In our present health system, with its underwriting standards and infinite detail aimed at maximizing income while minimizing outgo, employers and insurers have a big incentive to learn all they can about your private health information.
In a universal system, as described by today's New England Journal of Medicine, those incentives disappear. Everyone pays the same (even if some pay with a subsidy), everyone gets the same coverage, and those incentives to snoop no longer exist.
As long as those incentives remain privacy concerns will win-out and health IT is going to lose. At least among Democrats.
Which means if health IT providers want to see that $20 billion they may have to go against the interests of their best customers.
The health IT industry is now squarely east of the rock and west of the hard place.