Tuesday, February 10, 2009

Step One of Government Health Care Takeover Hidden In Stimulus Package

Here's the followup on today's earlier post on Bloomberg's piece about hidden health care legislation in the stimulus package. I'm afraid we're a bit behind on this one. My searches today showed that the other bloggers have been talking about it for weeks- we took notice only after Rush and Drudge brought it to national attention yesterday. My only excuse is that the stimulus bill was so depressing that we never looked at it. Maybe that was their strategy all along.

There is a lot of discussion about the hidden health care policy in the bill and I'm not sure how accurate it all has been. I've gone to the bill itself to try to make sure that my description of the health care inclusions in the bill are accurate. I'll also point out that the following discussion is not the only reason to oppose the bill. In principle the whole thing stinks. These are just some of the especially low points. Under the guise of a anything-is-justified-because-the-sky-is-falling stimulus package we usher in the beginning of the Obama socialized medicine era.

The bill establishes a National Coordinator for Health Information Technology. His purpose is to oversee the development of a federal electronic health care system (pp 441). Included among his duties the director ‘‘(2) improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patient-centered medical care; ... (4) provides appropriate information to help guide medical decisions at the time and place of care;... (9) promotes prevention of chronic diseases; (10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and (11) improves efforts to reduce health disparities." (pp 442).

Isn't that fantastic? We now will have a government officer, probably to be reverently referred to as Mr. (or Ms.) Coordinator, that will make health care better. He will lovingly "guide medical decisions at the time and place of care." He will promote prevention of chronic disease. He will promote a more effective market place- isn't that great, the federal government will step in to help the market be more of a market! He will help improve health disparity. If we're lucky, he may even turn back death.

‘The National Coordinator shall, in consultation with other appropriate Federal agencies... update the Federal Health IT Strategic Plan... to include specific objectives, milestones, and metrics with respect to... the utilization of an electronic health record for each person in the United States by 2014." (pp 445)

The National Coordinator will appoint the HIT committee (Health Information Technologies Committee) composed of "providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information." (pp. 457)

This committee will advise the Coordinator on how to best achieve his stated mission of stepping in to help the market be a safer and more federally-approved market, help doctors make good decisions, etc. Perhaps this group will make the Coordinator's decisions bipartisan if he can't get bipartisan support from democratically elected officials.

The biggest question I have is whether health care practitioners will be forced to use the electronic medical system. Will they will be forced to follow The Coordinator and the People's Committee's recommendations on appropriate medical decisions, having a "more fair" market, spreading the wealth, etc?

I couldn't find a clear answer to that question. The bill talks about paying practitioners to use the electronic system, but those provisions were found under the headings of Indian Health Services and Medicare. However, the following slightly menacing statement is found at least twice in the bill: "The Secretary shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use..." (pp 518, pp 541)

I sincerely believe that a national medical database is not a bad idea. It is an idea that deserves discussion. But it's not getting that discussion. It's being ramrodded down senators' throats by President Obama. He tells them we're in a national crisis. Don't think about it- just vote yes.

But this database, and especially the powers attached to the Coordinator, are a big deal. They take up over 100 pages of the 680 page stimulus package. This is Phase One of Obama's Change for socialized medicine. Why is it buried in the stimulus bill? Is the Democratic Force for Change afraid America wouldn't support it in open discussion?

Rusty Scalpel

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