As a government employee, David Brailer, M.D., is barred by law from lobbying Congress to restore a $50 million appropriation for his Office of the National Coordinator for Health Information Technology trimmed last month from an omnibus federal appropriations bill.
That doesn't mean healthcare professionals can't call their elected representatives and gripe about the cut.
"I'm a federal employee," Brailer said. "I work for the president. I don't lobby Congress. If you think it's a raw deal, tell people about it."
Brailer's remarks came Friday morning at the annual summit on healthcare quality and patient safety in Chicago, sponsored by the Joint Commission on Accreditation of Healthcare Organizations.
Brailer, who had maintained his silence in the days since the Nov. 19 passage of the bill in which his budget was whacked, appeared reluctant to address the topic. In responding to a question from the floor by an attendee to the Chicago conference, he read quotes attributed to him in a New York Times article published hours earlier. The article quoted Brailer as saying the cut was "a bad bounce" but added, "I have absolute confidence that the president is totally behind what we're doing."
Brailer told his Chicago listeners he had spoken with President Bush and "I have first-hand knowledge of this. I stand by my comments."
Without specifically naming them, Brailer said there are forces who, while not opposed to the expansion of healthcare IT, are also willing to ignore it.
"We are now in a fight with the big dogs," he said. "I'll just deal with whatever I get," he said, adding, "The game is afoot, big time."
Brailer was questioned again about the budget cut later Friday as he attended a panel discussion hosted by Evanston (Ill.) Northwestern Healthcare on physician/patient connectivity. Representatives from the suburban Chicago hospital group and from the Marshfield (Wis.) Clinic, as well as several Evanston Northwestern patients, discussed their experience with the Web portals used to facilitate the physician/patient links.
Brailer explained that healthcare IT is no longer a niche, but "is now a national issue. That means it's subject to all the tectonic forces that influence public policy. It's not about who's for it or against it, it's about who has a bigger priority."
As such, Brailer said, healthcare leaders need to educate the public and government policymakers about healthcare IT to ensure its place on the national list of priorities.
Brailer had asked for the money to use to help fund work on national healthcare IT standards and as seed money for various IT pilot projects. Brailer's office received $4 million for operations and perhaps some small grants out of $54 million appropriated for IT projects in the omnibus appropriation bill that passed and was sent to Bush for his signature ("Health IT office's project funding nixed"). The HHS budget was cut by $3 billion to help trim the nine appropriation bills rolled into the omnibus legislation to meet a $388 billion spending target.
The office of the national health IT coordinator, created in April by President Bush as an arm of HHS, has been run this year using existing funds in the HHS budget.