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Health Freedom Watch
October 2005

Contents:


Electronic Medical Records (EMRs): Trick or a Treat?

As the federal government moves full steam ahead to create a national interoperable (linkable) system of electronic medical records (EMRs), it is giving the American people a false assurance that the new system will safeguard and even improve their health privacy. In this effort, a new federal Commission on Systemic Interoperability was established (as part of the Medicare Modernization Act of 2003) to push for the creation and implementation of linkable electronic medical records and thus national sharing of health information.

The Commission vision statement says that it will "develop a comprehensive strategy.for the adoption and implementation of privacy-protected systems of electronic personal health information" (emphasis added). In its October 25 report titled "Ending the Document Game: Connecting and Transforming Your Healthcare through Information Technology," the Commission stresses that one of the benefits of a connected system of health-care information is that "By more effectively limiting unauthorized access and tracking who views personal healthcare information, interoperability provides patients with more security and confidentiality" (emphasis added).

Yet, unless the Commission amends or repeals the federal medical privacy rule, nothing could be further from the truth. As the Institute for Health Freedom has stressed many times over the past three years, under existing federal law individuals' records can be accessed by many third parties (such as insurers) without their consent, and they are not even entitled to know who has been viewing their records in most circumstances.

How can officials of the U.S. Department of Health and Human Services (HHS) and their various committees and commissions continue to claim that we will have greater health privacy with EMRs?  The reason:  because the federal government has turned the term 'health privacy' on its head. Citizens and policymakers should consider the following important fact: 'Health privacy' is not even defined in the federal medical privacy rule.

Thus when HHS uses the term, it does not necessarily mean a confidential relationship between doctor and patient. Rather, it means a system in which the government decides who can access people's health information.

Given HHS's misguided use of the term, a first step in the forthcoming national debate over EMRs should be for all parties to state unambiguously what they mean by 'health privacy' and whether they support the freedom to maintain truly confidential relationships with health-care providers. Only then will Americans know the full implications of adopting a national system of linkable electronic medical records. And only then will they be able to decide for themselves whether the forthcoming national EMR system is a trick or a treat.

Sources:

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Strong Supporter of EMRs Considers Presidential Run

One of the strongest and loudest proponents of electronic medical records (EMRs) is former House Speaker Newt Gingrich. He recently told an online health magazine that "paper kills" and "Paper [medical] records are an utterly irrational national security risk." Gingrich is fond of stressing how EMRs could save money and lives. But what about the freedom to maintain confidential relationships with health-care providers? Is this freedom not worth restoring and saving, too?

Gingrich announced on October 13 that unless another candidate for president promotes his ideas, he might run for the Republican nomination in 2008. It's likely that EMRs and health-privacy issues will become a hot topic in the next presidential election. Thus, here are some important questions that Americans should consider regarding the upcoming national debate:

  • Should Americans have the right to maintain private contracts with the health-care providers of their choice, and therefore the freedom to pay privately for care and avoid sharing health data with government, insurers, and other third parties?
  • Should individuals be free to weigh for themselves the costs and benefits of saving money and having more efficient health care versus protecting their privacy?
  • Should the federal government serve as the largest payer for health care in the United States-indeed, the world-thereby making it one of the largest storehouses of health data?

Given the serious concerns that so many citizens have about health privacy, this issue is certain to remain an important topic. A national debate on privacy could provide a great opportunity to expose the truth about the federal medical privacy rule: how it actually eliminates consent and thus the control that individuals have over the flow of their personal health information.

Sources:

  • United Press International, "Group Pushes Electronic Medical Records" (October 19, 2005).
  • CBS News, "Newt Gingrich Considers Run For President" (October 14, 2005).

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Is Big Brother Planning to Tag and Track Prescription Drugs Electronically?

The U.S. Department of Health and Human Services (HHS) announced on October 5 that it is funding pilot programs for establishing electronic prescription-drug systems. HHS states "As part of the support to establish high-quality efficient e-prescribing systems, $6 million is being awarded by CMS [Centers for Medicare & Medicaid Services] to fund e-prescribing pilot programs using...[standards], as required by the Medicare Modernization Act of 2003." Additionally, Healthcare Informatics Online points out that electronic prescribing is a focal point of the Medicare Modernization Act (MMA) of 2003, stressing that under Medicare Part D (which takes effect in 2006), prescriptions can be renewed with just a mouse click.

Since the federal government now is the largest payer for health care in the United States, it has the ability to coerce physicians into implementing anti-privacy practices they might not set up in a truly free-market system. Citizens should watch to make sure the federal government does not use its Medicare muscle to apply financial penalties to physicians who do not write electronic prescriptions. All told, a national mandatory (or coerced) electronic prescribing system would make it much easier for Big Brother to tag and track citizens' use of prescription drugs.

What's more, the Food and Drug Administration (FDA) is promoting the use of radiofrequency identification (RFID) technology to "enhance the safety and security of the [prescription] drug supply" in the United States by 2007. According to the FDA's Center for Drug Evaluation and Research, RFID is a state-of-the-art technology that "uses electronic tags on product packaging to allow manufacturers and distributors more precisely to track drug products as they move through the chain of custody, from the point of manufacture to the point of dispensing. It is similar to the technology used for tollbooth and fuel purchasing passes." [Emphasis added]

One has to wonder how such electronic tagging would be used by FDA, Medicare and other government entities. Will it be used simply for inventory purposes or to monitor citizens' use of prescription drugs, too?

As the nation moves forward with modernizing its health-care system, it should not overlook the most important, principled reform of all: being free to choose one's health-care providers and treatments, and to maintain confidential relationships.

Sources:

  • HHS Press Release, "HHS Accelerates Use of e-Prescribing and Electronic Health Records" (October 5, 2005).
  • Healthcare Informatics Online, "Getting Started on e-Prescribing Standards."
  • Statement by Robert J. Meyer, M.D., Director, Office of Drug Evaluation II, Center for Drug Evaluation and Research, FDA before the Subcommittee on Regulatory Affairs, Committee on Government Reform, U.S. House of Representatives (September 7, 2005).

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2005 Institute for Health Freedom.