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CCHF Health Freedom eNews

September 26, 2012

President's Commentary

Computerized medical records increase costs and threaten lives. In the past 10 days the harsh and unpleasant, but completely predictable, truth about computerized medical records has emerged.

First, consider the cost. Health information technology was supposed to save the health care system  $77.8 billion a year. In 2004, President G.W. Bush issued an executive order to build a national health information network (NHIN). In 2009, Obama's Congress appropriated  $36.5 billion to build the NHIN using financial incentives for doctors and funding state-based health information exchanges (HIEs). The 2009 Recovery Act ("stimulus") also threatens doctors with financial penalties in 2015 if they refuse to buy and use an interoperable (linkable, online) electronic medical record.

Now in a major  review of 35,510 studies of health information technology (IT) -- a review funded by the U.S. government -- researchers from McMaster University confirm, "The savings claimed by government agencies and vendors of health IT are little more than hype," wrote professors Stephen Soumerai and Ross Koppel in  The Wall Street Journal. Of the 35,510 studies only 31 examined outcomes in light of the cost-saving claims, and with few exceptions, "the preponderance of evidence shows that the systems had not improved health or saved money."

The New York Times also  reveals that use of health IT (computerized medical records) increases costs for Medicare. With just the click of a mouse, a doctor can "clone" previous detailed histories or choose a "standard exam" box which charges Medicare for a complete exam even if it was never done. This is a major problem with "template-generated" systems. 

Second, consider patient care. As Soumerai and Koppel report, the software "is generally clunky, frustrating, user-unfriendly and inefficient." 

I'll add that it's unsafe. In 2005, JAMA published a  paper by Koppel and co-authors showing health IT facilitates 22 types of medical errors. Christopher Nemeth and Richard Cook  wrote a response in a bioinformatics journal: "There really is a problem with healthcare IT and the problem is not an artifact of the particular system that the paper's research covered...Heeks et al. have contended that 'many - even most - health care information systems are failures.'"

I love their reason why. As they explain:



"The core issue is to understand healthcare work and workers. On the surface, healthcare work seems to flow smoothly. That is because the clinicians who provide healthcare service make it so. Just beneath the apparently smooth-running operations is a complex, poorly bounded, conflicted, highly variable, uncertain, and high-tempo work domain. The technical work that clinicians perform resolves these complex and conflicting elements into a productive work domain. 

Occasional visitors to this setting see the smooth surface that clinicians have created and remain unaware of the conflicts that lie beneath it. The technical work that clinicians perform is hiding in plain sight. Those who know how to do research in this domain can see through the smooth surface and understand its complex and challenging reality. Occasional visitors cannot fathom this demanding work, much less create IT systems to support it.

In other words, if you aren't a doctor or a nurse, you have no idea what's really going on. They continue: "...[H]ow should we view these new IT systems that garner such enthusiasm? They are, in a word, experiments." 

This makes you a guinea pig. How do you like being forced to participate in a knowingly flawed experiment when your life depends on it? Talk to your doctors and nurses about this. And tell your candidates for Congress how you feel now before they are elected. Let's start moving toward a repeal of the NHIN, the HIEs and the EHR mandate.

Now on to the news . . .

News to Know:

Bill Frist Goes Liberal

Current GOP members of Congress are not impressed. A week ago, former U.S. Senator and former Majority Leader Bill Frist (R-TN) told POLITICO, "I am supportive of exchanges and 'Obamacare' generally."  In a commentary in  The Week, he asserts, "As a doctor, I strongly believe that people without health insurance die sooner...State exchanges are the solution. They represent the federalist ideal of states as 'laboratories for democracy.'...I love the diversity and the innovation."

Frist is talking the talk of the Left. Lack of insurance kills no one. And like many of his former colleagues, Frist must not have read the Obamacare law although it's been available for two years. All state-run Exchanges must follow this federal law and nearly 13,000 pages of federal regulations (so far). There's no democracy, no diversity, no independent state laboratory. And it certainly isn't "federalist," unless he defines that word as federal control. Wouldn't you like to know who's lining his pockets? It could be the single-payer advocate, the Robert Wood Johnson Foundation. He, along with Obama's former budget director Peter Orzag, just became new  trustees of the RWJF Board of Directors. 

Sicker by the Numbers

Health plans can no longer refuse to cover the sick even if the sick never paid a dime to the company. As a result, health plans are no longer insurance companies. To offset this financial risk, Obamacare  requires states to conduct "ongoing analysis of all insurance transactions, customers and claims in each state." They must create "individualized risk scores" for all people. Using these numbers (scores), government will transfer "risk adjustment" payments from insurers with lower-risk enrollees to those with higher-risk enrollees using Obamacare "risk corridors" for the payments.

As one analyst said, "the entire country is going to get a lot sicker on paper." Another said, "an insurer will have an incentive to give people the absolutely most thorough physical of their lives when they join because if there is even a trace of conditions like cancer or diabetes or whatever, the insurer may be able to get more risk adjustment money." 

STUDIES: Newborn Screening Should Require Consent

It's the end of Newborn Screening Awareness month. Here's some good news: two new reports on Newborn Screening support informed parent consent. One report,  "Maintaining Trust in Newborn Screening: Compliance and Informed Consent in The Netherlands" concludes that due to  various unexpected findings from newborn screening (false-positives, carrier status, genetic data on parents, untreatable conditions), consent requirements would maintain parent trust and compliance with the screening. 

Another study called  "Newborn Screening in America: Problems and Policies," was just published by The Council for Responsible Genetics. Their report includes information from an interview with CCHF's president. The author concludes that the screening program and the storage of newborn dried bloodspots (DNA) "evolved purely through happenstance, instead of developing through critical, strategic planning" resulting in "disadvantages of the system being overlooked or dismissed." She also notes that non-invasive prenatal genetic diagnosis (NIPD) could take the place of NBS, but lead to changes in the "characteristics of the human population" through abortion.

The author discusses recent lawsuits over storage of baby DNA, and suggests "a two-tiered model of consent with separate opt-in informed consent procedures for both screening and storage of newborn bloodspot samples." She notes that NBS "is one of the few forms of genetic testing to which almost everyone is exposed," yet a Utah study found "limited" parental knowledge of the screening and the storage. She concludes that "the absence of informed consent procedures in many states is troubling" and regarding a need for discussion and debate about the program's practices, she writes, "this discussion cannot happen quickly enough." [emphasis added]

Prisoner Euthanasia in Belgium

Several years ago euthanasia activist Philip Nitschke praised euthanasia as possibly "the last frontier in prison reform." Now we learn that between 2005 and 2009, four Belgium inmates were voluntarily euthanized and their organs donated. This made the news in 2011 when it was leaked to a concerned politician. Belgium euthanasia laws contain certain protections: the request be repeatedly made, the patient be in constant and unbearable physical or psychological pain, and two or three doctors must approve the request.  But Michael Cook, author of  BioEdge, says even if these criteria are adequate for ordinary people, they are "absurd" for prisoners:

"Prisoners are psychologically vulnerable. For some of them, their confinement itself is a source of constant and unbearable psychological pain. They are clearly a burden that the state will not regret shedding. They are often friendless and alone in the world. They can be under acute pressure to conform to norms set by other prisoners. A craze for euthanasia could easily sweep through a jail."

HIPAA's "Blue Button" Ruse

Two years ago, the Veteran Affairs Adminstration created the Blue Button to "enable patients to view and download their information in simple text format." The Office of the National Coordinator (ONC) is advancing the Blue Button  for all patients. Patients could send data from their providers to their "personal health records," email accounts, and other holding places. ONC's Farzad Mostashari,  says the Blue Button "moves us from personal health records tethered to this particular provider's or that particular health plan's data source to the concept of a personally controlled health record."

This is all part of HIPAA's facade of privacy and control. The patient has no control over his own record. Furthermore, the personal health record (PHR) is not the same as the more detailed electronic health record (EHR) created by the clinic and hospital. The so-called federal HIPAA privacy rule, combined with the HITECH Act,  gives 2.2 million entities access to the EHR without patient consent. The Blue Button, the "personal health record," and the "HIPAA privacy form" patients are asked to sign are all meant to convince patients that they have control and privacy when they have none.

Stats of the Week:

$308 billion - cuts to Medicare Advantage (HMO plans) that are part of the  $716 billion cuts under Obamacare (Politico Pro, 9/21/2012).

$14,500 - per bed cost to hospitals to buy an electronic health record system (BNA Health IT, 9/14/12).

$2,700 - annual per bed cost to hospitals to operate an EHR (BNA Health IT, 9/14/12).

500,000 - jobs that could be lost in the health care sector next year under sequestration.

News Release of the Week:

Oklahoma Suit Against IRS Highlights Government Overreach of Affordable Care Act

ST. PAUL, Minn. - Oklahoma Attorney General Scott Pruitt filed an amended complaint to his lawsuit against the Affordable Care Act, alleging that a new IRS rule violates the Administrative Procedures Act and conflicts with the Affordable Care Act.

Though Oklahoma does not plan to create a state-based health insurance exchange, the federal government is allowed to implement an Exchange on behalf of the state, Now, the IRS has created new rules associated with the Affordable Care Act which were not properly vetted using the Administrative Procedures Act and may therefore be illegal. The ACA allows only state-based Exchanges to issue tax credits and premium subsidies, but the new IRS rules allow the federal Exchange to issue tax credits and premiums subsidies. According to the Citizens' Council for Health Freedom, this administrative overreach threatens businesses in Oklahoma and around the country with significant tax increases. Continue reading

Featured Health Freedom Minute:

Big Database in the Sky

The Institute of Medicine wants a unified health database they call a "Knowledge Network of Disease." It would hold data from doctors, labs, medical device companies, insurers, government, medical record companies, researchers, and patients. The data would include DNA, diagnosis, treatments, clinical trials data, claims data from insurers and other data. Continue reading

Twila Brase broadcasts a daily, 60-second radio feature, Health Freedom Minute, which brings health care issues to light for the American public. Health Freedom Minute airs on the entire American Family Radio Network, with more than 150 stations nationwide in addition to Bott Radio Network with over 80 stations nationwide.

Click here to listen to this week's features.

Citizens' Council for Health Freedom
161 St. Anthony Avenue, Ste 923
St. Paul, MN 55103
Phone: 651.646.8935 • Fax: 651.646.0100

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