The political argument against health IT
Lots of people want to limit healthcare automation, judging from talkbacks here at ZDNet Healthcare.
Their rallying cry is privacy. A group called Patient Privacy Rights, headed by Texas psychologist Deborah Peel (right) and lobbyist Ben Barnes, is their advocate. (Picture from Womenvote.)
Their mission statement does not say they're against automation. Just the opposite. They just want informed consent for every release of records.
This sounds fine until you're faced with your first HIPAA form. You can't get service without signing the form. So what good is the form?
Far more important than releasing the information is assuring that it's not misused. But PPR even opposes the use of anonymous data, like Google's work tracking the flu.
So what is the real issue here?
As Peel wrote to The New York Times this week, the bogeyman is the misuse of data in order to limit access to "jobs, credit and opportunities in life."
Isn't the real enemy, then, health insurance underwriting, which pushes employers to get around privacy in order to limit risks and costs? Then look at PPR's board and who do you find -- a former Blue Cross lobbyist, Charles E. "Ed" Baxter!
If health coverage is guaranteed, and patient health is not an issue in making employment decisions, then the incentive to get private data on patients is greatly reduced.
This does get right back into the question of health IT. Because, as Express Scripts has proven, there is no such thing as "ironclad security."
Deal with the underwriting issue and the value of most thefts like that at Express Scripts drops to near zero.
Sure, there will be blackmailers, and lawsuits, and incentives for individual people to go after your personal "secrets," like the fact you were a psychological patient of, say, Dr. Deborah Peel.
But law enforcement can deal with that threat. Security people can deal with most hackers seeking single records. It can't deal with the more systemic threat of employers or insurers seeking risk reduction by denying coverage or claims.
Thus are the problems of health care reform and health IT reform linked tightly together, by politics.