Meaningful use is a concept that could be applied to patients

Posted May 16, 2011

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During a family vacation in Orlando, I am thinking about the Medicare requirements for electronic medical records. As a physician, I will need to prove that I am a "meaningful user." Although the government is dangling financial incentives to use an EMR, penalties begin in 2015 for failing to demonstrate meaningful use.

Now let's contrast these requirements with what I'm seeing today at the theme park. I see multitudes of morbidly obese people and morbidly obese children eating ice cream, cheeseburgers and other junk food. I see sunburned smokers huddling like drug addicts next to the attractions. I see fellow citizens daring fate to strike them down with diabetes, hypertension, strokes and cancer.

And then the absurdity of it all is apparent. Why am I being threatened with penalties from Medicare when some of the main drivers of health care costs are not being addressed? Obesity, smoking and risky behaviors are dangerous, irresponsible, expensive, unpatriotic and damaging to the financial well-being of the U.S.

Why not penalize patients who refuse to lose weight, stop smoking and stop irradiating their skin on the beach? Maybe patients should be required to prove that they're meaningful users of health care. If they cannot, their health care premiums should be higher. Why not?

Unless Americans stop poisoning themselves, health costs will keep rising. If the government thinks ratcheting down payments to providers is the solution, we're doomed. Eventually, just like Medicaid in many offices, Medicare will not be accepted for payment, because the cost of providing the care will exceed reimbursements. Medicare will cease to be a safety net for the elderly and disabled.

Now I'm going to return to watching my kids enjoy their carrots.

Peter A. Klein, MD, Stony Brook, N.Y.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/05/16/edlt0516.htm.

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