The Conservative US View of Health IT.

The following appeared a couple of weeks ago.

Health of the State

The president’s plan for your medical records

James Bovard

The computerization of personal healthcare records is one of the showpieces of the new stimulus bill. President Obama promised, “We will make the immediate investments necessary to ensure that within five years all of America’s medical records are computerized.” Congress ponied up $19 billion to subsidize the digitization of patient files and creation of electronic healthcare tracking systems. The ultimate goal is “the utilization of a certified electronic health record for each person in the United States by 2014.”

Shoved into a 1,400-page bill passed in a panic, the plan went largely undebated. But the implications are horrifying. Doctors will be coerced into a massive federal healthcare scheme, and government will serve as the leaky repository of patients’ most intimate information. Much as the Patriot Act pried, this measure intrudes on a far more personal level. No patient left behind—or alone.

The president promises that computerizing doctors’ records will “cut red tape, prevent medical mistakes, and help save billions each year.” But in fact, the federal mandate is likely to destroy the progress being made with voluntary efforts to computerize records in a way that assures confidentiality and individual control of health data.

At this point, fewer than 20 percent of the nation’s physicians have gone full-speed on computerization. Obama’s plan offers between $44,000 and $64,000 to doctors who computerize patient records and up to $11 million per hospital. “On the stick side of the equation,” the Wall Street Journal reported, “the measure includes Medicare payment penalties for physicians and hospitals that are not using electronic health records by 2014.” If records are digitized on the federal dime, it will be far easier for politicians to claim the resulting information.

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Team Obama is promising that the government will scrupulously respect the privacy of the newly computerized private data—a claim eerily reminiscent of President George W. Bush’s 2004 promise that no American was being wiretapped without a warrant.

Consider the feds’ record on protecting the confidentiality of personal records. Rep. Joe Barton (R-Texas), co-chairman of the Congressional Privacy Caucus, and 3,000 other people’s health files were on a National Institutes of Health laptop stolen last year from a car trunk. The Veterans Administration was disgraced in 2006 after computer files with the Social Security numbers and other personal information of more than 20 million veterans were stolen. A VA inspector general report condemned the agency for its grossly negligent attitude toward protecting medical records.

But the biggest betrayal occurred with the Health Insurance Portability and Accountability Act of 1996, known as HIPAA, which left the Department of Health and Human Services to define medical privacy. When HHS finally proposed regulations in the last month of the Clinton presidency, it noted, “The electronic information revolution is transforming the recording of health information so that the disclosure of information may require only a push of a button. In a matter of seconds, a person’s most profoundly private information can be shared with hundreds, thousands, even millions of individuals and organizations at a time.” But the Bush administration blocked the proposed privacy regulations and instead issued rules that largely abolished a patient’s consent over the use of his own medical data. It rolled out a red carpet to industries hungry to exploit private health information.

Harvard law professor Richard Sobel observed, “HIPAA is often described as a privacy rule. It is not. In fact, HIPAA is a disclosure regulation, and it has effectively dismantled the longstanding moral and legal tradition of patient confidentiality.” Physicians B.K. Herman and D. Peel noted in a 2004 article entitled “The End of Medical Privacy” that “the Hippocratic Oath, the foundation of medical ethics and the most important of all patients’ rights, has been rescinded by federal decree.” The Patient Privacy Rights Foundation warns that “over 4 million businesses, employers, government agencies, insurance companies, billing firms, and all their business associates that may include pharmacy benefits managers and pharmaceutical companies as well as marketing firms and data miners” are entitled to see and use individuals’ healthcare records.

The issue is not whether the personal health information the government commandeers will be abused. It is simply a question of when, where, and how.

Medical data does not simply track the number of times a person goes to the doctor seeking a cure for a runny nose or stubbed toe. Medical records can include details of long-ago abortions, impotence or sexually transmitted diseases, anti-depressants and mental breakdowns, AIDS or HIV status, or any number of diseases. No information is more integral to a person’s existence—or more deserving of discretion.

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Surveys show that tens of millions of Americans are already engaged in deceptive or evasive behavior because they fear that their medical information could be used against them. The dread that computerized records will end up in a federal database would make far more people engage in “privacy-protective behavior.” But of course the trust between doctors and patients is irrelevant compared to politicians’ promises to take care of everyone.

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The computerization of individuals’ health records is a stepping stone toward Obama’s proclaimed goal of universal coverage. And there can be no universal coverage without universal submission.

This is why superior private alternatives that have been rapidly evolving are unacceptable to the feds. Both Microsoft and Google now offer individuals the opportunity to place personal health information online in secure accounts. Microsoft’s HealthVault program and Google Health both offer better privacy guarantees than Uncle Sam does. There was no need for tens of billions of dollars in subsidies or the threat of endless penalties for these companies to create and offer such products. They simply responded to consumer demands for their services—but forced no universal program.

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Thus we are left with a facade of privacy protection and the reality of an iron fist for data collection. The Obama mandate is guaranteed to subjugate doctors and patients to politicians and bureaucrats. We’ll be destroying real confidentiality for a bogus promise of efficiency. And Americans will be stuck with the huge bill for creating their own digital fetters.
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James Bovard is the author of Attention Deficit Democracy and eight other books.

The full, rather long article is here (bold emphasis is mine):

http://www.amconmag.com/article/2009/mar/09/00009/

It is worth a browse only to see how various ideas, and some facts, can get conflated into a rather paranoid rant.

Clearly ‘Team Obama’ will have a job persuading James and his mates to go along with this!

Just so there is no misunderstanding – I post this for amusement. I find the views quite silly – but it is always useful to know how the kooky 10% think!

David.