It’s hard to miss and even harder to ignore the headlines on the war against opioids. (Shouldn’t it be a war against addiction instead???) MedPage Today reported that the second bundle of opioid-related bills — 32 in this bundle, for a total of 57 — had passed committee and was on its way to the House for consideration.
One of the bills, The Overdose Prevention and Patient Safety Act substantially changes the confidentiality standards for substance abuse. According to the MedPage Today article, “Specifically, the act would allow anyone involved in treatment, payment, or healthcare operations — e.g., healthcare providers, health plans, and healthcare clearinghouses — access to patient information without first requiring a patient’s consent.”
I don’t even know where to begin.
This means we are stripping patients of a basic right to privacy about their medical records. And notice the word “anyone” would have access. When you extrapolate what this means, this is such a broad spectrum of access you might as well post the information on Facebook (which is looking to get into medical records, anyway).
Unfortunately, I think this merely a symptom of a much larger disease of which most of us are unaware.
At the end of April, Dr. Elizabeth Lee Vliet wrote an excellent article exposing major threats to patient privacy in wake of the disclosure that Facebook was exploring the medical records business. (This is worth reading.)
In addition to Facebook involving itself in our private lives, in 2014 the TARP (Troubled Assets Relief) act was passed. While this was a stimulus act to help the economy, it had a seemingly unrelated provision. In support of Medicare and Medicaid programs, it required physicians to adopt electronic medical records. (We’ve all had varying, interesting experiences with those.) What most people don’t realize that these records are then required to be sent electronically to the federal government — without further patient consent. As Dr. Vliet points out, this is patently unconstitutional.
The medical information compiled in the database would then be used to decide which treatments would be allowed based on such factors as age, weight, health condition, life expectancy, and “quality adjusted life years” (QALYs). In effect, your own medical data is then used against you to deny medical treatment you may need but the government decides is “unnecessary” or too costly.
But wait, it gets better.
On May 6, a 10-year federal government program was launched called “All of Us.” It’s goal is to compile your personal medical and lifestyle information. It isn’t just focused on medical treatment you may receive, as specified in TARP. This project seeks ALL of your personal health and lifestyle information: medical records, psychiatric records, drug abuse/addiction treatment, lifestyle, personal habits, your physical measurements such as blood pressure, weight, lab results, all health care visits, medications you are taking, AND even your DNA.
Theoretically this information is going to be used for research. Research for what? By whom? Will it be used as global data showing trends or will you be specifically targeted because your DNA indicates you may be at risk for certain diseases or personality traits?
When I think of all those HIPAA forms I’ve signed in countless doctors’ and medical facility offices telling me how they are safeguarding my privacy, I don’t know whether to laugh or to cry. I feel like Dorothy in The Wizard of Oz being told not to pay attention to the man behind the curtain. In this case, the man behind the curtain is the federal government accumulating, using, and sharing our personal patient data.
We’ve been — and are being — robbed and we didn’t even know it. Worse, there are no cops to call.
In writing this post, I have borrowed heavily from Dr. Vliet’s excellent article. I am grateful to her for the research and opinions she provided.