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Health Freedom Watch
November 2009

Contents:


Senate Mandatory Health-Insurance Bill Infringes on Choice and Privacy

The Senate’s newly released health-reform bill (“Patient Protection and Affordable Care Act”) infringes on Americans’ health-insurance choices and medical privacy, says Sue Blevins, president of the Institute for Health Freedom (IHF) – a patients’ rights group in Washington, D.C.

The bill would (among many other provisions):

  • require nearly every legal resident to buy government-sanctioned health insurance;
  • increase Medicare payroll taxes on individuals earning over $200,000 per year and couples earning over $250,000 per year (raising $54 billion in taxes over 10 years);
  • slap a new tax on “Cadillac” health plans (high-cost plans offered by employers to their employees) – raising $149 billion in taxes over 10 years (2010–2019); and
  • finish laying the building blocks for a computerized “Nationwide Health Information Network” (NHIN) without patients’ consent.

Section 937 of the bill, titled “Dissemination and Building Capacity for Research,” includes the following provision:

‘‘(f) BUILDING DATA FOR RESEARCH.—The Secretary [of Health and Human Services] shall provide for the coordination of relevant Federal health programs to build data capacity for comparative clinical effectiveness research, including the development and use of clinical registries and health outcomes research data networks, in order to develop and maintain a comprehensive, interoperable data network to collect, link, and analyze data on outcomes and effectiveness from multiple sources, including electronic health records.” [Emphasis added.] (See pages 1683-1684 of the bill.)

Dissemination of the collected data will be governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) medical privacy rule, which actually permits patients’ personal health information to be shared among more than 600,000 organizations without patients’ consent. “Combining a mandatory national electronic medical-records data network with the so-called HIPAA privacy rule means patients will lose control over the flow of their personal health information,” says Robin Kaigh, an attorney and medical-privacy advocate.  “The only way to ensure that patients control their personal health data is to make sure patient consent is obtained before data can be shared.”

IHF points out that Dr. Bernadine Healy, former head of the National Institutes of Health, recently stressed in U.S. News & World Report:

“…[T]he doctor-patient relationship was never meant to be other than confidential and privileged and solely for the benefit of the patient. Patients expect it, or they would not be forthcoming. And doctors take the Hippocratic oath, pledging to hold sacred their patients’ secrets. This pledge of confidentiality, however, is now challenged by a world where computers rule and health information falls into many hands. One might well ask whether medical privacy is just too outmoded a concept for today’s information-hungry world. We had better decide…."

Do you really wish to have your personal health information become part of a Nationwide Health Information Network without your consent? 

IHF is encouraging citizens to call their Senators as soon as possible and tell them to “vote no on a motion to proceed” on Senator Reid’s mandatory health-insurance bill, because it infringes on patients’ choice and privacy.

Sources:

  • Congressional Budget Office, Letter to Senator Harry Reid, November 18, 2009.
  • Patient Protection and Affordable Care Act,” Senator Harry Reid’s 2,047-page health-reform bill released November 18, 2009.
  • “Senate Says Health Plan Will Cover Another 31 Million,” New York Times, November 19, 2009.
  • “Electronic Medical Records: Will Your Privacy Be Safe?” by Bernadine Healy, M.D., U.S. News & World Report, February 17, 2009.

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49% Oppose; 47% Favor Democrats’ Mandatory Health-Insurance Plan

Two-thirds (66%) say an increase in competition is more likely than increased government regulation to reduce the cost of health care. That’s one reason there is strong support for removing the exemption from anti-trust laws currently enjoyed by insurance companies.

The following is from Rasmussen Reports:

Forty-seven percent (47%) of voters now favor the health care plan proposed by President Obama and congressional Democrats. With the exception of bounces following nationally televised presidential appeals, that’s the highest level of support measured for the legislative effort all year.

The latest Rasmussen Reports national telephone survey finds that 49% are opposed to the plan. [Emphasis added.]

Intensity is still stronger among those who oppose the push to change the nation’s health care system: 25% Strongly Favor the plan while 39% are Strongly Opposed.

Since July, support has generally remained between 41% and 46%. Last week, the effort was supported by 45% of voters. Two weeks ago, it was supported by 42%.

Rasmussen Reports continues to track public opinion on the health care plan on a weekly basis. Next week’s update will give an indication as to whether these numbers reflect a trend of growing support or are merely statistical noise.

As has been the case for months, Democrats favor the plan while Republicans and voters not affiliated with either major party are opposed. The latest numbers show support from 79% of those in the president’s party. The plan is opposed by 78% of Republicans and 61% of unaffiliated voters.

Fifty-six percent (52%) of voters now say passage of the legislation will increase health care costs while 45% say it will hurt the quality of care.

Still, 54% now say the reform plan is at least somewhat likely to become law. That figure includes 19% who say passage is Very Likely. The debate has now moved to the Senate where a different version of the legislation is expected to emerge.

Over the weekend, the abortion issue divided Democrats and created challenges for House Speaker Nancy Pelosi. Earlier polling showed that 48% nationwide favored the abortion ban, but most supporters of health care reform didn’t want to address the issue. Just 13% of all voters wanted abortion coverage mandated in the legislation.

Another issue that arose during the debate was immigration. Eighty-three percent (83%) of voters say that proof of citizenship should be required before anyone can get health care assistance from a government program.

Voters also favor competition, and 65% would like to remove the existing anti-trust exemption for health insurance companies. Two-thirds (66%) say an increase in free market competition will do more than government regulation to reduce health care costs.

While voters are skeptical of the plan working its way through Congress, 54% say major changes are needed in the health care system. Sixty-one percent (61%) say it’s important for Congress to pass some reform.

But most fear that the plan might encourage companies to drop coverage for employees and shift their workers on to the government health care plan. A plurality of Democrats believe this would be good for workers, but most Republicans and unaffiliated voters disagree. As Scott Rasmussen, president of Rasmussen Reports, wrote in the Wall Street Journal: “The most important fundamental is that 68% of American voters have health insurance coverage they rate good or excellent. … Most of these voters approach the health care reform debate fearing that they have more to lose than to gain.”

Health care reform remains the top priority for Democratic voters. However, it ranks fourth on a list of four among Republicans and unaffiliated voters. Overall, 38% of voters see deficit reduction as most important among the four priorities listed by the president earlier this year, while 23% cite health care reform as tops.

Polling on the health care topic by many firms has created some confusion. In particular, polls on the “public option” show a wide variety of results. A recent poll in The Washington Post found that 57% support a government-run health insurance company to compete with private insurers, but Rasmussen Reports polling shows that support is very soft. In fact, people are strongly opposed to a public option if they think it could lead employers to drop the existing coverage they provide employees. The fact that results are so subject to change based upon minor differences in question wording suggests that voters do not have firm opinions on the public option.

Virtually all polling shows a plurality or majority opposed to the current plan in Congress. [Emphasis added.] The poll in The Washington Post found just 45% support for the congressional plan among all adults. Additionally, support for the current plan has remained stable suggesting that public opinion is firmly established at this time.

Other recent polling shows that 49% would rather see no health care legislation passed this year than see the current bill become law. Two-thirds (66%) say an increase in competition is more likely than increased government regulation to reduce the cost of health care. That’s one reason there is strong support for removing the exemption from anti-trust laws currently enjoyed by insurance companies.

Only 31% believe Congress has a good understanding of the proposed health care reform.

National survey of 1,000 likely voters by Rasmussen Reports (margin of sampling error, +/- 3 percentage points with a 95% level of confidence).

Source: “Support for Congressional Health Care Proposal Up to 47%, 49% Opposed,” by Rasmussen Reports, November 16, 2009: http://www.rasmussenreports.com

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Effectiveness of Electronic Health Records Questioned

American hospitals, physicians, and other health-care providers will be penalized if they don’t go digital by 2015, as mandated by the economic “stimulus” law.  Many claim that electronic health records (EHRs) will save money and reduce errors.  But a recent Washington Post article points out that bipartisan enthusiasm for EHRs has obscured questions about the effectiveness of health information technology (HIT).

The article notes that “Interviews with more than two dozen doctors, academics, patients and computer programmers suggest that computer systems can increase errors, add hours to doctors' workloads and compromise patient care.”  It continues “‘Health IT can be beneficial, but many current systems are clunky, counterintuitive and in some cases dangerous,’ said Ross Koppel, a sociologist at the University of Pennsylvania School of Medicine who published a key study on electronic medical records in 2005.”

The Post reports that “the Senate Finance Committee has amassed a thick file of testimony alleging serious computer flaws from doctors, patients and engineers unhappy with current systems. On Oct. 16, the panel wrote to 10 major sellers of electronic record systems, demanding to know, for example, what steps they had taken to safeguard patients. ‘Every accountability measure ought to be used to track the stimulus money invested in health information technology,’ said  Sen. Charles E. Grassley (Iowa), the panel's ranking Republican.”  One of Grassley’s letters cites the following concerns:

  • “Over the past year, I have received complaints from patients, medical practitioners and technologies engineers regarding difficulties they have encountered with the HIT [health information technology] and CPOE [computer physician order entry systems] devices in their medical facilities. These complaints include, for example, faulty software that miscalculated intracranial pressures and interchanged kilograms and pounds, resulting in incorrect medication dosages.” [Emphasis added.]
  • “In addition, it has been reported that HIT/CPOE manufacturers rely on a legal doctrine known as ‘learned intermediaries,’ to shift responsibility for errors in the HIT systems to physicians, nurses, pharmacists, and other health care providers. The manufacturers allegedly argue that the health care provider should be able to identify and correct errors caused by the software. It has also been reported that HIT/CPOE contracts with medical facilities may include ‘hold harmless’ provisions that absolve manufacturers of these products of any liability for errors that are allegedly HIT/CPOE system or software failures. These contracts may also include ‘gag orders,’ which prohibit health care providers from disclosing system flaws and software defects.” [Emphasis added.]
  • “Furthermore, it was also reported to me that there is no system in place to track, monitor and report the performance of these systems/devices, which could impact a health care provider’s ability to make informed decisions regarding the implementation of an HIT/CPOE system.”

Rather than using federal mandates and funds to force hospitals, physicians, and other health-care providers – and thus their patients – to use EHRs, would it not be better to allow all parties involved to contract privately for the record keeping systems of their choice?  Those providers and patients who are comfortable with EHRs and who trust their security should be free to use such systems. But those providers and patients who prefer to maintain paper records and/or a higher level of security should be free to do so without being penalized.

If in a free market EHRs really provided better quality and help lower costs, providers and patients would use them as they pursue their best interests.

Sources:

  • “Electronic Medical Records Not Seen as a Cure-all,” by Alexi Mostrous, Washington Post, October 25, 2009.
  • United States Senate Finance Committee, Letter to Cerner Corporation, October 16, 2009.

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2009 Institute for Health Freedom.