Bush Administration Decides Not to Require Written Patient Consent for Sharing Medical Records

No, that WAS the goal of the Clinton Administration HCFA 1995, 1997, and 1999 codes. But then again, you are clearly not involved in the medical billing process.

really?

I can show that California Governor takes money from HMO's. Wanna see?

we physicians can NOT receive payment from the insurer unless we tell the insurer what we did and why. That forces us to release your medical information to them, or else YOU have to pay for the visit.

This way the government will be able to cull out the unworthy easier.

CATO

Actually, IHMO, third party payors (like health insurance companies) have no reason to evaluate the specifics for a patient visit. However, Clinton attempted to force data sharing between the insurers and providers. The third party payors do not need to be making database systems to pivot and rotate data (invading patient privacy in the process).

You are incorrect in your interpretation of HIPAA. The original concern posted was correct and is indeed what is occuring.

Good points, Bones, but I just don't trust W doing any kind of shortcuts with the status quo.

I just don't think the Constitution and personal liberty means anything to him.

I would be willing to give W the benefit of the doubt, if it were January 2001, but you know he has not given me or any conservative a single reason to trust or to like him.

But you are right on about the costs of health care.

You are entirely correct. In fact, I receive daily emails from various companies (many based in Florida) who use scare tactics to panic doctors into blowing hundreds of dollars on "compliance" books, consulting, and measures.

Yes I know and it's about time that you all are able to get back to what you do best. Focus on cures and healing the sick without a trial lawyer in your waiting room.

There probably would be "miraculous healings" of many with ailments that are strung on for the purpose of getting a quick buck if defrauders knew there was no paycheck in it.

WilliamWallace1999, you made a little Haiku with your attacks on Action-America that you apparently think are necessary in order to make your point:

     you big dufuss
     wackos like you
     the dork you are

Since you seem to have some understanding of this, I think that Haiku is beneath you.

Everyone, just how safe do you feel when you get "privacy notices" that say "we do not release any personal information except as permitted by law?" Not safe.

I do not think that some understand the privacy regulations contained in HIPAA, because if they did they would not be defending any aspect of it, including the recent "adjustments." Moreover, just because you think that any individual can somehow by taking uncommon actions avoid losing his or her privacy is no reason to advocate ill-advised and illegal federal programs that will in fact hurt the privacy of most of the population.

HIPAA was permitted to pass by a pathetic REPUBLICAN Congress simply because RINO Bob Dole did not want RINO Nancy Kassebaum to retire without ever having done one proactive thing in her career. It's a classic example of a bill too big to be understood by Congress critters. Few even read the bill, as usual. It handed a huge victory to HillaryCare advocates. We thought we won in 1994, and then let down our guard and so were sabotaged by Bob Dole and his ilk.

Moreover, in its implementation Congress specified (illegally abdicating its job to make the laws) that if Congress had not written HIPAA privacy details by a certain date that they would let the regulations be written by none other than Donna Shalala, the woman who once cluelessly confused cirrhosis and psoriasis, and her bureaucratic minions. The Republicans then IRRESPONSIBLY sat on their hands until the deadline passed so the Democrats got to craft the details!

HIPAA therefore represents a disgusting and traitorous (to true Republicans) and wholesale surrender by the Republicans to the Democrats. Loyal Republicans who are not RINOs are therefore very much upset by HIPAA and see nothing good about it, and your defense of it is therefore remarkable.

The fact of the matter is that Electronic Medical Records were not the true impetus for the HIPAA "privacy" regs -- just the opposite. Electronic Medical Records are what finally make wholesale massive privacy invasion possible for the government and its little fascist allies like RAND. The removal of explicit permissions is exactly what they have been after all along because they want to mine the information. The HIPAA act itself STANDARDIZES all electronic healthcare transactions (as to transmission protocols) and therefore makes it much more likely that privacy violations can occur on a massive scale. Moreover, it virtually REQUIRES electronic medical records because it is too hard to comply with many of the provisions without them. And the more electronic records there are, the easier they are to steal. Therefore it meets the classic MO of the Clintonistas:

(1) decide what freedoms you want to limit in order to gain power,
(2) pick a method for stopping the freedoms which can be named something exactly the opposite of what is actually happening (steal medical privacy by using a "privacy protection act"),
(3) write regulations that will cause a massive outpouring of protest by conservatives who were not fooled in the first place,
(4) read the protests and deduce from them the methods by which the opposition will plan to get around those rules,
(5) ignore the protests but re-write the regulations to route around the conservative opposition and be even more onerous and self-sustaining,
(6) IMMEDIATELY upon implementation make sure that you steal the gold--make sure that many corporations like RAND, in the name of "research," steal all the information and do all the damage they can, and even ship the information offshore; and when the Republicans finally wake up most of the genie will be out of the bottle forever even if they repeal HIPAA.

So now they get the final piece of what they want. Instead of an unworkable act that would be repealed promptly due to its unworkability, they now get even more permission to export and mine personal medical information combined with a de facto packaging of that information into electronic records systems which are required to communicate using a standardized health information transfer protocol. A perfect setup for the government medical complex / Big Brother.

HIPAA needs to be completely repealed right now. Maybe the frustrating and idiotic parts will help assure its repeal sooner. People who are willing to fight and pay cash for medical care (which actually will only help if the physician is not a "covered entity" on HIPAA) in the name of privacy should not be advocating "sugar coating" of HIPAA to make it more palatable to either patients or the medical care community, because that will only permit HIPAA to become more firmly entrenched.

You are beyond clueless about this issue. If you want personal privacy, then don't let somebody else pay for your healthcare. The majority of the healthcare dollars spent today are by EMPLOYERS. If you want the shareholders to foot the bill for your care, then you give up your libertarian autonomy you big dufuss. If you want privacy, then get out your checkbook and PAY FOR YOUR CARE. Negotiate your own deals.

Tell me if you have home owners insurance do you allow the company to come in with a camera and take pictures of all your belongings and personal items as a term of coverage? Or would you say hey it's my privacy either except the risk and my money or go away? Privacy is privacy. Insurance by employer is part of EARNINGS or in LEU of WAGES FOR WORK PERFORMED. One way or another either through Higher Wages or by benefit this need will have to be addressed. So referring to the stockholders like they are some mistreated party paying for it is Hog Wash. A worker is worthy of pay. Services are provided by worker Bartering is done by employee & employer as to the terms of payment & benefits.

There are several reasonable issues to address. One is HMO and Insurance companies contract or sub contract their pharmaceutical coverage. Among the big names involved is Merck/Medco. So much for the promised privacy and the pharmaceutical companies not getting your info. As a sub contractor the info won't be sold but rather shared with them.

There's good reasons for medical insurance though. This is not the good old days. The good old days before MRI's and nuclear medicine and other treatment and diagnostic measures. A week in the hospital with prudent testing I think if paid out of pocket would wipe out about 90% of the posters in here lifesaving's then some. Catastrophic Illness Insurance will work to just a certain extent. It has to reach a very substantial amount to kick in. So in the mean time which do you do feed the family or pay the hospital?

Private Insurance can work. Medium sized companies {voluntarilly} not mandatory} can cut the expense on the share holders by becoming at least partially self insured. They should be encouraged to purchase such by tax breaks as well as self employed and others worker who pay private premiums. The payroll clerk or some one in the companies office oversees & writes the re-embursment checks to the employee. You need answers they give them. In event of catastrophic illness the company carries a separate policy to cover this so it doesn't wipe out the companies assets or effect profits.

The major fault right now in health care was done by congress itself when it created the HMO act. Up until that time market pressures kept private pay insurance in check. The insurance company diversifies a portion of their premiums into other investments. HMO's on the other hand are shell companies set up to ration out health care with little or no capitol or investments to cover their risk. All money above payout goes into CEO & management wages and shareholders while providers set by trying to work through the gauntlet of justifications and paper work the HMO's can dish out. Yes they will spend $15 in labor to deny payment for a $15 dollar procedure.

As well in HMO's you have so called medical directors playing ghost doctor second guessing your private care physician and diagnosing you without so much as ever seeing you in person. What is driving up health care? HMO's that's what.

My pharmacist has 6-8 persons doing what he and 2 others were doing just 10 years ago. The others are writing out paper work dotting I's crossing T's for the HMO looking for even the slightest hint of a very small clerical error to deny payment for as long as possible.

The doctor had to hire extra staff & take extra patients for the same reason. Yet you will see both parties cheering this on. The HMO & insurance industry is the most represented business in this nation. It as well enjoys having nearly two thirds of our laws & codes on the books written for the sole purpose of protecting their profit margins.

Somewhere in between these problems is answers all can live with. Number one rescind the HMO act. If they want business then they should be held to the standards of any other business. If they want to play doctor then they should be subject to malpractice if their decisions result in harm. Like I said before cap the liability either to a reasonable amount for damages or loss or if a life long damage they should be made to cover it. Why are HMO's being allowed better protection than a skilled surgeon who risk life, livelihood, and does the work at risk? Yes they are human and things happen either by act of GOD or the patient simply doesn't make it.

Too many doctors are sued over just this. Yet the same doctor can also say hey I think there is a likelihood of cancer I want such and such test done. Let me call your HMO and see about it. Well there's two kinds of test one is much less revealing of early stage cancer the other test can not only find in real early but during the testing can be removed. The doctor says I really feel better with a full test. The HMO says our medical director says do a partial. And partial it is. No cancer detected though medical warning signs indicated a possibility.

The same patient in two months shows up in the Emergency room with stage 4 cancer possibly curable but likely not. Now who do you think is responsible for this? The doctor who did the test? Not me! I would blame the HEY MOE'S Stooge medical director who did a diagnoses without seeing the patient and dictated the type procedure to be done. I think the patient is entitled to damages. Congress thinks otherwise. Now the person needs money, needs treatment, and has a family to support. Who is sueable? Who is going to be held accountable? In far too many cases the doctor who was right to begin with. The person who wanted to do what he knew was right.

Both parties need a good kick in the teeth for what they have done. Neither party could care less about you privacy, your rights, or even justice in a court of law.

BTW I'm not an ambulance chaser. I've know some one close to me who had just cause to ruin to doctors careers who needed ruining. One eventually killed a teenager through gross negliance. Neither were sued nor a settlement asked for. I'm sick and tired of paid off politicans giving away rights to corporate interest.

I can show that California Governor takes money from HMO's. Wanna see?

I believe you but the problem isn't isolated to California politics.

Trust them right! I have read the small print in some of the consent forms and I have either crossed out wording or written in other things. Health professionals are all just a part of a big money making corporation most of the time and it is money first. This is not a time when we have good ole house doctors that really care about your health. You are just a dollar to many and a number.
MCD

Your insurance company knows the specific tests you have had and want them to pay for. It wouldn't take a rocket scientist to figure out if you had a T Helper and Supressor every week and a HIV by PCR what your diagnosis was. Medical Necessity, gov reg, only allows you to have tests directly related to your diagnosis. So if the Dr. has ordered a GC and Chlamydia he's looking for STD's. You would be surprised how little privacy you actually have.

Thank you for taking the time to give such a cogent and thoughtful account of how we got into this current mess. If more people would actually explain what the situation is instead of attacking/lauding Bush and/or Clinton or belittling other posters for a lack of knowledge, we would have much more understanding of this issue.

So, I will ask you. Is there anything in either the Clinton or the Bush version of the regs that improves the situation, or are we just piling on more and more harmful rules? Why doesn't Bush just totally scrap the Clinton regs and let's make do with the status quo if we can't get the federeal government out of these issues altogether?

That's what I mean by my question:what problem are we trying to solve?

Tell me if you have home owners insurance do you allow the company to come in with a camera and take pictures of all your belongings and personal items as a term of coverage?

You prove my point with that statement alone. Unless you have photodocumentation of you personal effects or have had a site inspection by the insurance company, then good freaking luck trying to get them to pay off because you SAY there use to be a big screen TV in that hole in the wall. Have you ever tried to file a claim for stolen or destroyed "private" stuff?

Also, I did not let on I WAS a doctor; because I assumed THEN you would rant on about them and WELL YOU DID. I am a medical director for a small RURAL group and we are looking at a HUGE increase in cost to comply with this poorly thought out "privacy" law. We are going to spend an additional $500,000 just in the next year to comply with the idiotic regs promulgated by the government YOU seem convinced was trying to PROTECT you with this law. I can speak from personal experience that physicians all over the country were dreading the institution of these draconian regulations that the insurance industry had alread figured a way around. Medical management journals and meetings have been about almost nothing else for the last two years. Just ask yourself if you believe in this statement, "I'm from the government, and I'm here to help". Now look at which senior senator from New England is the FIRST to come out with a proposal to reverse GW's actions and ask yourself if you are really in the right.

There is no doubt that Sundquist ruined the both Tennessee economy and the reputation of the good Republicans in the state. My brother lives in Nashville and told me that people were moving from Kentucky just to live in Tennessee for the "free health care." Sundquist's low popularity and bad policies are reasons why Bush would not campaign with him in 2000.

My point is that you "proved" Bush was in favor of certain legislation simply because a person who favored those ideas endorsed him.

If this is how we define polititians, how would we label Pat Buchanan who was endorsed by skin-heads and racists?

I am living the regulatory quagmire created by Klintoon. The ad hominem attacks on the other poster were a visceral reaction to some of the "tin-foil" hyperbole manifest in his dissertation. As a red-neck with education, I find that issues with resonance in my own life seem to elicit some deeply repressed desires to "whup that boys ass". I humbly apologize to the other posters, but reserve the right to move between erudite commentary and my "Jeff Foxworthy" routine. BTW to Action-American, here's your sign.

I thought you all(especially Libertarians) were against Bush implementing the original Clinton EO. Now that he has discarded it, you all are still up in arms.

You're not surprised, are you?