Opinion
Senate health care bill: the five paragraphs you must read
Buried in the Senate's 2,074-page health reform bill are
provisions that undermine your health freedom and privacy.
By Sue Blevins and Robin Kaigh
from the November 23, 2009 edition
Washington and New York - "There is no such thing as a little
freedom," said Walter Cronkite. "Either you are all free, or
you are not free."
Whether you're for or against federal efforts to help people buy health
insurance, you should know that the reform bill before the Senate would
mandate a healthcare system that is definitely "not free."
What most of us know about the Democratic bill is that it requires nearly
all Americans to have health insurance. What most of us don't know is
that it requires us to buy a minimum level of insurance approved by the
federal government, and forces health plans and providers to share our
personal health information with the federal government and other
entities.
If this bill becomes law, we could each be assigned a national
beneficiary ID number or card (possibly an electronic device). And our
personal health information will flow electronically to the US secretary
of Health and Human Services (HHS) – and many others – without our
consent.
Sound farfetched? Buried in the
Senate bill's 2,074 pages are provisions that actually permit and
foster such things. Freedom and privacy are often lost in the fine print
– which is why we've been studying the Senate bill since it was released
Nov. 19 to help uncover the facts. Here are five highly invasive
provisions Americans should know:
1. Mandatory insurance
Bill text: "Sec. 1501. Requirement to Maintain Minimum
Essential Coverage.... An applicable individual shall for each month
beginning after 2013 ensure that the individual, and any dependent of the
individual who is an applicable individual, is covered under minimum
essential coverage for such month."
Translation: Uncle Sam will now serve as your national insurance
agent and force you to buy "minimum essential coverage" – or
else you'll have to pay an annual fine.
However, what Congress considers "minimum essential coverage"
and "essential health benefits requirements" includes
comprehensive coverage that many neither need nor want. Plus, those who
prefer to carry catastrophic-only coverage won't have a free range of
options for such coverage.
Bottom line: In a free society, the government should not force
citizens to buy any product nor should the government mandate citizens'
level of health-insurance coverage.
Rather than imposing penalties to coerce people into
government-sanctioned health insurance, Congress should offer incentives
to help those who wish to buy insurance but find it unaffordable.
Congress could allow everyone to deduct the full cost of health insurance
(and provide tax credits for those with no tax liability), while offering
assistance to those who can't afford insurance and subsidize high-risk
pools for those with preexisting conditions.
Helping those in need is a much better way to reform our nation's
healthcare system than overhauling the entire system and putting Big
Brother in charge of deciding what is acceptable coverage for nearly
every American.
2. Electronic data exchanges
Bill text: "Sec. 1104. Administrative Simplification…. (h)
Compliance. – (1) Health Plan Certification. – (A) Eligibility for a
Health Plan, Health Claim Status, Electronic Funds Transfers, Health Care
Payment and Remittance Advice. – Not later than December 31, 2013, a
health plan shall file a statement with the Secretary, in such form as
the Secretary may require, certifying that the data and information
systems for such plan are in compliance with any applicable standards (as
described under paragraph (7) of section 1171) and associated operating
rules (as described under paragraph (9) of such section) for electronic
funds transfers, eligibility for a health plan, health claim status, and
health care payment and remittance advice, respectively."
Translation: Requiring everyone to buy federally sanctioned health
insurance, and then forcing qualified plans to comply with Administrative
Simplification requirements, provides the government and health industry
with power they would not be able to exercise in a free market.
Administrative Simplification rules are a product of the Health Insurance
Portability and Accountability Act (HIPAA) of 1996. They lay the
foundation for a nationally linked database of personal health
information. A federal "Nationwide Health Information Network"
(NHIN) is well under way in the United States, without assurances that
individuals will control their personal health data.
Bottom line: Americans should be able to contract privately with
the insurance companies of their choice. Patients should be able to
decide whether to have electronic or paper medical records, and not have
the government require electronic records, which are then included in a
nationally linked database.
3. Real-time health and financial data
Bill text: "Sec. 1104. Administrative Simplification…. (4)
Requirements for Financial and Administrative Transactions. – (A) In
General. – The standards and associated operating rules adopted by the
Secretary shall – (i) to the extent feasible and appropriate, enable
determination of an individual's eligibility and financial responsibility
for specific services prior to or at the point of care.... (i)
Eligibility for a Health Plan and Health Claims Status. – The set of
operating rules for eligibility for a health plan and health claim status
transactions shall be adopted not later than July 1, 2011, in a manner
ensuring that such operating rules are effective not later than January
1, 2013, and may allow for the use of a machine readable identification
card."
Translation: Administrative Simplification rules are being
expanded to gather real-time financial and health data on individuals
through a tracking ID, possibly a "machine readable" ID card
(electronic device).
Bottom line: Moving forward with real-time data collection without
an ethical patient consent provision means everyone loses their
health-privacy rights. Congress needs to enact strong patient consent
provisions for all health data, especially data collected
"real-time."
4. Health data network
Bill text: "Sec. 6301. Patient-Centered Outcomes Research.…
(f) Building Data for Research. – The Secretary shall provide for the
coordination of relevant Federal health programs to build data capacity
for comparative clinical effectiveness research, including the
development and use of clinical registries and health outcomes research
data networks, in order to develop and maintain a comprehensive,
interoperable data network to collect, link, and analyze data on outcomes
and effectiveness from multiple sources, including electronic health
records."
Translation: Your personal health information may soon be studied
by government scientists. Washington is creating a new research center
that plans to use patients' electronic health records for conducting
research and creating disease registries. The data network is
comprehensive and includes use of electronic health records.
Bottom line: Federal funds should not be used to collect data
electronically and conduct research on patients' personal health
information without their consent.
5. Personal health information
Bill text: "Sec. 6301. Patient-Centered Outcomes Research….
(B) Use of Data. – The [Patient-Centered Outcomes Research] Institute
shall only use data provided to the Institute under subparagraph (A) in
accordance with laws and regulations governing the release and use of
such data, including applicable confidentiality and privacy
standards."
Translation: Think your health privacy is protected? It's not.
This language refers to "applicable confidentiality and privacy
standards," but HIPAA's so-called privacy law permits individuals'
personal health information to be exchanged – for many broad purposes –
without patients' consent (See 45 CFR Subtitle A, Subpart E – Privacy of
Individually Identifiable Health Information; section 164.502(a)(1)(ii)
"Permitted uses and disclosures").
Bottom line: Trust is a must for ensuring quality healthcare.
Thus, as stated above, Congress needs to pass a strong, ethical patient
consent law that ensures patients have control over the flow of their
personal health information.
What about the consent of the governed?
All told, the national mandatory health-insurance bill puts the federal
government in charge of individuals' insurance choices and data privacy.
This philosophy of governing is the opposite of America's founding
principle: consent of the governed.
Without health freedom and privacy rights, Congress is opening the door
for many wrongs to be committed – all in the name of covering the
uninsured.
Sue Blevins is president of the Institute for Health Freedom in
Washington. Robin Kaigh is an attorney and medical-privacy advocate in
New York.
http://www.csmonitor.com/2009/1123/p09s04-coop.html
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