Congress passed the Patient Protection and Affordable Care Act (PPACA or Obamacare) without first reading it. As Nancy Pelosi noted at the time, “we have to pass the bill so that you can find out what is in it.” The repercussions of such a move are becoming clearer by the day as legislators and policy groups learn more and more about what is actually in the bill.
The latest discovery concerns patient medical information. The federal government, under the authority of Obamacare, intends to collect and aggregate confidential patient records for anyone who maintains health insurance and sees medical providers. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has proposed a rule demanding insurance companies submit detailed health information about their customers.
In general, sharing medical records amongst providers can provide more efficiency in the medical care field. Electronic medical records, in particular, help prevent repetitive and unnecessary treatments, reduce errors, and provide instant access to a patient’s medical history. Electronic medical records can lead to a more streamlined healthcare experience for patients and providers alike, lowering healthcare costs and saving time.
Increasing medical records collaboration among providers can be accomplished through the private sector. For example, Blue Cross and Blue Shield of North Carolina and Allscripts recently announced a $23 million program to encourage more doctors to utilize electronic medical records.
Of course, patients should have to consent to allow providers to share their sensitive medical information and healthcare providers should be held responsible if there is a breach of confidentiality.
Under the proposed HHS rule, however, patients cannot opt out of the government having access to their medical information.
Nonetheless, HHS has proposed three potential ways to obtain patient information. The first option, a centralized approach, would require health insurers to give data directly to HHS bureaucrats in Washington, DC. The state approach would require health insurance companies to give information to the 50 states while the third option would require insurers to maintain the data themselves with government oversight.
Regardless of the option selected, this rule gives the government access to every American’s health records. Not only is this an intrusion into the private and very personal medical information of patients, but it is also troublesome when reviewing the government’s track record of managing individuals’ confidential information. There have been several incidents in recent years of bureaucrats accidently losing computer equipment and mismanaging security breaches that result in the exposure of millions of citizens’ confidential information.
One may argue that private companies have also been guilty of losing important private information to computer hacking and employee carelessness. Private companies, however, can be sued in civil court for their negligence or quickly fire responsible employees. Government, on the other hand, can more easily evade lawsuits and/or must go through a long and tedious appeals process to fire its employees.
And let’s not forget to ask why the Obama administration seeks this information. HHS argues this rule is necessary to compare performance of insurance companies and medical providers.
But why do we need the federal government to do this? Patient consumers are the people most likely to know the quality of medical providers and insurers. We don’t need Big Brother telling us which doctors to see, what medical procedures to have, and which health insurers to choose. We should trust patients to make these decisions themselves by looking at private market indicators like provider approval ratings and word of mouth.
Moreover, this intrusion into our personal medical records is the inevitable next step after accepting the premise of the unconstitutional individual insurance mandate. Once government gets this involved in the health insurance industry, they feel justified in making it their business what we do with that insurance coverage.
This latest Obamacare discovery should be labeled for what it really is – another attempt at a power grab that allows the federal government to spy into the private lives of citizens regardless of our rights to privacy and liberty.
“Electronic medical records, in particular, help prevent repetitive and unnecessary treatments, reduce errors, and provide instant access to a patient’s medical history. Electronic medical records can lead to a more streamlined healthcare experience for patients and providers alike, lowering healthcare costs and saving time.”
In my experience, none of this is actually true. EMR (or newer term EHR – electronic health records) actually does not produce “instant access to health records” because each office is independent and uses different systems that do not share information. This is true among hospitals as well. Only the VA system used a single EMR that is truly national.
Secondly, errors when using an EMR are almost certainly increased. This occurs because each EMR is set up to copy the old patient visit each subsequent visit. This causes redundancy in the records and leads to poor accuracy of the chart (unless extreme care is taken to clean it up which in my experience is almost never done). This is done on purpose to satisfy all the government regulations in order to get reimbursed for the exam and procedures done by the physician. Medicare lays out the guidelines and the EMR makes sure that everything is in the record even when it is inaccurate.
Thirdly, claiming that it is “more efficient and streamlined” is not correct. It is rare to find an office that becomes more efficient after implementing and EMR. Even after the initial terrible adjustment phase, the systems do not allow physicians to see more patients because it just trades one form of documentation for another that is foreign to many of our older practitioners. If is becomes “more efficient” it is probably at the expense of accuracy.
Fourthly, and probably most importantly, EMR actually increases health care costs. It was a shock for our government to find out that EMR raises the health care costs because the more extensive (albeit inaccurate) documentation allows higher level exam codes to be used. (see point #2). This leads to higher level charges for patient visits automatically generated by the EMR. Patient visits then cost us more.
EMR’s are not microsoft windows and are incompatible with each other. Each is different and there is an economic incentive to keep it that way. Plus they cost upwards of 100K to buy and often are exorbitantly expensive to keep up, year over year. This added cost leads to doctors offices being squeezed and trying to cover the overhead. More importantly, it leads to significantly increased costs within the health care system.
JCP M.D.
James,
Thank you for taking the time to share your firsthand knowledge on this subject. Unfortunately it seems that many of these decisions are being made without including actual doctors with hands on experience.
I hope that as the debate continues more M.D.’s make their voices heard.
Francis
I know a number of doctors and registered nurses and have yet to find one who like ObamaCare. They want it repealed. They want Obama gone! fjh
As the changes are being considered to automate medical records, the Medical Society, the Hospital Association, the insurance companies, ER doctors, and other interested parties – including consumers – are all in the room. Furthermore, consumers will be able to impose restrictions on access to the medical records.
Thanks James for a sensible response to the misleading article.
I want my medical care to be supervised and controlled by the federal government, so I can experience the efficiency of the US Postal Service and the compassion of the Internal Revenue Service.
The government that brought us $500 hammers and $600 toilet seats will certainly reduce medical costs for all.
Adding 30M people to the Medicaid/Medicare programs will surely save money. (“I lose money on every sale, but I make it up in volume.”)
I also want ALL the bureaucrats in DC to have access to my private medical information, because I know they are all scrupulous and ethical, and their information systems are foolproof. (Not counting the 10,000 tax rebates that went to penitentiary inmates, the hundreds of $millions paid each year in social security benefits to the deceased, and the $billions paid in Federal retirement checks for the deceased – one for over 37 years.)
Everything I know about Obamacare scares me.
FCO, MD
JCP M.D. mentioned: “Only the VA system used a single EMR that is truly national.” is unfortunately, not entirely accurate. As a patient of the VA Medical system, if I travel from NC to San Diego, CA and need medical treatment, I contact the VA Medical Center in La Jolla, CA they have no idea who I am. I am not 100% sure but I believe the EMR’s do not cross VISN lines.
(VISN’s are regional and translate to: Veterans Integrated Service Network)
The VA system is national. I’ve worked in 4 different states and have always had access to any medical records from patients who cross state lines. That VA in CA must be “off the grid” so to speak. (Or else they are just too lazy to access your remote information).