Health care reform

The doctor-patient relationship has long been confidential and covered by legal privilege.

by Mary Budinger — 

Tucked into the federal economic stimulus bill is a massive health care reform package. The details will take time to be worked out, but it is clear, out of the starting gate, that the government will have much more involvement in your health care than ever before. It is not clear yet just who will be considered a health care provider — massage therapists?

Electronic medical records have gotten the green light; privacy advocates say you will have no privacy. Hospital records, which now exist only in each hospital’s computer system, will soon be accessible through a national database. By the end of 2014, every visit you make to a doctor’s office and a pharmacy will become part of that electronic national database.

The Department of Health and Human Services will access your information without your knowledge or permission for what is called “research purposes.” Many assurances have been made about how the data review will protect our identities.

The doctor-patient relationship has long been confidential and covered by legal privilege. Without confidentiality, patients cannot be expected to be forthcoming. A nationalized, central clearinghouse for electronic health records threatens to overturn the nature of that relationship.

Protection of privacy has a dismal track record. Remember when Britney Spears was in the hospital and her records were leaked? Or when Joe the Plumber’s tax records made it to the newspaper? Want to run for public office? What if someone gets a hold of your records and claims that an antibiotic you took for infection was really taken for an STD? Nobody — nobody — wants their medical records on the front page.

“Like so much in medicine, government’s intrusion into the control over all of our health information can appear innocuous, but turns out to be pernicious,” said Dr. Eric Novack, a Glendale, Ariz., orthopedic surgeon. “The authorized spending of $20 billion will turn out to be a drop in the bucket of the real financial costs to enact the proposed system, but the real cost will be the ceding of control over our most precious possession — our health — to faceless, nameless bureaucrats in Washington.” Bank records, for example, are not contained in a central, nationalized database.

Novack spearheaded Arizona’s Proposition 101 last year, which was designed to preserve the right to make a full array of choices in health care services, including the right of individuals to pay directly for medical services without needing the permission of a third party. Providers would have been exempt from requirements that they either charge fees set by the government or charge nothing.

“If you like Halliburton, you will love national health care because you can count on one hand the number of companies the government can turn to for this big job,” Novack says. “Health care is four times the size of defense. If you think corruption and a lack of transparency in military contracts are problems, just wait until the concept gets applied to health care.”

Dr. Novack is deeply committed to getting the basic principles of Proposition 101 back to the ballot in 2010. He is confident that victory can be achieved with adequate resources, a clear message and the support of everyone who believes in the simple concept: “My health belongs to me.”

Mary Budinger is an Emmy award-winning journalist. She is a medical freelance writer and researcher about and for alternative medicine. 602-494-1999.

Reprinted from AzNetNews, Volume 28, Number 2, Apr/May 2009.