David J. Brailer never really sought the spotlight. Yet here he is in Harrisburg, Pa., on a hot July day in a Hilton () ballroom in front of 500 physicians. The 46-year-old doctor is the chief evangelist for President George W. Bush's effort to remake the $1.9 trillion U.S. health-care business by using information technology to save money and lives. In town to persuade physicians to join his cause, Brailer starts off with what's wrong with the current system.

Doctors throughout the country already limit the number of Medicare enrollees they treat because of low reimbursements. Short of a miracle, the cuts likely to go into effect next week and will further limit Medicare recipients' access to care. As expected, a Senate bill to block a 10.6 percent cuts in clinicians Medicare reimbursements was unable to get the support it needed yesterday. A procedural vote failed to get the 60 votes necessary for the bill to move ahead. Senator John McCain didn't vote on the bill; Senator Barak Obama voted in favor.