Magazine article The American Conservative

Health of the State: The President's Plan for Your Medical Records

Magazine article The American Conservative

Health of the State: The President's Plan for Your Medical Records

Article excerpt

THE COMPUTERIZATION of personal healthcare records is one of the showpieces of the new stimulus bill. President Obama promised, "We will make the immediate investments necessary to ensure that within five years all of America's medical records are computerized." Congress ponied up $19 billion to subsidize the digitization of patient files and creation of electronic healthcare tracking systems. The ultimate goal is "the utilization of a certified electronic health record for each person in the United States by 2014."

Shoved into a 1,400-page bill passed in a panic, the plan went largely undebated. But the implications are horrifying. Doctors will be coerced into a massive federal healthcare scheme, and government will serve as the leaky repository of patients' most intimate information. Much as the Patriot Act pried, this measure intrudes on a far more personal level. No patient left behind--or alone.

The president promises that computerizing doctors' records will "cut red tape, prevent medical mistakes, and help save billions each year." But in fact, the federal mandate is likely to destroy the progress being made with voluntary efforts to computerize records in a way that assures confidentiality and individual control of health data.

At this point, fewer than 20 percent of the nation's physicians have gone full-speed on computerization. Obama's plan offers between $44,000 and $64,000 to doctors who computerize patient records and up to $11 million per hospital. "On the stick side of the equation," the Wall Street Journal reported, "the measure includes Medicare payment penalties for physicians and hospitals that are not using electronic health records by 2014." If records are digitized on the federal dime, it will be far easier for politicians to claim the resulting information.

But the feds have no technological silver bullet to distribute to docs across the land. David Kibbe, a top technology adviser to the American Academy of Family Physicians, warned Obama in an open letter late last year that existing medical software is often poorly designed and does a miserable job of exchanging information. Kibbe declared, "If America's physician practices suddenly rushed to install the systems of their choice, it would only dramatically intensify the Babel that already exists."

Marc Roberts, a Harvard professor of political economy and health policy, notes, "Many healthcare systems are now intentionally building medical record systems that are nonstandardized and noncompatible so they can own and control the data."

In the same way that George W. Bush bragged about the percentage increase in homeownership, President Obama will be able to boast about the increase in doctors' offices using electronic records. It didn't seem to matter to Bush that many of the new federally subsidized homeowners went bankrupt, and it may not matter to Obama that the federally controlled health-record system is bound to be a trainwreck.

The administration estimates that digitizing health records will create 212,000 jobs. But the New York Times noted in January, "So far, the only jobs created have been for a small army of lobbyists trying to secure money for health information technology." At best, the plan will create jobs for legions of clerks. The low skills required would make a mockery of the promise that digitizing records will result in a sharp decrease in medical errors since the data-entry process would almost certainly produce vast bogs of blunders. Perhaps the real job creation will be for undercover agents to go around to doctors' offices to see whether there are compliant keyboards on the premises.

The idea that the feds will be dictating quality standards for private businesses is laughable, considering Uncle Sam's abysmal record on computer modernization. The IRS and the FBI have each gone through buckets of billions of dollars in vain efforts to create computer systems that were non-Paleolithic. …

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