Goal: Open or expand 1,200 community health centers
Target: Mission accomplished 2006 Promised in: 2001 Progress: The Health and Human Services Department later gave itself a deadline of 2008 but says it reached this goal by December 2007. The number of patients treated at health centers has increased by 60 percent since 2001, the administration says. Nonetheless, the new centers are struggling with a shortage of doctors.
Goal: Cut malaria deaths in half in "at least 15 endemic African countries"
Target: Still in progress 2010 Promised in: June 2005 Progress: The President's Malaria Initiative is a five-year, $1.2 billion program. It coordinates with a number of private programs; together, they show promise. The solution is not complicated. In Zanzibar, distribution of mosquito nets and spraying of insecticide have cut the infant infection rate from 20 percent to less than 1 percent. World Health Organization programs have cut infant deaths in Ethiopia by 51 percent, in Rwanda by 66 percent, and in Zambia by 33 percent.
Goal: "Most" Americans will have electronic health records
Target: Still in progress 2014 Promised in: April 2004 Progress: The president appointed a national coordinator for health information technology. Congress has consistently cut budget requests for his office. The request for 2009 is $66 million, an increase of $5.6 million from 2008. In 2006, Bush directed federal agencies to use improved health technology systems.
A New England Journal of Medicine study finds that fewer than one in five doctors use electronic health records. Small practices in particular resist the system because of its cost and installation time. The administration announced a Medicare pilot project this year in 12 cities to give doctors incentives to switch. Congress is working on draft legislation to address privacy concerns, which have also held back the transition to electronic records.
Goal: "Most" Americans will have electronic prescriptions
Target: Maybe someday 2009 Promised in: April 2004 Progress: Electronic prescriptions have made far less progress, despite the earlier deadline. In 2007, just 3 percent of all prescriptions were electronic. A bill in Congress would require Medicare to switch to all-electronic prescriptions by 2011.
This article appeared in the Saturday, July 19, 2008 edition of National Journal.
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