With someone in charge change can be fast

SCM Microsystems writes to say its eHealth terminal has now been certified by German authorities and will start showing up in doctors' offices and pharmacies nationwide next month.

This is a game changer for 82 million people.

The eHealth 100 can handle current and future German health cards, as well as a variety of other input formats. It can link to Linux, Windows or Macintosh systems.

Germany is using smart cards to handle the chores of data privacy, tasks assigned in America to the HIPAA law. Patients and providers each have their own identity cards, and the entire system features an audit trail.

This is what happens when you have a centralized system. Such a deal could not happen in the U.S., where you currently have to negotiate with multiple insurance providers, hospital networks and payment networks.

Debates within the German system are not like those in the U.S. Instead of talking about access, they talk about rationing. Some 130,000 people demonstrated in Berlin yesterday, demanding more money for the system.

The German government is trying to add capacity through private clinics and cap public expenditures. But it is a hard sell.

The eHealth terminals represent the kind of "win" which some American politicians claim will transform our health system and lower costs.

It may lower costs. But it is not a silver bullet. Because the "win," while significant, is on the margins. Health care inflation is much bigger than anything technology can solve.