued the best way to curb these growth rates was a market-based health care system that was patient-centric, provider-friendly, and consumer-driven.

He also argued the Medicare Modernization Act of 2003 is working and that seniors are overwhelmingly satisfied with the program.

On the industry slowness to adopt electronic health records, Frist said clearer financial incentives were needed and suggested that an extra 1-2% of fees could be paid to doctors who use them. He agreed health-IT generally has strong potential to improve care and help control costs, but did not dig too deeply into details.