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Ted Kennedy's Medical Records Plan Raises Privacy Fears Dave Eberhart, NewsMax.com When Sen. Ted Kennedy (D-Mass.) recently introduced his Efficiency in Health Care Act - or eHealth Care - to cut administrative costs in the medical care industry, he touted, "Recent breakthroughs can enable Internet-based methods of bill processing to cut costs dramatically." Kennedy's bill, along with a host of others presently winding through Capitol Hill, seeks to tweak the so-called "administrative simplification" provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II). HIPAA required the Department of Health and Human Services to, over time, establish national standards for electronic health-care transactions and national identifiers for providers, health plans, and employers. It also addressed the security and privacy of health data, resolving that such standards would improve the efficiency and effectiveness of the nation's health-care system by encouraging the widespread use of electronic data interchange in health care. Translated: the law moves medical record-keeping from paper to digital. The move would improve efficiency, but it also raises privacy concerns as government access to personal medical records will be made easy. Story Continues Below
One person who is worried about the changes is Dr. Jane Orient, M.D., executive director of the respected American Association of Physicians and Surgeons (AAPS). Last month, Dr. Orient was ringing alarms in testimony on Capitol Hill, warning lawmakers that, while digitizing medical records in the private sector wasn't necessarily a problem, government access and control was. She argues that a "standardized" system managed by the federal government would be disastrous – giving government bureaucrats access to your most private medical records. The concern is that with a few strokes on a keyboard, a government official may be able to find out your medical history – including personal issues relating to psychiatric care, sexual matters, addictions, and any health issue that you may want to keep from the public domain. Dr. Orient also advised lawmakers, "Sen. Kennedy's call for ‘paying for value and results' rather than for all services rendered in good faith illustrates the immense chasm of understanding of American health care that currently exists between the U.S. Senate and the practitioners of modern medicine." Orient basically argues that Kennedy's bill pays doctors only for medical treatment that ultimately ameliorates the patients' conditions. But if the government and insurance companies only pay for ‘successful' outcomes, Orient maintains, physicians who want to remain financially solvent might be forced to restrict their practice to patients with a relatively good prognosis and who are inclined to follow doctor's orders.
"If they try to impose a national standard, it's going to lead to chaos," Dr. Orient explained to NewsMax. "And it's probably going to make medical records even more unintelligible than they already are, and much less accurate."
Kennedy, however, insists that his legislation will streamline medical record-keeping and create stringent standards for financial transactions such as billing and claims processing. He says to get that result, the federal government must demand "adoption of the same kind of high-volume, speedy, cost-efficient technology that has dramatically lowered administrative costs in other industries." Orient is equally steadfast, adding, "The government-dictated medical information technology movement and the intrusive, restrictive central planning in American medicine that it would foster would render the practice of modern medicine as we know it today virtually impossible." Dr. Orient suggests that "the quality and privacy of medical care would suffer" and may scare many practitioners out of the health care field as they "become demoralized and withdraw from active practice as soon as possible, unwilling to perform under constant surveillance by bureaucrats." But Kennedy insists that what he is proposing is just sound business and not a stifling new trend in restrictive central planning, as Orient suggests.
"Processing a single transaction in health care can cost as much as $25," Kennedy says by way of example. "Banks and brokerages have cut their costs to less than a penny per transaction by using modern information technology. Administrative costs account for almost a third of total health-care spending. That's more than $400 billion a year. Reducing administrative costs to the level of other industries would save enough to finance universal health care several times over…"
AAPS and Orient don't dispute that the technology might save the federal government money, but they are worried about the risk of medical privacy being invaded – especially when the federally appointed panel to suggest specific ways and means seems devoid of privacy advocates. The panel, "the American Health Information Community," was appointed by Health and Human Services Secretary Mike Leavitt last month and is "charged with advising the secretary on how to make health information digital and interoperable." In fact, the panel is part and parcel of President Bush's initiative to digitize patient health-care records over the next decade, so that "patients, doctors, hospitals and insurance companies will have access to vital and confidentiality-protected medical information immediately and efficiently, helping to reduce medical errors, improve quality, lower costs and eliminate paperwork hassle," according to HHS.
The AAPS says the 16-member panel is composed strictly of medical industry reps and government officials - a sign, they believe, that does not augur well for close attention to issues of patient privacy. NewsMax notes, however, that one Community commissioner, Nancy Davenport-Ennis, CEO of the National Patient Advocate Foundation, doesn't fit the feared mold. "The Internet looked like the answer to our dreams of a modern world, but it has become a dangerous place for storing personal records of any kind," warned Orient. Meanwhile, the first meeting of the American Health Information Community was held in Washington, D.C., on October 7, 2005. Not a short-fused affair, the community will be chartered for two years with the option to renew, and a duration of no more than five years. HHS intends for the community to be succeeded within five years by a private-sector health information community initiative that, among other things, would set additional needed standards, certify new health information technology, and provide long-term governance for health-care transformation. Orient urges Congress to allow the new technology to evolve and to be voluntarily adopted as it becomes useful, as the profession has done with new imaging technology, surgical procedures, and medications.
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