Is all the emphasis on making medical records electronic a first step

[BR_Parkway]

in steering us into single payer health care? Obama knows the backlash they'd create if he just announced a plan like that and would have to work carefully step by step to not trigger that at this point. Sure, he's stated that he's going to support affordable, private insurance - but he's also very pragmatic. He knows the public and polls are on his side. He knows he'd have to fight Congress and the entrenched money interests.

But as he's talking past the media filters directly to the public, he keeps mentioning it - today going a little further about how hard it is for US companies to compete with foreign companies that don't have health care costs.

But if we were going to move to single payer - having an electronic system set up and in place is an obvious requirement. And I'm a firm believer that the steps taken that we see today are still 3-4 places behind the steps in this man's mind.

[ThomWV]

1. It is a start to both that and a national ID card.

And who knows, maybe some clever fellow or gal in one of our intelligence agencies might find use for such a data base too.

[lynnertic]

3. Which is the Mark of the Beast.

Just kidding (but there is danger. It'd too easy to link medical records to National ID. There are REAL concerns about how electronic health records can be used in a discriminatory fashion.)

(How fun will it be to suddenly get viagra ads in the mail shortly after being diagnosed hypertensive? Or discover that you're not qualified for a job like 'mail carrier' because your last blood test showed high blood sugar? Or you run for local office and the paper prints how many drinks you have per week?)

(Don't pretend that data breaches don't occur all the time. And the more people who have access to your records - like insurance companies, the more vulnerable you will be.)

I won't say anything bad about them, not out loud.

[ipfilter]

21. Anything new is the mark of the beast. nt.

[lynnertic]

24. I was speaking in hyperbole. I'm not afraid of Beasts. But

(Don't pretend that data breaches don't occur all the time. And the more people who have access to your records, the more vulnerable you will be.)

[KT2000]

2. I don't think so

It has long been an idea to save money. He almost has to do this because it has been floated as necessary to save money for so long. He needs to get it out of the way first.
But you are right - it would make it easier to implement a single payer plan.

[wolfgangmo]

18. I own a clinic

We oppose this move if it is stored in a central database. I cannot guarantee the safety of any records if I do not control the method of storage. If this happens then you will see MASSIVE abuse of information.

Besides, this is VERY expensive to implement and is a being pushed hard by the big conglomerates. Your small local clinic cannot implement this easily. Some of them, and perhaps a majority, would either merge or just go out of business.

Make no mistake, this has nothing to do with universal health care. The 2 issues are completely separate. Canada doesn't use a system like that and neither does any other national health care plan. Japan comes closest.

[KT2000]

19. Interesting.....I also think

it is a bad idea but for other reasons.
I live in a rural community and some doctors participate in a mini version of this. A doctor visit is more of a data entry experience and the patient is supplying the info.

Then - there is another problem. Sometimes a patient's care is determined by the quality of their insurance. Sometimes a dr will dismiss a patient with a stress diagnosis and some meds. That will follow the patient everywhere they go whether it is correct or not. To change that - it becomes a dr against dr situation, and that is sometimes affected by personal relationships within the community.

Electronic records have been recommended as a panacea for saving the current system and saving money but it will not work that way.

[bobbolink]

20. Thanks for speaking out. Doubt many will listen until it's too late...

:(

[OneGrassRoot]

22. I have worked with this industry for 15 years. I agree. n/t

[deaniac21]

4. No, it's just a smart thing to do.

[EFerrari]

6. I don't know of any computer system secure enough to have my record on it.

:shrug:

[Arkansas Granny]

9. That's my greatest concern, also. Who would oversee those records?

The government, the medical profession or would it be outsourced overseas?

[deaniac21]

10. All of those things can be worked out. I don't understand people

afraid of computers.

[Arkansas Granny]

12. It's not fear of computers that concerns me. I'm concerned about who

could gain access to the information. We've all heard stories about computers being hacked and credit information being stolen. If reports are to be believed, even the Pentagon computers have been hacked, and I would imagine that they have some of the strictest security measures available. So, if this info was stolen, could it wind up in the hands and databases of insurance companies and be used to deny coverage or benefits? There is much medical info that should only be known by patients and their medical providers. Who is going to administer this program to insure that all the data remains confidential? Who would you trust?

[BR_Parkway]

15. It's the data breaches that people are afraid of, the identity theft, even

the simple and stupid like some nosy person poking in where they don't belong.

Or the potential for mis-use - and the more ways we can think to combat it, the even more ways folks will come up with something new

[leftofthedial]

5. doing this at the same time as enshrining the private insurance companies

as the perpetual owners of our national "health care," means that individuals are screwed beyond belief.

[Liberal Elitist]

7. Similar project in UK NHS late and overbudget...

..but for some unknown reason politicians are always keen on these IT projects - makes it look like they're doing something I guess.

New NHS computer system on brink of failure, warn MPs:

http://www.guardian.co.uk/society/2009/jan/27/nhs-it-computer-programme-health-public-accounts-committee

[Gormy Cuss]

8. No. The two aren't related.

One can argue that a single payer system should include electronic medical records management for efficiency but the push to handle the records first is mostly likely because of lobbying by those who would benefit from federal underwriting of this task -- the software and insurance companies.

[this_side_up]

11. IMO, it's the foundation for culling

the herd.

The guvmint desk jockeys will decide if you are young enough to benefit from any treatment (i.e. be able to hold a job and produce tax monies for them). If not, too bad. No medical care for problem(s) x, y, z for you.

Curiosity wonders....what are they going to do with those who cannot
be rehabbed? the blind, deaf, paralyzed, mentally ill, murderers, rapists
and child molesters, hard drug smugglers, manufacturers and dealers.

[SoCalDem]

13. No single-payer /universal/ national health care without ID cards

It's just a fact..

[flashsmith]

14. It will make you safer, but won't save money.

I work at a medical practice management software company. Nearly all insurance claims are sent electronically to the insurance company from the doctor's computer system. The insurance company then sends back a rejection the next day. One or two people at the doctors office then have to spend hours on the phone to the insurance company trying to get them to pay a legitimate claim. Often, the doctor has to personally get on the phone to discuss the legitimacy of a procedure with some nurse, candy stripper or lesser medical professional at the insurance company. This is where horrific amounts of money are being squandered. We don't need a single payer system. We just need payers that pay what they owe without the stall tactics.

The current push is for all doctors to use electronic prescriptions. This should reduce the number of people being killed or injured because of a doctors poor handwriting or because of a severe accent when calling in a prescription. Also, if you don't have insurance, you probably shop around at a variety of drug stores to find the best price. You won't be able to get a drug interaction warning since the pharmacy won't have a list of all the drugs you are taking, just the list of drugs you purchased at that particular store. We have to interface with a prescribing system called SureScripts. We send the prescriptions to them and they send it to the pharmacy. I don't believe they do a drug interactions analysis at the moment, but they certainly could if they were in the mood to do so.

The Government is developing a electronic medical record system which they say they will provide to doctors for free. Unless it really sucks, companies like mine are going to have a hard time competing with that. It's already impacted my business as doctors aren't inclined to purchase software that will be available for free in the near future. So, just the software company that got the contract is making money off of it, not the rest of us.

As far as a full electronic medical record, doctor's won't use them unless they are forced to. It takes a lot longer to enter the information electronically then it does to just write it on paper. Time is money, so most doctors won't do it. Only if the government or the insurance companies require it will you ever see it happen.

Regarding a centralized chart for a patient, I can't help but think of the Seinfeld episode where Elaine goes to a doctor to have a rash treated and the doctor writes "Difficult" on the chart. After that, Elaine can't get treatment with any doctor in the city. A centralized chart makes Elaine's experience a possibility for all of us.

By the way, if you think any of your medical records are private, think again. If you have ever sued someone or been sued, the first thing the lawyers do is go after your medical records no matter how irrelevant they are to the case. Your lawyer will bitch about it but the Judge will always grant access. Even mental health records are not sacrosanct. The bar is higher for mental health records but not much. So, anything you tell your doctor can and will be used against you in a court of law. If your going to a shrink, I'd tell him/her you were uninsured, refuse to provide your Social Security Number and pay with cash so the lawyers wouldn't have a trail to follow, especially if you ever plan to become a conservative talk show host with delusions of grandeur.

[Hannah Bell]

16. no, it's a step to centralize *all* your info on a central database,

the better to deny you coverage should anything bad turn up on a checkup.

[Romulox]

17. No, it's a subsidy to insurance co's, and a first step in mandatory private insurance.

President Obama has spoken out against Single Payer. :hi:

[Bread and Circus]

23. Yes, alongside "federal health insurance" that Obama wants to provide.

Federal Health Insurance will be the back door to popularize the notion that the gov't can provide good affordable health care.

Obama knows a frontal assault might get shot down. However, FHI would be the trojan horse for federalized health care as long as they ran it well and it was cost effective.