Health Freedom Watch
Will Bill Gates Help Pave the Way to True Health-Privacy Rights?
By Sue Blevins
At a recent meeting in Washington, D.C., Microsoft chairman Bill Gates called on Congress to pass a comprehensive privacy law this year, allowing consumers to control how their medical information is used. He also stressed that a new privacy law should balance consumers’ rights with government’s need to protect against terrorism.
Gates also implied that some privacy protections have gone too far and have become annoying to consumers. According to Network World, “He talked about the Health Insurance Portability and Accountability Act (HIPAA), passed by Congress in 1996, which puts strict controls on the release of information. HIPAA too often asks patients to sign documents allowing the release of their medical records, he said. HIPAA is evidence ‘we don't always get it right the first time,’ Gates said. ‘All I know is I keep signing those forms.’”
It’s great to see an influential leader like Bill Gates calling for a federal privacy law that allows individuals to control the flow of their health information. But he appears to be misinformed about the HIPAA rule. As Theo Francis pointed out in the Wall Street Journal article “Taking Control: Setting the Records Straight,” the rule actually permits over 600,000 doctors, insurers, and others to access electronic medical records—without consent—for purposes related to treatment, payment, or health-care operations.
Francis wrote, “Over the past three years, millions of Americans visiting doctors’ offices, pharmacies and hospitals have been handed forms and brochures discussing privacy rules under…HIPAA. Many assume signing somehow protects their privacy. It doesn't. In fact, the disclosure notice essentially details the many ways a doctor can use and disclose medical information—often without a patient’s consent or knowledge.” (Emphasis added.)
Meanwhile, Harris Interactive notes that many people are concerned about potential privacy abuses with electronic medical records (EMRs). Citing a 2006 national survey, Harris Interactive reports that 62 percent of respondents think that the use of EMRs makes it more difficult to ensure privacy. The largest group—42 percent—said privacy risks outweigh expected benefits; 29 percent disagreed, while another 29 percent were not sure.
There is no consensus regarding the public’s support for moving to electronic records (from paper records):
Clearly, opinions and desires about privacy differ widely, which is why a one-size-fits-all law won’t meet the needs of millions of Americans.
- One out of five Americans (21 percent) says he/she would want the right not to have any of his/her medical records entered into a new electronic record system;
- 12 percent said they would want to be able to designate which parts of their medical records were entered or not entered into an electronic record system;
- 27 percent said they would want to be notified of the change to electronic medical records and have the effect (of the handling of their personal medical information) explained to them; and
- 22 percent said they did not want to be notified of the change to electronic medical records since they didn’t think it would affect their relationship with their doctors and how their doctors handled their information. (17 percent were not sure; 1 percent “other”).
So what can Congress do to ensure that individuals really control their medical records? Congress should pass a law which states clearly that (1) personal health information cannot be disclosed (in any form) without express, written, and informed consent; and (2) those who prefer efficiency to privacy are free to waive their rights. Thus people who want to choose what information is shared electronically would be free to do so, while those who find the consent process annoying could avoid it.
Given that Bill Gates strongly supports individual control over the flow of personal medical information, perhaps he will help pave the way to a true federal health-privacy law.
- “Gates Calls for New Privacy Law,” Network World, March 7, 2007.
- “The Benefits of Electronic Medical Records Sound Good, But Privacy Could Become a Difficult Issue,” Harris Interactive press release, February 8, 2007.
- “Taking Control: Setting the Records Straight,” by Theo Francis, Wall Street Journal, October 21, 2006.
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Universal Coverage Relieves Citizens of Responsibility and Liberty
By Jeffrey Singer, M.D.
If Arizona’s governor gets her wish, families earning $60,000 a year can get the taxpayers to relieve them of the responsibility of covering their children with health insurance. That’s what Governor Napolitano proposed in her State of the State address.
The irony is the state currently pays about $110 a month to insure a single child. Private insurance companies charge as little as $35 a month for the same coverage. With 23 private insurance companies competing for the business, why should the taxpayers fund a government-run alternative that may ultimately drive these private companies out of the children’s health insurance business?
Incremental Approach to Single-Payer Health Care
Actually, there is a larger agenda at work here. The “Hillarycare” debacle of the early 1990s taught supporters of a Canadian-style “single payer system” that it is politically very difficult to enact radical reform all at once. So they have adopted an incremental approach. They employ the mantra of “universal coverage.” As long as the public is focused on getting everyone on some sort of health plan, the nature and source of funding of the plan gets lost in the discussion.
Pushing the expansion of Medicaid programs to cover more children is the easiest place to start. Who can be against helping kids? It’s also the cheapest place to start. Most children are healthy and require few visits to clinics or hospitals. That’s why health insurance premiums are so low for children. Most health insurance premiums are the same for a family whether they have one, two or three children.
The next step in the strategy is to cover more adults. Several states, most recently Massachusetts, have enacted expansions of their Medicaid programs to cover people earning up to 300 percent of the poverty level ($60,000 per year). In California, that is part of Gov. Arnold Schwarzenegger’s latest proposal. As Medicaid becomes available to more and more of the middle class, incentives develop for individuals and small businesses to drop their private insurance and get the taxpayers to pick up the tab.
Eventually, only a sliver of the population younger than 65 (the very wealthy) will not be covered by government-run health insurance. Those over 65 are already in a mandatory government plan with no legal way to choose an alternative. It’s called Medicare.
Doctors and patients decry the regulations, restrictions and intrusiveness of Medicare. Patients buy Medigap coverage to offset some of its deficits. Most doctors and patients like Medicaid even less. Yet the record and reputation of government-run enterprises is not enough to overcome the shortsightedness and selfishness of many in “organized medicine” and small business associations.
Many doctors urge “universal coverage,” enticed by the hope that, with Medicaid expansion, they will get paid for previously uncompensated care to uninsured patients. Small businesses find it more and more attractive to drop their own employee health insurance coverage if the state offers to take over the job. Even if they have to fund a payroll tax (as in Massachusetts), it still amounts to a huge drop in their overhead costs.
When Taxpayers Pay, Government Demands More Regulatory Control
The prospects for the quality and any future advances in health care delivery are at stake here. The right to choose our lifestyles and decide on the risks we are willing to take is also in jeopardy. As taxpayers are required to foot the bill for these choices, the government will demand more regulatory control over our lives. Already most private business owners around the country are no longer allowed to decide if they will allow smoking on their premises. In New York City, the government decides the trans-fat content of restaurant and prepared foods.
Arizonans and Americans need to understand this very important principle: when the state relieves us of responsibilities, it also relieves us of liberty.
Source: Revised version of “State’s Latest Government-Run Intrusion,” by Jeffrey Singer, M.D., originally published in the East Valley Tribune (Phoenix, AZ), February 13, 2007 (reprinted with permission).
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Vaccination-Choice Coalition Calls for Protecting Parental Rights
The following excerpt is from the March 2007 issue of AAPS News:
Until now, most parents have accepted incremental government intrusions into family life and medical decision-making. But Governor Rick Perry of Texas crossed the line, igniting a firestorm of protest with Executive Order RP 56. The Order states: “Rules. The Health and Human Services Executive Commissioner shall adopt rules that mandate the age appropriate vaccination of all female children for HPV [human papillomavirus] prior to admission to the sixth grade.”
Although the Texas legislature was considering bills on this issue, the Governor decided to override its authority. Irrespective of legislative action, “this order shall remain in effect and in full force until modified, amended, rescinded, or superseded by me or by a succeeding governor.”
Merck doubled its lobbying budget in Texas and has funneled money (Merck declines to say how much) through Women in Government. Gov. Perry has ties both to Merck and to this advocacy group of women legislators.
“Mandates can ease doctors’ concerns about ordering the vaccine,” said Renee Jenkins, president-elect of the American Academy of Pediatrics (AMNews 1/29/07). Many physicians have declined to take the financial risk of stocking the expensive vaccine ($360 wholesale for the 3-shot series), as parents don’t want to pay. Gov. Perry has ordered Vaccines for Children and Medicaid to pay. Additionally, Texas law requires insurers to pay for all mandatory vaccines.
A nationwide mandate would mean $4 billion in annual revenue for Merck. Some have alleged that HPV stands for “help pay for Vioxx” litigation. Unlike with drugs taken voluntarily by sick patients, manufacturers are shielded from liability arising from government-mandated childhood vaccines…. Mandates are being pushed with unprecedented speed—Gardasil was approved by the FDA in June 2006 and “recommended” by the ACIP (Advisory Committee on Immunization Practices) for females aged 12 to 26 in January 2007.
Though Gov. Perry likens Gardasil to polio vaccine, HPV is sexually transmitted. And there is no mandate to vaccinate the persons who could transmit the infection to the girls: men of all ages—a gross departure from usual public health policy….
Outraged parents and grandparents brought their children to an AAPS press conference in Dallas to demand that Gov. Perry rescind his Order. They are not mollified by the provision that the health department will “modify the current process in order to allow parents to submit a request for a conscientious objection affidavit form via the Internet.”
“Parents should not have to get permission from the state to make informed consent medical decisions for their own children,” writes Dawn Richardson, of PROVE (Parents Requesting Open Vaccine Education). Moreover, she states that the process of opting out is a “bureaucratic nightmare.”
The new “Hands Off Our Kids” coalition organized by AAPS sent a letter to Gov. Perry urging him to rescind the Order, return vaccine policy to elected representatives, and allocate no taxpayer funds toward the HPV vaccine or make full disclosure of all financial interests, meetings, and negotiations that led up to the Order. The more than 60 signatories included the American Academy of Environmental Medicine; Rep. Ron Paul (R-TX); former Rep. Bob Barr; 16 Texas physicians; a number of parents and grandparents; and a broad coalition of advocacy groups [including the National Vaccine Information Center, www.NVIC.org].
The Order violates parental rights and privacy, overreaches executive powers, imposes an unjustified tax burden, and violates sunshine in government, states the letter….
Source: “Hands Off Our Kids,” AAPS News, March 2007 (excerpt reprinted with permission).
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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2007 Institute for Health Freedom.