Thursday, September 24, 2009

Health Care Reforn: Letting It All Hang Out

The American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009, includes billions in provisions for healthcare information technology (health IT).
The idea is to have one unified, computerized system with everyone's complete health care records on it, in one place, accessible by medical professionals. The "up" side is that our records will be available to doctors and/or medical people in case of emergency. We will no longer have to fill out paperwork every time we see a new doctor; everything will be available to him or her with a few clicks of a mouse. And in theory our insurance information should be there as well.
The "down" side is that whoever has access to the system will be able to know virtually all our medical history, including treatment for depression, venereal diseases, drug or alcohol problems, sexual preferences and problems, and anything else that might appeal to a snoop's prurient interests.
"Oh," you say. "That doesn't bother me. I have nothing to hide." And perhaps you don't right now. I can't help remembering that one of the early jobs for the Watergate burglars was to get Daniel Ellsberg's medical records from his psychiatrist's office. Obviously any astute political person would take steps to make sure that his/her personal records stay off this proposed system.
And what about everyday people? I was in a doctor's office recently where I could hear someone on staff blurt out, "He's got AIDS," about a patient who had just left. No, I never went back to that office.
But over the years I have heard stories of Mr. X who has an artificial, well, thing. (Snicker.) I wonder if he has any idea that's public knowledge. Or politician Y whose chart indicates his life expectancy is, well...."He's got one foot in the grave, and the other is on a banana peel." Wouldn't the other guys like to know about that? Or nice young lady Z who came in for testing, because "her former boyfriend developed syphilis lesions." Hmmm...and she applied for a teaching job? And these are the sort things one catches in passing without really wanting to know.
Yes, there are some things that are desirable about a huge, grand database. But wise is he who has a physician he can trust, who will on request keep certain information off the system. No matter what safeguards or sanctions they put in place to protect our medical information, human nature being what it is, there is absolutely no way anyone can guarantee that it will remain confidential.

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