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<DIV><FONT face=Arial color=#0000ff><A
href="http://news.yahoo.com/s/csm/20091123/cm_csm/yblevins">http://news.yahoo.com/s/csm/20091123/cm_csm/yblevins</A></FONT></DIV>
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<H1>Senate health care bill: the five paragraphs you must read</H1>
<DIV class=byline><CITE class=vcard>By Sue Blevins and Robin Kaigh </CITE></DIV>
<DIV class=byline><CITE class=vcard></CITE> </DIV>
<DIV class=byline><ABBR class=timedate
title=2009-11-23T01:00:00-0800>Mon Nov 23, 4:00 am ET<SPAN
class=937104718-24112009> </SPAN></ABBR>– "There is no such thing as a
little freedom," said <SPAN class=yshortcuts id=lw_1259011299_0>Walter
Cronkite</SPAN>. "Either you are all free, or you are not free."</DIV>
<P>Whether you're for or against federal efforts to help people buy health
insurance, you should know that the reform bill before the Senate would mandate
a healthcare system that is definitely "not free."</P>
<P>What most of us know about the Democratic bill is that it requires nearly all
Americans to have health insurance. What most of us don't know is that it
requires us to buy a minimum level of insurance approved by the federal
government, and forces health plans and providers to share our personal health
information with the federal government and other entities.</P>
<P>If this bill becomes law, we could each be assigned a national beneficiary ID
number or card (possibly an <SPAN class=yshortcuts id=lw_1259011299_1>electronic
device</SPAN>). And our personal health information will flow electronically to
the US secretary of Health and Human Services (HHS) – and many others – without
our consent.</P>
<P>Sound farfetched? Buried in the Senate bill's 2,074 pages are provisions that
actually permit and foster such things. Freedom and privacy are often lost in
the fine print – which is why we've been studying the Senate bill since it was
released Nov. 19 to help uncover the facts. Here are five highly invasive
provisions Americans should know:</P>
<P><B>1. Mandatory insurance</B><BR>Bill text: "Sec. 1501. Requirement to
Maintain Minimum Essential Coverage.... An applicable individual shall for each
month beginning after 2013 ensure that the individual, and any dependent of the
individual who is an applicable individual, is covered under minimum essential
coverage for such month."</P>
<P>Translation: Uncle Sam will now serve as your <SPAN class=yshortcuts
id=lw_1259011299_2>national insurance agent</SPAN> and force you to buy "minimum
essential coverage" – or else you'll have to pay an annual fine.</P>
<P>However, what Congress considers "minimum essential coverage" and "essential
health benefits requirements" includes comprehensive coverage that many neither
need nor want. Plus, those who prefer to carry catastrophic-only coverage won't
have a free range of options for such coverage.</P>
<P>Bottom line: In a <SPAN class=yshortcuts id=lw_1259011299_3>free
society</SPAN>, the government should not force citizens to buy any product nor
should the government mandate citizens' level of health-insurance coverage.</P>
<P>Rather than imposing penalties to coerce people into government-sanctioned
health insurance, Congress should offer incentives to help those who wish to buy
insurance but find it unaffordable.</P>
<P>Congress could allow everyone to deduct the full cost of health insurance
(and provide tax credits for those with no tax liability), while offering
assistance to those who can't afford insurance and subsidize high-risk pools for
those with preexisting conditions.</P>
<P>Helping those in need is a much better way to reform our nation's healthcare
system than overhauling the entire system and putting Big Brother in charge of
deciding what is acceptable coverage for nearly every American.</P>
<P><B>2. <SPAN class=yshortcuts id=lw_1259011299_4>Electronic data
exchanges</SPAN></B><BR>Bill text: "Sec. 1104. Administrative Simplification….
(h) Compliance. – (1) Health Plan Certification. – (A) Eligibility for a Health
Plan, Health <SPAN class=yshortcuts id=lw_1259011299_5>Claim Status</SPAN>,
<SPAN class=yshortcuts id=lw_1259011299_6>Electronic Funds Transfers</SPAN>,
<SPAN class=yshortcuts id=lw_1259011299_7>Health Care</SPAN> Payment and
Remittance Advice. – Not later than December 31, 2013, a health plan shall file
a statement with the Secretary, in such form as the Secretary may require,
certifying that the data and information systems for such plan are in compliance
with any applicable standards (as described under paragraph (7) of section 1171)
and associated operating rules (as described under paragraph (9) of such
section) for electronic funds transfers, eligibility for a health plan, health
claim status, and health care payment and remittance advice, respectively."</P>
<P>Translation: Requiring everyone to buy federally sanctioned health insurance,
and then forcing qualified plans to comply with Administrative Simplification
requirements, provides the government and health industry with power they would
not be able to exercise in a free market.</P>
<P>Administrative Simplification rules are a product of the <SPAN
class=yshortcuts id=lw_1259011299_8>Health Insurance Portability and
Accountability Act</SPAN> (HIPAA) of 1996. They lay the foundation for a
nationally linked database of personal health information. A federal "<SPAN
class=yshortcuts id=lw_1259011299_9>Nationwide Health Information
Network</SPAN>" (NHIN) is well under way in the United States, without
assurances that individuals will control their personal health data.</P>
<P>Bottom line: Americans should be able to contract privately with the
insurance companies of their choice. Patients should be able to decide whether
to have electronic or paper medical records, and not have the government require
electronic records, which are then included in a nationally linked database.</P>
<P><B>3. Real-time health and financial data</B><BR>Bill text: "Sec. 1104.
Administrative Simplification…. (4) Requirements for Financial and
Administrative Transactions. – (A) In General. – The standards and associated
operating rules adopted by the Secretary shall – (i) to the extent feasible and
appropriate, enable determination of an individual's eligibility and financial
responsibility for specific services prior to or at the point of care.... (i)
Eligibility for a Health Plan and Health Claims Status. – The set of operating
rules for eligibility for a health plan and <SPAN class=yshortcuts
id=lw_1259011299_10>health claim status</SPAN> transactions shall be adopted not
later than July 1, 2011, in a manner ensuring that such operating rules are
effective not later than January 1, 2013, and may allow for the use of a machine
readable identification card."</P>
<P>Translation: Administrative Simplification rules are being expanded to gather
real-time financial and health data on individuals through a tracking ID,
possibly a "machine readable" ID card (<SPAN class=yshortcuts
id=lw_1259011299_11>electronic device</SPAN>).
<P>Bottom line: Moving forward with <SPAN class=yshortcuts
id=lw_1259011299_12>real-time data collection</SPAN> without an ethical patient
consent provision means everyone loses their health-privacy rights. Congress
needs to enact strong patient consent provisions for all health data, especially
data collected "real-time."
<P><B>4. Health data network</B><BR>Bill text: "Sec. 6301. Patient-Centered
Outcomes Research.… (f) Building Data for Research. – The Secretary shall
provide for the coordination of relevant Federal health programs to build data
capacity for comparative clinical effectiveness research, including the
development and use of clinical registries and health outcomes research data
networks, in order to develop and maintain a comprehensive, interoperable data
network to collect, link, and analyze data on outcomes and effectiveness from
multiple sources, including <SPAN class=yshortcuts
id=lw_1259011299_13>electronic health records</SPAN>."
<P>Translation: Your personal health information may soon be studied by
government scientists. Washington is creating a <SPAN class=yshortcuts
id=lw_1259011299_14>new research center</SPAN> that plans to use patients'
electronic health records for conducting research and creating disease
registries. The data network is comprehensive and includes use of electronic
health records.
<P>Bottom line: <SPAN class=yshortcuts id=lw_1259011299_15>Federal funds</SPAN>
should not be used to collect data electronically and conduct research on
patients' personal health information without their consent.
<P><B>5. Personal health information</B><BR>Bill text: "Sec. 6301.
Patient-Centered Outcomes Research…. (B) Use of Data. – The [Patient-Centered
Outcomes Research] Institute shall only use data provided to the Institute under
subparagraph (A) in accordance with laws and regulations governing the release
and use of such data, including applicable confidentiality and privacy
standards."
<P>Translation: Think your health privacy is protected? It's not. This language
refers to "applicable confidentiality and privacy standards," but HIPAA's <SPAN
class=yshortcuts id=lw_1259011299_16>so-called privacy law</SPAN> permits
individuals' personal health information to be exchanged – for many broad
purposes – without patients' consent (See 45 CFR Subtitle A, Subpart E – Privacy
of Individually <SPAN class=yshortcuts id=lw_1259011299_17>Identifiable Health
Information</SPAN>; section 164.502(a)(1)(ii) "Permitted uses and disclosures").
<P>Bottom line: Trust is a must for ensuring quality healthcare. Thus, as stated
above, Congress needs to pass a strong, ethical patient consent law that ensures
patients have control over the flow of their personal health information.
<P><B>What about the consent of the governed?</B><BR>All told, the national
mandatory health-insurance bill puts the federal government in charge of
individuals' insurance choices and data privacy. This philosophy of governing is
the opposite of America's founding principle: consent of the governed.
<P>Without health freedom and privacy rights, Congress is opening the door for
many wrongs to be committed – all in the name of covering the uninsured.
<P>Sue Blevins is president of the Institute for Health Freedom in Washington.
Robin Kaigh is an attorney and medical-privacy advocate in New
York.</P></DIV></BODY>
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