Tags: Another | HIT | Health | Care

Another HIT on Health Care

Wednesday, 18 May 2005 12:00 AM

Whether we are ready or not, Big Brother increasingly demands control of Americans' medical information.

In a recent effort, former House Speaker Newt Gingrich teamed up with Sen. Hillary Rodham Clinton, D-N.Y., in support of the 21st Century Health Information Act of 2005, introduced into Congress on May 11 by Reps. Tim Murphy, Republican from Pennsylvania, and Patrick Kennedy, Democrat from Rhode Island.

According to Gingrich, the bill would allocate money for federal grants to support private-sector initiatives to adopt Health Information Technology (HIT). This is one step further to "mandate the use of electronic systems to drag the medical system into the 21st century" to help achieve his goal of a "collaborative government" that "manages by outcomes."

Last year, Sen. Clinton foretold a bright future when overseers can "connect the dots of our conditions and our care over the years" with "electronic connectivity."

Sen. Edward Kennedy, D-Mass., calls adoption of health information technology a "peaceful revolution" that will bridge the "quality chasm" while controlling costs.

These politicians imply that health information technology is about improving health care and reducing costs. We find that it's actually about centralized control of American medical care.

If the technology favored by Gingrich and Clinton is so great, why have doctors and hospitals not already adopted the kinds of health information technology advocated?

After all, modern medicine is already awash with technology. In our own field of radiology, information technology makes possible such technologic advances as computed tomography (CT), magnetic resonance imaging (MRI) and sonographic imaging.

These technologies were adopted and used by the medical profession because they improved diagnosis and treatment of human ills – not because of an answer-to-all-evils mandate by government.

Additionally, both doctors and patients increasingly use the Internet because of the treasure trove of medical information available.

But health professionals have been relatively slow to adopt electronic medical records.


One important reason is the very stringent legal requirements for the management and privacy of patient data included in the 1996 Health Insurance Portability and Accountability Act (HIPAA).

On the one hand, so-called privacy laws restrict even routine sharing of medical data and threaten physicians with imprisonment for not handling patient data correctly. On the other hand, legislators propose mandating creation of even more government-controlled medical information databases available to government-authorized persons. These would allow government agents even more tools for observation, policing and control.

Medicare insurance carriers already deny Medicare claims because of simple and easily corrected errors found in electronic and paper claims. Will Medicare also start withholding payment if a patient's health information files don't pass muster with a Medicare clerk? We can bet on it.

States can already take a physician's license away for keeping "inadequate" records. This throws the doctor out of medical practice, regardless of how well he actually takes care of patients.

We observe that federal grants, such as those proposed in the new bill, usually foster only one type of innovation – finding ways to get more grant money. By diverting creative people from research and innovation to mining for grant money and political favor, government financial incentives most often impede real innovation.

With computer capacity continuing to expand at Moore's law rates (doubling of computer chip capacity and power every 18 months or so) and the additional compounding of information-processing power of networked computers, the prospect for knowledge-enhancing medical care is wondrous and pregnant with possibility. But rapid advances require many and diverse experimental applications, not a tight fit to the specifications of a federal grant program.

In addition, government grant specifications will, by definition, be behind the times because it's impossible for anybody to plan for creativity, as noted by George Gilder in his seminal book "Wealth and Poverty." After all, creativity is something that happens tomorrow that nobody thought of today.

Parenthetically, this is also why central planning, especially in socialism, is always behind the times.

Attempts to reduce medical errors with health information technology can actually increase errors in the real world as medical professionals concentrate on filling in paperwork instead of listening to and examining the patient.

What about computer helping make important medical information available for emergencies? Dr. Jane Orient, executive director and past president of the Association of American Physicians and Surgeons (AAPS), writes:

"In a true emergency, review of the old medical record is one of the last things a good physician does. First, he takes care of the ABCs: airway, breathing, circulation. Next, he obtains the history of what recently happened (which will not be in the chart!), probably while simultaneously examining the patient. He is also ordering tests to evaluate the patient's current status. Last week's EKG, chest X-ray, or blood sugar doesn't matter nearly as much as today's."

Crucial items of past history such as serious allergies should be on a Medic-Alert bracelet, not somewhere in cyberspace.

Currently, doctors and hospitals are using or testing thousands of computerized medical-records systems; some will be fruitful while others will die away. And this is vastly preferable to having the government eventually dictate one way to use information technology in medicine.

To encourage natural growth and innovation, Congress does not need to pass another health care act. Instead, it should repeal a great number of laws, beginning with the egregious Health Insurance Portability and Accountability Act (HIPAA) of 1996 and other onerous restrictions, such as those limiting the medical freedom of Medicare recipients.

Legislators are meddling in medicine – not to help us, but to control us.

Tell them to back off.


Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues.


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Whether we are ready or not, Big Brother increasingly demands control of Americans' medical information. In a recent effort, former House Speaker Newt Gingrich teamed up with Sen. Hillary Rodham Clinton, D-N.Y., in support of the 21st Century Health Information Act...
Wednesday, 18 May 2005 12:00 AM
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