It's so tempting to become cynical when one considers the many
unjust and downright disgraceful games that are played in Washington.
If I hadn't been carefully tracking the issue myself since
1999, I don't think I'd believe that a so-called federal privacy
rule could actually legalize unconsented access to people's
health information. It's astonishing how things can be labeled
the opposite of what they are and then pushed on the American
public-against their will-by large lobbying groups. If a natural-supplements
company had provided such misleading information, it probably
would have been shut down and those responsible jailed!
But regardless of the injustices and misleading propaganda about
this medical-privacy rule, I'm staying optimistic and here is
The American Public Wants Privacy
The good news is that the American public still wants medical
privacy. Poll after poll shows this. That is why the large
lobbying groups that want to gather and use people's health
information, without first obtaining their consent, have had
to resort to the federal government to create a give-me-unfettered-access-to-health-data
rule they know would never fly in the free market. We can view
the cup as half-empty by focusing on the fact that we've had
forced on us a rule we don't want. (Of course, most Americans
don't know their privacy has been taken away, because they are
continually misled by government and special-interest groups.)
But the cup-is-half-full view is this: that government and
industry have to lie proves that the public doesn't want to
give up its health privacy!
A Lie Can't Last Forever
Another reason I'm optimistic is that I truly believe that a
lie can't last forever. I am convinced that sooner or later
the public will become informed about how the rule actually
does the opposite of what it purports to do. When sensitive
health data gets leaked, people are going to wonder how it happened.
That's when they'll dig deeply and discover the truth about
the lack of medical privacy (defined as the ability to keep
one's information confidential and determine for oneself if
others can have access to it). That is why true privacy advocates
must continue to tell the truth about how the federal rule fails
to assure confidentiality of health matters.
Lawsuit Challenges the Rule
A lawsuit challenging the misnamed federal medical-privacy rule
could help expose the truth about it. Attorney Jim Pyles recently
argued a case (Citizens for Health v. Tommy Thompson)
on behalf of several organizations and privacy advocates, in
the U.S. Court of Appeals for the Third Circuit in Philadelphia.
According to the Philadelphia Inquirer, during the appeal
the judges became informed about how "The amended rule.rescinded
the consent requirement, meaning that in 'routine' matters,
patient permission was no longer needed for private records
to be shared with doctors, dentists, hospitals, HMOs, insurance
companies, billing firms and others. Records include test results,
diagnoses, physicians' notes and other information, some of
it embarrassing and all of it intensely personal." The Inquirer
reported that two of the judges "worried aloud that just about
anything could be construed as [related to] payment, treatment
and health-care operations-and thus could be shared." (See http://www.philly.com/mld/inquirer/news/nation/11094851.htm.
Note: This site requires readers to obtain a password.)
All the judges have to do is to read the rule in its entirety
and they'll see that it doesn't guarantee true medical privacy.
(The rule doesn't even define the term.) The judges could declare
the rule unconstitutional. Additionally, the court record will
provide evidence that the government has been misleading Americans
about the federal medical-privacy rule.
Consider, for example, the U.S. Department of Health and Human
Services Office for Civil Rights "fact sheet" about health privacy.
Titled "Your Health Information Privacy Rights," the so-called
fact sheet states "You have privacy rights under a federal law
that protects your health information." (See http://www.hhs.gov/ocr/hipaa/consumer_rights.pdf.)
But how can a federal rule granting more than 600,000 insurers,
doctors, data-processing companies, and many others access to
patients' records (without their consent) be considered protective
of privacy rights? In an honest and just world, it couldn't.
And with judges exposing the truth about the rule, the deception
might end sooner rather than later. I'm staying optimistic.
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National Health Spending Trends for
Government Spending to Grow, Private Spending to Slow, and
More Seniors to Enroll in Managed Care
National health expenditures are expected to grow to more than
$3.5 trillion in 2014, up from $1.8 trillion in 2004, according
to a recent Health Affairs article and projections from
the Office of the Actuary, Centers for Medicare and Medicaid
Services (CMS). That amounts to approximately $11,045 per capita
(in an estimated population of 324.6 million), an increase from
$6,039 in 2004.
Increase in Public-Sector Spending Growth
The Health Affairs article, titled "U.S. Health Spending
Projections for 2004-2014," projects faster growth in public-sector
spending on health care. The article reported these significant
- By 2014, total health spending is projected to constitute
18.7 percent of gross domestic product, from 15.3 percent in
- The faster public-sector spending growth is exemplified
by the introduction of the new Medicare drug benefit [which
takes effect in 2006]. While this benefit is anticipated to
have only a minor impact on overall health spending, it will
result in a significant shift in funding from private payers
and Medicaid to Medicare.
- In part because of this funding shift, our projection calls
for public funding of health care to exceed 49 percent by the
end of the projection period-a record share that could have
important implications for the budget as a whole.
Decrease in Private-Sector Spending Growth
Meanwhile, growth in private health care and insurance is expected
to slow from 9.9 percent in 2003 to 7.7 percent in 2004. The
article explains (again quoting):
- Two major factors contribute to this deceleration. First,
growth in the underlying costs of health benefits per enrollee
is projected to slow from 8.9 percent in 2003 to 7.7 percent
in 2004. Second, a modest downturn in the private health insurance
underwriting cycle appears to be under way.
- Private health insurance has historically exhibited a cyclical
pattern, known as the underwriting cycle, in which growth in
premiums first undershoots, and then overshoots, growth in the
underlying medical trend.
- Factors influencing this predicted turnabout are pressures
on Blue Cross/Blue Shield plans from state regulators in the
face of rising reserves.
- We assume that the take-up of health savings accounts (HSAs)
will be gradual and that further increases in all forms of cost
sharing will continue at a pace similar to that of the last
Increase in Medicare Managed-Care Enrollment
Finally, the Health Affairs article points out that the Medicare
Prescription Drug, Improvement, and Modernization Act (MMA)
of 2003 legislated payment increases to managed-care plans in
2004 and 2005. Quoting again:
- Our forecast assumes a shift in enrollment from traditional
fee-for-service (FFS) Medicare to MA plans [Medicare Advantage
plans, formerly Medicare+Choice].
- MA enrollees are expected to constitute about 30 percent
of total Medicare enrollees by 2014, compared with 12 percent
- "U.S. Health Spending Projections for 2004-2014," Health
Affairs, February 23, 2005.
- "National Health Care Expenditures Projections: 2004-2014,"
Office of the Actuary, Centers for Medicare and Medicaid Services
[Back to Contents]
Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2005 Institute for Health Freedom.