Friday, March 13, 2009


Computerization of personal health-care records is one of the showcases 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 doctors and hospitals computerizing patient record and creating electronic health-care tracking systems.

The ultimate goal of the Obama program is “the utilization of a certified electronic health record for each person in the United States by 2014,” as the stimulus bill stated. But having a massive electronic database will make it far easier for the government to coerce both doctors and patients. This is a peril as bad or worse than the Patriot Act.

Now less than 20 percent of the nation’s physicians have gone full speed on computerization. Mr. Obama’s plan offers grants of between $40,000 and $65,000 to doctors’ offices that computerize patient records, and up to $1 million per hospital. But if health records are digitized on the federal dime, it will be far easier for politicians to claim the resulting information.

While the Obama administration is showing the smiley face now, its plan calls for federal penalties for doctors who have not computerized their records by the year 2014.

One goal for the new federally subsidized computerization is creation of systems able “to exchange electronic health information with, and integrate such information from other sources.” This is a huge step toward a national database.

Team Obama and its congressional supporters promise the government will scrupulously respect the privacy of the newly-computerized private medical data. This is reminiscent of President George W. Bush’s 2004 false promise that no American was being wiretapped without a warrant.

The feds have an appalling record for protecting the confidentiality of veterans’ health care records. The issue is not whether the personal health information government commandeers will be abused. Instead, it is simply a question of when, where and how it will be exploited.

Medical data do not simply track how many times a person went to his doctor seeking a cure for a runny nose or stubbed toe. Medical records could include details on long-ago abortions, impotence or sexually transmitted diseases, anti-depressants and details of breakdowns, or HIV-positive status.

Access to personal mental health records makes it easier to exploit someone’s vulnerabilities. Psychologists were brought to Guantanamo to exploit the weaknesses of detainees for interrogations. The same peril could face the millions of Americans who received psychological treatment if their records are fed into centralized databases.

When a policeman pulls you over for a speeding ticket, he could quickly access a database with your health records - including any therapy. Even before he walked up to your car window and demanded your identification, he would know if you had a “problem with authority.”

What if the Internal Revenue Service agent who audits you knows all your secret fears, as disclosed to a therapist years ago? Would you trust the government to play fair in such a situation?

Yet politicians tell us not to worry. Actually, privacy is very lucrative for congressmen: They reap millions of dollars when they betray it. Rep. Roy Blunt, Missouri Republican, and Sen. Tom Harkin, Iowa Democrat, each received more than a million dollars in contributions from health professionals and the pharmaceutical industry since 2000, and each sponsored industry-favored amendments in the stimulus bill that would undermine patient privacy, The Washington Post reported. Campaign contributions will ultimately determine how centralized health data are used.

The perils of a database on 300 million Americans’ health records must be seen in light of the other data the federal government has already gathered. The Pentagon’s pursuit of Total Information Awareness on the American people - combined with Congress’ contempt for assuring that federal agencies obey the law - illustrates why surveillance horrors have only begun.

The Obama mandate is guaranteed to further subjugate doctors and patients to politicians and bureaucrats. Citizens will be stuck with the huge bills for creating their own digital fetters. But destroying real privacy for a bogus promise of health care is a fool’s bargain.

James Bovard is the author of “Attention Deficit Democracy” (2006) and eight other books. This piece is adapted from an article in the current issue of American Conservative.

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