'$27 billion really did focus the mind'

Michael Grunwald

The genesis and legacy of HITECH

In his book, The New New Deal: The Hidden Story of Change in the Obama Era (Simon & Schuster), Michael Grunwald, a correspondent for TIME magazine, makes a compelling case that President Obama's 2009 stimulus bill, the American Recovery and Reinvestment Act (ARRA), is probably more transformative in the long run than Roosevelt's New Deal. A big part of that mammoth $800 billion legislation, of course, is the $27 billion Health Information Technology for Economic and Clinical Health (HITECH) Act, which is devoted to digitizing the nation's medical records and rewiring healthcare for the 21st century. Grunwald spoke to Healthcare IT News about Obama's rationale for giving healthcare pride of place in the legislation, the negotiations and revisions that led to the creation of meaningful use, the ways it has set the stage for broader healthcare reform, the jobs it has created  -  and why health IT may just be the most lasting, bipartisan and transformative piece of the stimulus bill.

You call ARRA one of the "most ambitious and least understood" pieces of legislation in American history.

In Washington, it's just considered this $800 billion joke: levitating trains to Disneyland, and snowmaking machines in Duluth, and mob museums and all sorts of nonsense that isn't in the actual stimulus. And even nationally, a year after it passed, the percentage of Americans who believed it created any jobs was lower than the percentage of people who believed Elvis was alive. But this was by far the biggest energy bill in the history of the planet. And it was not just for energy, but it also laid the groundwork for healthcare reform, it was the most ambitious education reform in decades, the biggest infrastructure bill since Eisenhower, the biggest middle-class tax cut since Reagan, and the biggest investment in research, ever. And then, oh, by the way, just about every independent economist agrees that it helped prevent a depression and added 2 to 4 percent in GDP, which is the difference between contraction and growth. So it took this economy that was crashing at a 9 percent annual rate and losing 800,000 jobs a year, and within a few months you had the biggest improvement in employment in 30 years.

How did health IT become such a big part of the bill?