The Obama administration is using the economic stimulus package to show it has made serious progress on the president's health agenda, perhaps softening the blow if Congress fails to comprehensively address the issue this year.
In the legislation passed late Friday, Congress approved spending about $19 billion over the coming years on electronic health records and an additional $1.1 billion on research comparing which treatments work best for a particular disease.
Also, the bill sets aside about $1 billion for a "prevention and wellness fund." About $300 million of that money would provide additional immunizations. Most of the rest of that money will go to state and communities to help them tackle smoking, obesity and various preventable health problems.
"This represents the beginning steps of the president's health reform vision," said Jenny Backus, a spokeswoman for the Health and Human Services Department. "It's designed to get relief to people who need it most and to do everything we can to bring down the cost of health care, and improve access and quality."
Some Republicans took exception to that vision on Friday. They focused their criticism on a new federal council that will coordinate what's called comparative-effectiveness research — when doctors and statisticians sift medical records to determine which treatments work best for a particular disease.
The government already spends hundreds of millions of dollars on such research. Democrats will greatly boost that spending, but they also establish a 15-member council whose members will annually report on the state of comparative effectiveness research and make recommendations.
Republican lawmakers claim the council will become a "government rationing board" that will make life-and-death decisions about which treatments doctors will be able to use.
"Congressional Democrats are using the cover of an economic crisis to advance an agenda that will destroy the doctor-patient relationship and set us on a course for government-administered health care," said Rep. Tom Price, R-Ga., a doctor.
Drug makers and medical-device manufacturers are wary that the council would cut demand for some of their products if they are found not to be any more effective than cheaper alternatives. They fear any recommendation made could be used by Medicare to say it won't pay for a particular treatment, a decision that likely would be echoed by private insurers.
"The goal of this board is to conduct research that will allow the federal government to deny needed health care," said Rep. Wally Herger, R-Calif.
To address concerns from Herger and other opponents, lawmakers said the bill states that nothing in the legislation allows the council to mandate coverage, reimbursement, or other policies for any public or private insurers.
"Don't we want to be spending our resources on what will improve care and what will help treatment?" Backus said. "There's widespread agreement on the need for comparative effectiveness. It's not a partisan thing."
Both President Barack Obama and his 2008 election opponent, Sen. John McCain, R-Ariz., called for comparative health research. They also talked about the need to put patient records on computer rather than relying on paper charts.
The bill calls for $17 billion in higher Medicare and Medicaid payments for doctors and hospitals, beginning in 2011, when they adopt electronic health records.
Officials said time is needed to set standards for the providers' computer systems if they are to get reimbursements. Eventually, Medicare rates will be cut for hospitals and doctors that do not use electronic health records.
Administration officials said the money for prevention programs will not only save lives but will also help stimulate the economy when more workers are hired to provide cancer screenings and counsel patients on quitting tobacco products and avoiding complications from diabetes.
The bill also sets aside $500 million to provide incentives for physicians, dentists and nurses to practice in communities where there is limited access to health care. The federal government provides scholarships and grants and helps people pay off their student loans if they agree to work in certain communities where there's a shortage of health care providers.