David M. Cutler, professor of economics at Harvard University, argues that if we spent more money on healthcare, the system would work better. In his recently published book, Your Money or Your Life: Strong Medicine for America's Health Care System, published by Oxford University Press, Cutler describes a medical care system in crisis. Cutler, who served on President Clinton's healthcare task force, applies an economic analysis to show that the key to improving the system is to change the way we organize healthcare.

News/online editor Bernie Monegain asked Cutler what role information technology might play in this reorganization.

"Surgeons make mistakes because people are fallible and computer technology is not used often enough as backup," you have written. So the first question is why computer technology isn't used more often as backup to people - and what will it take to change that?

I think the fundamental reason why is that we don't pay well for the use of technology. For example, there is no reimbursement for a physician setting up such a system; all there are is more costs. With all cost and no obvious financial benefit, physicians who feel squeezed now simply cannot make the investment. To do better will require a major restructuring of how we pay for medical care, away from the model of paying for physician visits and being poked and prodded to a model of paying for quality care and better outcomes.