Must Daschle choose between Ludd or Astroturf

Incoming HHS Secretary Tom Daschle today faces one of his first tests.

Patient Privacy Rights, an Austin-based group we've covered here before, has laid down the gauntlet against the Confidentiality Coalition, an industry-led group which masquerades as a public advocate while carrying business' water.

This sort of activity is conventionally called Astroturfing, the creation of a phony grassroots. Politicians have long used such groups to give the appearance of public input into pro-business politics.

To its credit, the Coalition is transparent about being an industry group. It has no Web site of its own, and the only confidentiality page on the Healthcare Leadership Council Web site makes no mention of it.

It mainly exists in letters to policymakers written by HLT President Mary Grealy or other officers of the group. At need, though, it certainly has the funding to launch a major public campaign. (Maybe we should call it Astroturf seed.)

While Patient Privacy Rights argues that the HLT, and the Coalition, are seeking a "blank check" for health IT from the new Administration, its focus obscures the real issue.

The real issue is the abuse of health information to deny coverage, jobs or advancement. The real issue is the value your health information has to people with an incentive to use it against you.

This creates a false choice between automation and liberty. If Daschle stands with automation, he stands against human rights. If he stands with PPR, he stands for Ludd.

The answer is to eliminate the incentive. That means guaranteeing coverage and eliminating the penalty businesses now face for hiring less than perfect physical specimens.

The political argument over patient privacy and healthcare IT systems does not ask the right question, which should be how to make things so no one cares what's in your file. Reduce the incentive and police can deal with the rest.