Former President Bill Clinton’s talk Wednesday at the 2013 HIMSS Annual Conference & Exhibition encompassed politics, economics, history, climate change, childhood obesity, health information technology, of course, and even the art of the deal.

Over the course of the keynote, he enumerated many problems with the healthcare system, but he concluded on an optimistic note. “There’s nothing wrong we can’t fix,” he said. “But we have all these horse-and-buggy systems, and you can change all that," he told the high-tech audience, calling on them to create an improved system that would be there for everybody – "so we don’t have unexamined lives and unexamined healthcare systems.”

[See also: Tweet recap: Bill Clinton at HIMSS13]

“You all know information technology and how we manage it is critical,” Clinton said at the start, adding that IT could play a vital role in improving access and providing leverage for the American people.

The political, social and healthcare impacts of the Affordable Care Act have yet to be determined, he told the audience. “It depends on how it’s implemented,” he said, and also on the decisions we all make outside of the ACA.

Meanwhile the national debt is rising with healthcare as a major culprit, he said, and he forecasted that healthcare would grow at three times the rate of inflation, spurred by aging baby boomers who are expected to live longer than previous generations. “The real people being affected,” he added, are being asked to move from a public system (Medicare) to private one, which costs more. “In this maelstrom, IT will become very important,” Clinton said. As he put it, information technology can help improve the quality and cost of healthcare delivery, and it can also provide access for people who have been left out of the system. “We need to do both things,” he said.

Clinton, who heads the Clinton Global Initiative, also called on the audience to consider the need for better healthcare around the world, in countries where "half of the people are still living on $2 or $2.50 a day. In those places people need systems that we take for granted.”

While he championed the need for such systems, he warned:  "At some point in the life of every nation, almost every system gets long in the tooth.”
Clinton transitioned into talk of Congressional gridlock, the fiscal cliff, the rising national debt and Steven Spielberg’s movie “Lincoln.”
“You’ve got to show up to work and make a deal,” he said, invoking Lincoln – the movie, which showed what Clinton called “the gritty touch world of politics.”

Clinton, who made reference to his own vegan diet earlier in the talk, tied childhood obesity to added healthcare costs. “It may not sound like high-tech,” he said, but if the country were to stop feeding the healthcare system so many sick people, “You improve quality and reduce costs.”

He gave a shout out to the Blue Button, a simple way patients can access their medical information, and he called for more transparency in healthcare pricing, asserting, “There’s no correspondence between what people pay and the quality of healthcare they get.”

Clinton sprinkled his talk with anecdotes and turns of phrases that elicited applause and often laughter from the audience.
But, it was the very last question that HIMSS President and CEO H. Stephen Lieber posed after Clinton’s talk that elicited the most response from the audience. Without mentioning Hillary Clinton’s name, Lieber asked Clinton if he was aware of any good candidates to be the next president, in essence asking, “Will Hillary run?” The answer: “I honestly don’t have a clue.”