The Death of Medical Privacy in America



By Arie Friedman, MD

As I have read through the Patient Protection and Affordable Care Act of 2010 (PPACA, aka ObamaCare), I have been repeatedly struck by the disregard the law has for patient privacy. Time and time again, the PPACA authorizes the federal government to obtain information about patients directly from their health care providers. A particularly vivid example is Section 4302, "Understanding Health Disparities: Data Collection and Analysis." Section 4302 literally opens up almost every medical record in this country for government review and data collection. Let's go through the section with an eye towards patient privacy issues:

(1) IN GENERAL- The Secretary shall ensure that, by not later than 2 years after the date of enactment of this title, any federally conducted or supported health care or public health program, activity or survey (including Current Population Surveys and American Community Surveys conducted by the Bureau of Labor Statistics and the Bureau of the Census) collects and reports, to the extent practicable--

(A) data on race, ethnicity, sex, primary language, and disability status for applicants, recipients, or participants;

(D) any other demographic data as deemed appropriate by the Secretary regarding health disparities.

There is no pussyfooting around in this first portion of Section 4302. Within two years, the Secretary of Health and Human Services will be obtaining extensive health and demographic data about every patient who participates in federally supported programs or who interacts with a public health department. This would encompass every single patient who participates in Medicare, Medicaid, TRICARE, or the Supplemental Children's Health Insurance Program (SCHIP). It is also a good bet that data will be obtained from the Veterans' Administration, government employees' health insurance programs, and patients receiving medical care at local Boards of Health. Lastly, I suspect that various regulatory mechanisms will empower state and local Public Health Departments to collect this data on everyone.

It is worth noting that the description of data to be collected is quite broad. Aside from the laundry list of information to be collected, paragraph (D) authorizes the Secretary of HHS to obtain any additional information whatsoever if it fulfills the purpose of investigating health "disparities." Nowhere in this section is there an actual definition of "health disparities." As a result, one can begin to get a picture of the limitlessness of this mandate.

Much more HERE

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