There is no doubt in anyone’s mind that the healthcare industry is a prodigious lobby and provides campaign contributions to all politicians and potential politicians to advance their own self-interests. While there is nothing wrong with the healthcare industry exercising their  First Amendment rights, there is the continual push for the industry to obtain access to individual health records which can be used not only to set rates, but to deny claims on the basis of prior conditions. Mostly by proving that the consumer, forced to fill-out a questionnaire in an extremely limited time frame, omitted a pre-existing condition which would have materially affected the consumers rate or even their ability to get insurance.

Now we find that, hidden in the bowels of the so-called stimulus package, is the beginnings of a national healthcare system and the authorization for another nationwide database – put in place without safeguards for the protection of non-public personal medical information – and severe penalties for the disclosure of this information to unauthorized third parties.

For those who believe that HIPAA (Healthcare Insurance Portability and Accountability Act) contains these protections, one need only consider the recent breaches of medical information by authorized healthcare or government workers to the media. Or the potential use of these records for embarrassment, blackmail, extortion or other coercive practices. It should be noted that President Clinton and Obama both declined to release their medical records to the media even under media pressure.

An assault on consumer privacy …

While I have openly warned against the use of private medical records repositories supported by Microsoft, Google and others – claiming that their user agreements provided little or no protection to the consumer against data breaches, that the information may, in fact, be sold to third-parties in an aggregated form without personally identifying information or be used by the repository for its own purposes, I have not issued a similar warning about government databases. I now am issuing the very same type of warning.

Without stringent data collection and usage guidelines that contain no exceptions and with strict penalties for the inadvertent or deliberate security breaches and/or unauthorized release of consumer health information, these databases pose a clear and present danger to the privacy rights of consumers. No large-scale government information system is secure as most breaches are perpetrated by those who have been trusted with the keys to the kingdom and who may be personally vulnerable to coercive outside influences. Witness the number of spies who have revealed information, not for ideological reasons, but for personal reasons involving sex, money and position.

The devil is in the details …

In spite of democrat protestations to the contrary, and who can believe hyper-partisan politicians, the stimulus bill contains the seeds of the destruction of personal privacy with regard to your confidential healthcare information.

According to CNSNews.com …

‘Exceptions’ in Stimulus Bill Allow Sale of Health Records

“It could become easier to sell and exchange the health information of Americans under the economic stimulus package that awaits President Barack Obama’s signature Tuesday.”

“The $787 billion American Recovery and Reinvestment Act that passed Congress last week allocates $19 billion to establish centrally linked health data infrastructure to contain the health information of ‘each American’ by 2014 and to set up the new office of the ‘National Coordinator for Health Information Technology.’”

Saying one thing and doing another?

“Though the legislation says there is a ‘prohibition on sale of electronic health records or protected health information,’ there are five pages of exceptions to the prohibition that include research, treatment of an individual, or a decision by the Secretary of Health and Human Services to waive the prohibition.

“One exception listed in the legislation is if, ‘The purpose of the exchange is for public health activities.’ Another exception is apparently to ensure the data – if sold – are not for commercial reasons, saying, ‘The purpose of the exchange is for research and the price charged reflects costs of preparation and transmittal of the data for such purpose.’
Another exception is rather broad saying, ‘The purpose of the exchange is otherwise determined by the secretary in regulations to be similarly necessary and appropriate’ in accordance with the other exceptions.”

Orwellian provisions …

Once again, we encounter the introduction of Orwellian language where up is down, right is left and good is evil.

“Further, one of the exceptions seemingly states the government can obtain an individual’s health information for the purpose of protecting an individual’s privacy. It reads: ‘The purpose of the exchange is for treatment of the individual, subject to any regulation that the secretary may promulgate to prevent protected health information from inappropriate access, use or disclosure.’”

“The legislation also says that the prohibition will be reviewed after 18 months. The review will further explore whether the government ‘may further restrict the exception described in paragraph (2)(A) to require that the price charged for the purpose described in such paragraph reflects the cost of preparation and transmittal of the data for such purpose, if the secretary finds that such further restriction will not impede such research or public health activities.’”

What does this mean? I pride myself on my ability to read original legislation and I have no clue to the meaning of this particular provision and the unintended consequences it might spawn.

“Some of these exceptions are already in the Health Insurance Portability and Accountability Act (HIPAA), a law with privacy provisions.”

“But the exceptions on exchanging or selling information could be more problematic to privacy if health records are digital, said Sue Blevins, president of the Institute for Health Freedom, a group that advocates health privacy issues. ‘Digital records without consent is a recipe for invasion of privacy,’ Blevins told CNSNews.com Monday. ‘Consent was gutted with HIPAA, but it is really hard to get out paper records. When they are made electronic, you can share data with a click of a mouse.’”

“Those who could be able to sell the information would be health care providers, insurance companies and other entities that collect the data.”

Bullshit from the Senate Finance Committee …

“A statement by the Democratic majority on the Senate Finance Committee says the information will not be used to influence treatment and that ‘Federal law makes your medical records--whether they’re on paper or in a computer--confidential to you and your health provider.’”

If this were literally true, there would be no objections by consumer privacy groups and the provisions would be clearly spelled out in plain English.

“However, some Republicans in Congress have questions about the government gathering the health care information of individuals, and what will be done with that information.
‘Making sure that providers can share information on a patient, making sure we can do that effectively and efficiently is a good thing. Having government decide about the course of treatment is not a good thing,’ Rep. Rob Wittman (R-Va.) told CNSNews.com.”

Our healthcare system is fundamentally flawed …

It is one thing for the government to cede unprecedented control to the insurance companies and subcontractors to manage the billing and payment systems, but it is a major systemic flaw when these private for-profit commercial enterprises are also allowed to restrict and/or re-direct your treatment modalities based on costs rather than medical efficacy.

“It goes right back to the government’s role should be between a patient and a provider. That information needs to be there for the patient and the provider to make decisions about their health care -- not for government to intercede.”

Robert Gibbs, the inarticulate bozo who provides the press briefings weighs in with politico-babble …

“White House Press Secretary Robert Gibbs said spending more on health information technology creates jobs, saves money, provides less bureaucracy and will save costs for small businesses.”

“If you go to the bank on the way home and take out your ATM card and get $25 out of your account to use this weekend, the transaction costs the bank – in many cases – half a penny. A medical transaction of your records from you doctor in Bethesda to an emergency room in Washington costs $10,” Gibbs said Friday.”

This bozo does not understand either the volume nor the complexity of the information being transmitted – so to make this comparison marks Gibbs as just another stupid political hack with little or no understanding of what he is speaking about. Especially considering that the data format for dealing with credit card data is uniform across the hardware platforms and there is no such mandatory standards for those currently using proprietary medical systems which may not even be able to communicate with each other, let alone in a secure manner.

“ ‘The president believes that by implementing health care technology, we can save billions of dollars in health care costs we see skyrocketing every year, putting more and more business out of business and is blamed repeatedly for patient safety and patient death,’ said Gibbs.”

Another stupid statement. Your medical records do little or nothing to prevent your nurse from giving you the wrong medication, the wrong dose or even giving you a transfusion during an operation which will be instantly fatal. I personally observed a nurse walk into a room, check the patients wristband, check the label on the medication – and then hang the wrong medication on the infusion rack. Only the protestations of the patient – which were received as being hostile and argumentative – saved the day as a doctor arrived to re-check the medication and noticed the error. That is not to say that records should not be cross-checked, but one might find that most medical errors (like the amputation of the wrong foot) are human errors and that medical systems have little or no effect at stopping these problems from occurring. 

Here are the words of some democrats who voted for this bill ...

"Meanwhile, members of the Senate told CNSNews.com that they were unaware of these health-care provisions included in the 1,071-page legislation."
 
“I have not looked at those particular provisions as much as I have on the general effectiveness [of the stimulus],” Sen. John McCain (R-Ariz.) told CNSNews.com on Friday. “I don’t know frankly enough about that provision to give you an informed comment.”  McCain is a member of the Senate Committee on Health, Education, Labor and Pensions.
 
“I don’t know,” Sen. Charles Schumer (D-N.Y.) told CNSNews.com, when asked about the provision.  “I haven’t thought about it.” <Source>

Serious about healthcare?

Want to really reduce the cost of healthcare, jail those who defraud the system rather than slapping them on the wrist or settling restitution claims for pennies on the dollars. Put in place a decent payment schedule which does not force the doctor to break a procedure into many little components and find ingenious ways to code the charges so as to earn a fair payment.

But, if you are really serious, stop treating medicine as a factory process that requires a doctor to see a patient every ten minutes. With this type of time-pressure, no doctor will have the time to peruse a patient’s history – computerized or not.

It is time that doctors; not administrators, doctor-administrators, nurse-administrators or clerical people manage the delivery of healthcare. And as for saving billions of dollars, do you want to bet that the savings goes to the bottom line of the health insurers and the profligate salaries and bonuses that are paid to health company executives.

What can YOU do?

Demand that healthcare be returned to doctors instead of clerks. Demand that insurers make available group pricing to all who wish to purchase insurance without regard to employment or employer. The purpose of a group policy is to spread the risk across the group – so as not to burden individuals who might suddenly be unable to afford insurance and turn to government assistance. Make healthcare affordable by removing the government from the process.

Treat those who offer to store your personal healthcare information free or for a fee with great suspicion until you can rest assured that your information will not be misused for commercial purposes or be released into the wild by evildoers.

Consider joining the Electronic Frontier Foundation (www.Eff.org) to support their advocacy of consumer privacy rights.

Be well and be safe.

-- steve

A reminder from OneCitizenSpeaking.com: a large improvement can result from a small change…

The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane. -- Marcus Aurelius

Reference Links:

CNSNews.com - ‘Exceptions’ in Stimulus Bill Allow Sale of Health Records

Exceptions: See Legislation, PDF pages 391-395.

Danger: The SINGLE most important key to protecting your health records! | One Citizen Speaking

Microsoft HealthVault: Can you trust Microsoft or any other commercial vendor with your health information? One Citizen Speaking