{"id":742,"date":"2009-03-02T09:58:59","date_gmt":"2009-03-02T14:58:59","guid":{"rendered":"http:\/\/jimbovard.com\/blog\/?p=742"},"modified":"2009-03-02T09:58:59","modified_gmt":"2009-03-02T14:58:59","slug":"obamas-great-medical-records-roundup","status":"publish","type":"post","link":"https:\/\/jimbovard.com\/blog\/2009\/03\/02\/obamas-great-medical-records-roundup\/","title":{"rendered":"Obama’s Great Medical Records Roundup"},"content":{"rendered":"

The American Conservative <\/strong><\/a>just posted my attack on Obama’s plan to digitize and centralize everyone’s medical records.
\nAh, the joys of positive thinking about Leviathan….<\/p>\n

HEALTH OF THE STATE<\/strong> March 9, 2009 American Conservative
\nby James Bovard
\n** The President’s Plan for Your Medical Records<\/em><\/p>\n

The computerization of personal healthcare records is one of the showpieces of the new stimulus bill. President Obama promised, \u201cWe will make the immediate investments necessary to ensure that within five years all of America\u2019s medical records are computerized.\u201d Congress ponied up $19 billion to subsidize the digitization of patient files and creation of electronic healthcare tracking systems. The ultimate goal is \u201cthe utilization of a certified electronic health record for each person in the United States by 2014.\u201d <\/p>\n

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\u2019 most intimate information. Much as the Patriot Act pried, this measure intrudes on a far more personal level. No patient left behind\u2014or alone. <\/p>\n

The president promises that computerizing doctors\u2019 records will \u201ccut red tape, prevent medical mistakes, and help save billions each year.\u201d 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. <\/p>\n

At this point, fewer than 20 percent of the nation\u2019s physicians have gone full-speed on computerization. Obama\u2019s plan offers between $44,000 and $64,000 to doctors who computerize patient records and up to $11 million per hospital. \u201cOn the stick side of the equation,\u201d the Wall Street Journal reported, \u201cthe measure includes Medicare payment penalties for physicians and hospitals that are not using electronic health records by 2014.\u201d If records are digitized on the federal dime, it will be far easier for politicians to claim the resulting information.<\/p>\n

But the feds have no technological silver bullet to distribute to docs across the land. David Kibbe, a top technology adviser to the American Academy of Family Physicians, warned Obama in an open letter late last year that existing medical software is often poorly designed and does a miserable job of exchanging information. Kibbe declared, \u201cIf America\u2019s physician practices suddenly rushed to install the systems of their choice, it would only dramatically intensify the Babel that already exists.\u201d <\/p>\n

Marc Roberts, a Harvard professor of political economy and health policy, notes, \u201cMany healthcare systems are now intentionally building medical record systems that are nonstandardized and noncompatible so they can own and control the data.\u201d<\/p>\n

In the same way that George W. Bush bragged about the percentage increase in homeownership, President Obama will be able to boast about the increase in doctors\u2019 offices using electronic records. It didn\u2019t seem to matter to Bush that many of the new federally subsidized homeowners went bankrupt, and it may not matter to Obama that the federally controlled health-record system is bound to be a trainwreck.<\/p>\n

The administration estimates that digitizing health records will create 212,000 jobs. But the New York Times noted in January, \u201cSo far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology.\u201d At best, the plan will create jobs for legions of clerks. The low skills required would make a mockery of the promise that digitizing records will result in a sharp decrease in medical errors since the data-entry process would almost certainly produce vast bogs of blunders. Perhaps the real job creation will be for undercover agents to go around to doctors\u2019 offices to see whether there are compliant keyboards on the premises.<\/p>\n

The idea that the feds will be dictating quality standards for private businesses is laughable, considering Uncle Sam\u2019s abysmal record on computer modernization. The IRS and the FBI have each gone through buckets of billions of dollars in vain efforts to create computer systems that were non-Paleolithic. The terrorist watch list has been a joke in part because numerous agencies used different software and created incompatible systems for identifying suspects. Remember the faulty no-fly list that grounded U.S. senators? Do we really want these same federal aces ruling on drug interaction and managing open-heart surgery?<\/p>\n

One of the plan\u2019s aims is to create systems able \u201cto exchange electronic health information with and integrate such information from other sources.\u201d This is a huge step toward a national database, and the centralization of 300 million Americans\u2019 health records should be seen in light of other data the government has already gathered. In the name of fighting terrorism, the feds have conscripted far more information than people realize. And the Pentagon\u2019s pursuit of Total Information Awareness on the American people\u2014combined with Congress\u2019s contempt for ensuring that federal agencies obey the law\u2014assures that the surveillance horrors have only begun. If the government has the right to fine doctors for not digitizing their patients\u2019 files, wouldn\u2019t the feds also claim a right to punish those who refuse to turn over the records?<\/p>\n

Team Obama is promising that the government will scrupulously respect the privacy of the newly computerized private data\u2014a claim eerily reminiscent of President George W. Bush\u2019s 2004 promise that no American was being wiretapped without a warrant.<\/p>\n

Consider the feds\u2019 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\u2019s 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. <\/p>\n

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, \u201cThe 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\u2019s most profoundly private information can be shared with hundreds, thousands, even millions of individuals and organizations at a time.\u201d But the Bush administration blocked the proposed privacy regulations and instead issued rules that largely abolished a patient\u2019s consent over the use of his own medical data. It rolled out a red carpet to industries hungry to exploit private health information. <\/p>\n

Harvard law professor Richard Sobel observed, \u201cHIPAA 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.\u201d Physicians B.K. Herman and D. Peel noted in a 2004 article entitled \u201cThe End of Medical Privacy\u201d that \u201cthe Hippocratic Oath, the foundation of medical ethics and the most important of all patients\u2019 rights, has been rescinded by federal decree.\u201d The Patient Privacy Rights Foundation warns that \u201cover 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\u201d are entitled to see and use individuals\u2019 healthcare records.<\/p>\n

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.<\/p>\n

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\u2019s existence\u2014or more deserving of discretion. <\/p>\n

We now know that psychologists were brought to the prison at Guant\u00e1namo to exploit detainees\u2019 weaknesses for interrogation purposes. Do the millions of Americans who have received psychological treatment want government agents to have access to their vulnerabilities? Suppose that when a policeman pulls you over for a speeding ticket he can quickly tap into a database with your health records, including any therapy. Even before he walks up to your car window and demands your identification, he will know if you have a \u201cproblem with authority.\u201d<\/p>\n

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 \u201cprivacy-protective behavior.\u201d But of course the trust between doctors and patients is irrelevant compared to politicians\u2019 promises to take care of everyone.<\/p>\n

Privacy is very lucrative for the Beltway boys: they reap millions when they betray it. Rep. Roy Blunt (R-Mo.) and Sen. Tom Harkin (D-Iowa) have each received more than a million dollars in contributions from health professionals and the pharmaceutical industry since 2000, and they each sponsored industry-favored amendments in the stimulus bill that would undermine patient privacy, the Washington Post reported.<\/p>\n

A flood of campaign contributions from the telecommunications companies swayed congressmen to award phone companies retroactive immunity last year for violating federal law and betraying their customers\u2019 privacy. If congressmen would vote to permit phone companies to wiretap people\u2019s calls and e-mails illegally and unconstitutionally, why expect that they would not sell out health privacy as well? Civil libertarians can score isolated victories here and there, but the bankrolls of the healthcare industry, insurance companies, and pharmaceutical manufacturers will trump in the end.<\/p>\n

The computerization of individuals\u2019 health records is a stepping stone toward Obama\u2019s proclaimed goal of universal coverage. And there can be no universal coverage without universal submission. <\/p>\n

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\u2019s 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\u2014but forced no universal program.<\/p>\n

For patients who prefer not to have their data online, Sue Blevins of the Institute for Health Freedom notes, health information could be stored electronically on \u201ccards that patients could take with them from doctor to doctor, rather than establishing a centralized system through the federal government.\u201d This would allow them to help new doctors quickly get up to speed on their medical history and avoid retaking tests. As long as progress is not paralyzed by a federal mandate, private companies will continue innovating and offering better, more secure solutions. But politicians reap no windfalls when problems are solved without their help. <\/p>\n

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\u2019ll 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.
\n__________________________________________ <\/p>\n

James Bovard is the author of Attention Deficit Democracy and eight other books. <\/p>\n","protected":false},"excerpt":{"rendered":"

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