The Death of Medical Privacy

American Thinker ^ | September 20, 2010 | Arie Friedman, MD

[neverdem]

>As I have read through the Patient Protection and Affordable Care Act of 2010 (PPACA, aka ObamaCare), I have been repeatedly struck by the disregard the law has for patient privacy. Time and time again, the PPACA authorizes the federal government to obtain information about patients directly from their health care providers. A particularly vivid example is Section 4302, "Understanding Health Disparities: Data Collection and Analysis." Section 4302 literally opens up almost every medical record in this country for government review and data collection. Let's go through the section with an eye towards patient privacy issues:

(1) IN GENERAL- The Secretary shall ensure that, by not later than 2 years after the date of enactment of this title, any federally conducted or supported health care or public health program, activity or survey (including Current Population Surveys and American Community Surveys conducted by the Bureau of Labor Statistics and the Bureau of the Census) collects and reports, to the extent practicable--

(A) data on race, ethnicity, sex, primary language, and disability status for applicants, recipients, or participants;

...

(D) any other demographic data as deemed appropriate by the Secretary regarding health disparities.

There is no pussyfooting around in this first portion of Section 4302. Within two years, the Secretary of Health and Human Services will be obtaining extensive health and demographic data about every patient who participates in federally supported programs or who interacts with a public health department. This would encompass every single patient who participates in Medicare, Medicaid, TRICARE, or the Supplemental Children's Health Insurance Program (SCHIP). It is also a good bet that data will be obtained from the Veterans' Administration, government employees' health insurance programs, and patients receiving medical care at local Boards of Health. Lastly, I suspect that various regulatory mechanisms will empower state and local Public Health Departments to collect this data on everyone.

It is worth noting that the description of data to be collected is quite broad. Aside from the laundry list of information to be collected, paragraph (D) authorizes the Secretary of HHS to obtain any additional information whatsoever if it fulfills the purpose of investigating health "disparities." Nowhere in this section is there an actual definition of "health disparities." As a result, one can begin to get a picture of the limitlessness of this mandate.

Next, Section 4302 describes where else the Secretary can turn for data collection and what other sorts of information the government is seeking:

(i) locations where individuals with disabilities access primary, acute (including intensive), and long-term care;

(ii) the number of providers with accessible facilities and equipment to meet the needs of the individuals with disabilities, including medical diagnostic equipment that meets the minimum technical criteria set forth in section 510 of the Rehabilitation Act of 1973; and

(iii) the number of employees of health care providers trained in disability awareness and patient care of individuals with disabilities; and

(E) require that any reporting requirement imposed for purposes of measuring quality under any ongoing or federally conducted or supported health care or public health program, activity, or survey includes requirements for the collection of data on individuals receiving health care items or services under such programs activities by race, ethnicity, sex, primary language, and disability status.

The authors of the law are letting us see a few of their cards. They are clearly looking to use the collected data to support mandates relating to "disability training and patient care of individuals with disabilities." I also believe that the last sentence means that we may see attempts to mandate foreign language translation capabilities in even the smallest of physician offices -- something that has popped up intermittently in other parts of this law.

Who will have access to all of this information? The answer is chilling:

(1) IN GENERAL- The Secretary shall make the analyses described in (b) available to--

(A) the Office of Minority Health;

(B) the National Center on Minority Health and Health Disparities;

(C) the Agency for Healthcare Research and Quality;

(D) the Centers for Disease Control and Prevention;

(E) the Centers for Medicare & Medicaid Services;

(F) the Indian Health Service and epidemiology centers funded under the Indian Health Care Improvement Act;

(G) the Office of Rural health;

(H) other agencies within the Department of Health and Human Services; and

(I) other entities as determined appropriate by the Secretary.

(2) REPORTING OF DATA- The Secretary shall report data and analyses described in (a) and (b) through--

(A) public postings on the Internet websites of the Department of Health and Human Services; and

(B) any other reporting or dissemination mechanisms determined appropriate by the Secretary.

Everyone -- including the public via the internet -- will have access to the analyses. Two paragraphs later, the law authorizes the Secretary to "make data ... available for additional research, analyses, and dissemination to other Federal agencies, non-governmental entities, and the public. ..." [Emphasis added.] As a result, not only will the analyses be made available, but so will the raw data.

Towards the end of Section 4302, the law addresses patient privacy issues:

(1) PRIVACY AND OTHER SAFEGUARDS- The Secretary shall ensure (through the promulgation of regulations or otherwise) that--

(A) all data collected pursuant to subsection (a) is protected--

(i) under privacy protections that are at least as broad as those that the Secretary applies to other health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033); and

(ii) from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary; and

(B) all appropriate information security safeguards are used in the collection, analysis, and sharing of data collected pursuant to subsection (a).

I'm not sure if the authors of this section understood what they have written. There is simply too much water under the bridge for Americans to believe that the federal government will be competent at the task of protecting such huge amounts of private information. Furthermore, there is no provision made for requesting patient consent for data collection. As an individual American, you will neither be asked for your consent nor even be notified when your health care information is assimilated by the Department of Health and Human Services. Finally, none of this deals with one of my primary privacy concerns as a physician -- to keep medical information private from the government itself.

The bottom line is that as a result of Section 4302 of the PPACA, The Department of Health and Human Services is now required to extensively and invasively collect personal medical information and widely distribute it in various forms including in its raw state. It is impossible to believe that the confidential nature of the doctor-patient relationship can survive in this new environment.

I have one last question. Will the Secretary be gathering information on reproductive health?

Dr. Arie Friedman, M.D. is a general pediatrician and medical practice owner in Northern Illinois.

[neverdem]

It's not just "The Death of Medical Privacy," but patients won't be forthcoming and honest in divulging medical histories, so more testing will be needed to make the diagnoses. Repeal the Patient Protection and Affordable Care Act of 2010. It's probably loaded with more unintended consequences.

[Clintonfatigued]

Here’s another act that needs to be repealed.

[Clintonfatigued]

Libertarian ping

[Vince Ferrer]

paragraph (D) authorizes the Secretary of HHS to obtain any additional information whatsoever if it fulfills the purpose of investigating health "disparities." Nowhere in this section is there an actual definition of "health disparities." As a result, one can begin to get a picture of the limitlessness of this mandate.

What if the government will not pay for a certain procedure or drug for you, so you pay it in cash. Would that be a disparity? If so, what is the penalty?

[ExTexasRedhead]

Makes all the privacy BS one has to sign at their doctor’s office a JOKE!!!!

Big Brother wants to decide if you live or die based on the information they collect (religion, age, ..... Sound like Germany 1933 yet???

[lovesdogs]

It's not just "The Death of Medical Privacy," but patients won't be forthcoming

No kidding. My dr's office personnel handed me a new form last week. It included some reasonable questions that had already been asked and answered. But some new ones were: Do you use seat belts?, have you ever used illegal drugs?, is there abuse in your home?, and the real kicker...are there guns in your home? I would not answer any of these questions and wrote a great big THIS IS NONE OF YOUR BUSINESS on the form.

My Dr explained that the government is forcing them to ask a certain amount of questions off of a list. She told me that the ones they selected were the least intrusive. Apparently the questions that they declined to ask were even worse. I am very hesitant about what I will and will not tell her from now on out. If there is even the tiniest risk of public disclosure, who in the world will be totally frank with a medical provider?

[hal ogen]

Make up weird data for them on things that are irrelevant for your medical visit. Screw with the system. It is OK to lie to a tyrannical government.

[onedoug]

DEATH PANELS

[SaraJohnson]

You now have to know that the government is in the examining room with you when you go to the doctor. Any notes they take become a part of your record and the government has ordered records be computerized and open to the government.

So...all of us will be angels and doctors will be “baffled” as to why we are ill.

[itsahoot]

Would that be a disparity? If so, what is the penalty?

That is the cool part, whatever the regulatory agency that hasn't yet been appointed, says it is.

[chris_bdba]

Did this overturn HIPAA or does this violate that law?

[GailA]

OBAMACARE MEDICINE KIT

[arkady_renko]

i) under privacy protections that are at least as broad as those that the Secretary applies to other health data under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033); and

[bamahead]

Libertarian ping! Click here to get added or here to be removed or post a message here!
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[neverdem]

Did this overturn HIPAA or does this violate that law?

I don't know, but being a thousand or two thousand plus pages long, I won't be surprised if parts are in conflict.

[neverdem]

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[oprahstheantichrist]

Thanks for the ping. This is the guy I voted for in the primaries, IL 10th district. He didn’t win, sadly.

[bert]

Death should be provided for those who wrote this monstrosity of liberty killing tyranny. Absent severe and memorable punishment, it will never completely go away. It is now precedent to be referred to forever by the tyrants who survive the coming war

[FreedomPoster]

I would expect that many parts are in conflict with HIPAA.

Of course, you won’t have standing to argue for your own medical privacy, and/or the question will get decided by activist statist judges.

[CSM]

Yep, the dems (libtards) have effectively legislated away Roe. The libtard followers that celebrate murdering the unborn are celebrating their legislating control over my physical being while handing us the tools to make any “medical procedure” illegal.

Dolts.