Are we going to single payer anyway?

The Centers for Medicare and Medicaid Services report that, despite the recession, the health care sector will grow in 2009, as the unemployed and uninsured push federal spending higher. Note that the second link is to an October report put out under the Bush Administration.

This came out the same day as a report from the Institute of Medicine saying that some form of insurance is "essential for health and well-being."

Then consider that a major goal of business in the health care debate is to get out of paying for health care as a benefit, pushing those costs to consumers or a government-mandated system.

As the Wall Street Journal writes:

As people are forced out of work and strapped employers trim benefits, the growth of private-sector spending on health care will slow. Meanwhile, with more people qualifying for Medicaid, the public health insurance program for the poor, the growth in public spending will increase. 

While some conservatives continue to call things like comparative effectiveness health fascism, it's market forces that are driving the reform agenda, not political argument.

From an IT perspective this may actually be a benefit. If more people are moving toward plans funded by the federal government, then the government's IT procurement decisions should be definitive in terms of standards and protocols.

If the VA, the military, Medicare and Medicaid build and re-build their IT infrastructure based on the same open standards, in other words, those become the standards the private insurance market will follow.

Assuming, of course, that the U.S. government builds to a single standard. Handing the work out as private contracts to different parties with different technologies could leave us worse-off than we are now.