Health Freedom Watch
(Email newsletter published by the Institute
for Health Freedom)
September 2005
Contents:
President’s Message: How Would Washingtonians
Want to Be Treated?
By Sue Blevins
Several reporters have called asking
for comments on the government’s push for a national electronic
medical-records database in response to Hurricane Katrina. I told the Washington Post that “many things are done during
a crisis that society normally would not accept.” On September 14 the paper reported that “The
federal government is making medical information on Hurricane
Katrina evacuees available online to doctors, the first time
private records from various pharmacies and other health care
providers have been compiled into centralized databases.”
The crisis and reporters’ questions
made me think: What
would the government have done if the tragedy had occurred in
Washington, D.C.? Would
Bill Frist’s and Hillary Clinton’s medical records have been
made electronically and instantly available to health-care providers
and government and law-enforcement officials across the country
without their consent? Would the personal health
information of Capitol Hill staffers have become accessible
to thousands of others without
their permission?
How long would their personal data be stored in the centralized
databases?
These questions are important for
all of us to consider.
And just as the tragic Terri Schiavo case made Americans
think about and define their preferences regarding end-of-life
matters, the Katrina crisis may push Americans to think about
and plan for how much information they want available and to
how many others during an individual or national emergency.
It’s hard to say how Washingtonians
would want to be treated.
But one thing I’m certain of: there are many thousands,
if not millions, of different opinions when it comes to privacy,
and the federal government can’t make the right choice for everyone. That is why individuals’
preferences should be upheld to the utmost degree possible—even
during a national emergency.
Source: “Health Records of Evacuees
Go Online,” Washington
Post, September 14, 2005: http://www.washingtonpost.com/wp-dyn/content/article/2005/09/13/AR2005091302128.html
[Back to Contents]
Government and Industry Groups Increase
Push for Electronic Medical Records
On September 13 the U.S. Department
of Health and Human Services (HHS) announced appointments to
a new federal committee to help speed up the development of
a national electronic medical-records system of interoperable
databases. The
recently established 17-member American Health Information Community
consists largely of government and industry representatives
with strong interests in data collection, such as health insurers. Their goal is to advance
President Bush’s call for electronic health records within ten
years.
A critical issue that must be addressed
is: Do Americans
have a right to privacy?
If so, how would a national system of electronic medical
records affect that right?
It’s clear that under the existing federal medical-privacy
rule, creating a national database or linking electronic medical-records
databases could be a recipe for breaches of confidentiality. That’s because, as the
Institute for Health Freedom has stressed over and over, the
rule eliminates the freedom to decide who has access to one’s
health information in most circumstances.
Additionally, there are serious concerns
regarding the potential conflicts of interests in the medical-privacy
arena. For example,
the New American
reported on September 5 that former HHS Secretary Tommy Thompson
recently joined Applied Digital, a Florida company that owns
VeriChip. The article
points out that Verichip is “the company that specializes in
making implantable radio frequency identification chips (RFID)
for both people and pets.”
The article further cites The Business (a London-based publication) report
that Thompson “is putting the final touches to a plan that could
result in US citizens having [an RFID] chip inserted under their
skin.” The New American also notes, “According to The Business report, ‘the RFID capsules would be
linked to a computerized database being created by [HHS] to
store and manage the nation’s health records.’”
It is important to note that the privacy
rule was modified to eliminate
patient consent while Thompson was HHS secretary. Americans must continue to monitor closely
the intended and unintended
consequences of health-care reforms. Eliminating the precious ethic of consent
is hardly an improvement.
Sources:
- Office of the National Coordinator for Health Information
Technology (ONCHIT), American Health Information Community Press
Release, September 13, 2005: http://www.hhs.gov/healthit/ahic.html
- “Electronic Medical-records Plan Raises Fears: Privacy Advocates
Missing from Feds' Recommendation Panel,” World Net Daily, September
17, 2005: http://worldnetdaily.com/news/article.asp?ARTICLE_ID=46370
- “The New Healthcare System,” New American, September
5, 2005: http://www.thenewamerican.com/artman/publish/article_2089.shtml
- “‘Health Chips’ Could Help Patients in US,” The Business
(London), July 31, 2005: http://www.rednova.com/news/display/?id=196561
[Back to Contents]
Prescription for Privacy Invasions
State governments nationwide soon
plan to track electronically Americans' use of commonly prescribed
medications for pain, anxiety, attention-deficit disorder and
sleep disorders.
On August 11, President Bush signed
into law the National All Schedules Prescription Electronic
Reporting Act of 2005. It authorizes 60 million taxpayer dollars
over five years to establish electronic prescription drug surveillance
programs in all 50 states and the District of Columbia. It requires
those dispensing controlled substances (such as pharmacists
and physicians) to submit information to state governments within
one week of filling prescriptions, including patients' names,
addresses and telephone numbers. Data also will be collected
on animal owners whose pets are prescribed controlled substances
by veterinarians.
Congress's stated purpose of the law
is to help physicians identify and treat prescription drug addiction
and abuse. (According to the National Institute on Drug Abuse,
2.7 percent of the population age 12 and older use prescription
drugs for non-medical purposes.) However, the legislation goes
much further than its announced intent by also allowing local,
state and federal law-enforcement agents to use the nationwide
electronic prescription drug data.
How will the new law affect patients
and doctors? How will it affect individuals' health privacy?
What can citizens do to prevent invasions of their medical privacy?
Government prescription drug monitoring
programs could foster mistrust between patients and physicians.
Patients logically would be less likely to trust doctors who
are required by law to submit information to states. Also, individuals
whose pain needs are not being met and who choose to shop around
for better pain-management services could be viewed suspiciously
by state governments, or wrongly labeled as addicts or criminals.
Some may turn to illegal drugs as an alternative to prescription
medications.
Under the new tracking systems, physicians
could lose autonomy because state agents, rather than individual
private physicians, would set medical-prescribing standards.
Physicians also could be encouraged to view "doctor shoppers"
as potential prescription drug abusers. Yet, in a free society
we should be encouraging competition and shopping around for
health-care services, like we do in most other areas of our
lives.
Additionally, the new law will greatly
undermine Americans' health privacy because citizens don't have
a right to opt out of the state electronic databases. Nor do
they have a right to know whether their personal health data
are being accessed by many others, including law-enforcement
officials.
At the same time, the existing misnamed
federal medical privacy rule (that was established several years
ago) permits states and many others to share patients' personal
health information without individuals' consent. Yet, many citizens
are not being adequately warned about this. When patients receive
the federally mandated notices about their so-called "privacy
rights" upon visiting health-care providers or picking up prescriptions,
the notices fail to fully inform patients that they do not have
the final say in deciding who can access their personal health
information. Unfortunately, the federal government has misled
Americans into believing that the rule protects their privacy,
when it actually facilitates data sharing—without guaranteeing
confidentiality.
What can citizens do to prevent erosion
of their health privacy? They should work at both the federal
and state levels to restore the legal right to give or withhold
their consent before personal health information is shared with
governments and others. Americans also should uphold the right
to contract with and maintain truly confidential relationships
with the doctors and other health-care providers of their choice.
Congress and President Bush may have
had good intentions in creating state electronic prescription
drug monitoring programs. But the new law could interfere greatly
with patient-doctor relationships. All told, it would most likely
lead to less physician autonomy and more invasions of health
privacy for many citizens nationwide.
Note:
This article was written by Sue Blevins originally for the Cato
Institute and distributed by Knight Ridder/Tribune Information
Services.
Sources:
[Back to Contents]
Health Freedom Watch is a monthly email newsletter published
by the Institute
for Health Freedom (IHF), a national nonprofit, educational
organization whose mission is to bring the issues of personal
health freedom to the forefront of the American health-policy
debate. IHF monitors and reports on national policies that affect
citizens' freedom to choose their health-care treatments and
providers, and to maintain their health privacy--including genetic
privacy. IHF is not affiliated with any other organization.
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