Obamacare wants to know us all better....MUCH better.

Did anyone not see this coming? I am a little surprised it's coming as a priority while key areas of the program are being delayed and set aside though. It shows what the main thrust and thinking is for what really matters.

The Centers for Medicare and Medicaid Services (CMS) wants to require health care providers to include “social and behavioral” data in Electronic Health Records (EHR) and to link patient’s records to public health departments, it was announced last week.

Health care experts say the proposal raises additional privacy concerns over Americans’ personal health information, on top of worries that the Obamacare “data hub” could lead to abuse by bureaucrats and identify theft.

Indeed.... I'd say it does raise just a few concerns. Little concerns... Hardly worth mentioning .... Like WHAT precisely does my social behavior have to do with my medical history, if it isn't a DIRECT cause and effect? Smoking to Lung Disease. I get it. Drinking to Liver Diease. Gotcha! ....and we weren't already doing that much? This wasn't already recorded? I find that impossible to believe.

The agency said adding social and behavioral data to patients’ online records will improve health care.

“Increasing EHR adoption has the potential to improve health and health care quality,” the contract’s statement of work (SOW) reads. “Parallel advances in analytic tools applied to such records are fueling new approaches to discovering determinants of population health.”

Ahhh... That isn't the point then. DATA MINING us like little nodes of information to analyze, sort, segregate and order action on is the idea here. How silly to think otherwise.

“It’s including more pay for performance requirements on physicians to collect all sorts of data in order to get government reimbursements,” he said.

The 2009 American Recovery and Reinvestment Act gave authority to the CMS to pay hospitals and doctors that make the switch to electronic health records, to “encourage widespread EHR adoption.”

Source

Anyone else recall being told all that electronic record creation *WOULD NOT* be turned into some super-record on us all? Oops... Another lie told. Another lie forgotten. No surprises....but I'm sure sick of it, eh?

Looks like you guys in the US will be lining up for the chip sooner than you thought, you're now 1 step away.

This is just too funny.

reply to post by wrabbit2000


I guess we all need to do our part in helping reduce spending or unsocial people unhealthy for ..... blah! Can't even finish being sarcastic here.

There is no way that we can allow this to go on like we are caddle.
Stop the world from spinning, I want to get off now.

Personally, I will not be participating in this pogrom. If you choose to do so, you deserve what you have coming. People, it is way past time to stop feeding the beast. Stop paying your taxes. End rampant consumerism; buy only the bare necessities You are all promulgating your own enslavement. STOP NOW!

reply to post by wrabbit2000


I wrote a reply, deleted it.
I wrote another reply, deleted it.

What's to say?

I'm glad this came out, though. Now, maybe now, we can all come together (left, right, liberal, conservative) and say ENOUGH!

This isn't about health care.

It is about control.
It is about invasions of privacy.
It is about a central authority that will invade every aspect of our lives.

reply to post by wrabbit2000


I work for a major insurance provider in the Medicare department. The main reason for this is to keep certain individuals from doctor hopping. Think about it, you go to doctor A for a pain and he gives you narcotics. You want more. Doctor A wont give you more for so many days. SO you go to Doctor B who doesnt know Doctor A already gave you drugs so he prescribes you narcotics as well. Narcotic drug addiction is a rising problem in our country. It is killing people. I bet you also did not know that the majority of people on Medicare under the age of 65 are on Medicare because they get SSI for "psych" illnesses.

Another thing to consider is patients (especially the elderly) are not always forthcoming with their medical history. Some diagnosis depend on thorough histories to determine the real diagnosis.

If a patient comes with aches and pains the doctor may first think arthritis, but if they have a history of psych issues, depression and psych illnesses can be the reason instead and allow the doctor to make a better diagnosis. These same members that do not disclose their REAL entire personal medical /psych history are the same ones that will sue a doctor for malpractice for misdiagnosis. EVERY SINGLE TIME. This costs you and I in the long run and causes our doctors to not be able to affordably provide care.

Everyone screams they want more affordable healthcare. Although I know Obamacare is not the answer. (that is another thread) No one wants to be active in assisting affordable healthcare on their own. As a patient you have an obligation to provide every ounce of truth you can when you fill out that medical questionnaire every doctor gives at a new patient visit. It is crucial. How many people really do it? Very few. I have been guilty myself.

I work with the medicare community (members) every single day. I can tell you they are very shy about asking questions and being proactive in their healthcare. This is just another way to help our providers give the most accurate diagnosis and treatment the first time.

For example, Jane Doe age 78 goes to the new doctor for headaches. She moved to another state. She has past history of migraines but leaves that off of the new patient questionnaire because she is too lazy to properly fill it out. So the new doctor (before shared info) might order a cat scan, start from scratch ruling out a stroke, burdening medicare with thousands of dollars in unneeded tests, where if he had her history he would say, "Mrs. DOe, I see you have a history of migraines. Is this the same kind of headache? " Depending on her response he could then give her meds that she has taken before (lessening chances of side effects and further visits) or order more tests if she says no.

Our elderly, bless their hearts, are private people. When it comes to healthcare we cannot afford for them to be private people.

The HIPAA Privacy Rule provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of health information needed for patient care and other important purposes.

Health care Privacy Act

The bottom line, is Obama (as much as I hate him) did not do this. It was already done. Your healthcare info has always been able to be shared with other healthcare providers.

I think he is being more transparent about it than other leaders in the past.

I hope you know, I am just explaining from the Medicare side why this is necessary. Doctor hopping, failure to disclose previous ailments, they all cost you and I money and raise our rates for insurance.

I am not an advocate of Obamacare. I think it sucks. I think it is going to cause the middle income americans to go without and pay penalties instead of getting treated for illnesses. I think it will cause epidemics in disease. But what do I know? lol

I hope this helped!

Another Obama promise broken. If his teleprompter had an integrated lie detector on it, it probably would have self destructed on the very first day of his campaign..

This item WILL be used and exploited 100% of the time. The entire thing is BS, it is clearly to gain an illegal upper hand against any citizen they don't like, and they are showing that they really don't like, or respect the American citizenry at all

Also, another gun control tool that these social rejects have been swooning over.

They even seem to want triple redundancy on all these new abortions of freedom they are hard at work on.

reply to post by k21968


Your post honestly helps in seeing the micro-reasoning for this piece of the process. It doesn't help at all to address the concern of the process overall.

I think since about a week after NCIC (National Crime Information Center) went online to woo and wow everyone deemed worthy of it's highest access levels, those same people were immediately pitching a fit over some jackwagon in Climax, Idaho entering a typo to cross reference the wrong data on someone important to something.

NCIC was/is, last I knew, still considered the Holy Grail of single source information to just enter a name and stats and get back a digital dossier. For all it's faults, and all it's issues...Nothing much better has replaced it at the level it's used and updated....at least that I've heard of for something usable at all levels.

If this was private...and ALL private-sector, the argument would be moot, but it isn't. It's nothing like private, and you can bet anything that at higher levels, these individual databases are being combined. Databases which need not exist in these forms, and where info could be gotten without the super-centralized and single source solution.

It's making a virtual 'Everthingica on Everyonica'. The new Holy Grail...and I'd guess a few years off at this rate. Although we'll never hear about it, I'm sure. There won't be ribbon cuttings or grand ceremonies with giant cartoon gavels for this achievement. Just for those breathing the rarefied air, deemed worthy of access.

That's my problem, far more than the individual arms making slight over-reaches, on each effort.

Wrabbit,

Your social history matters exponentially when it comes to healthcare.

If you drink alcohol, some medications can kill you or not work at all.
If you have a pysch illness or past history of one, certain meds will exacerbate that illness.

I dont see the conspiracy here. What are your fears of your entire medical history being made available to healthcare providers providing care to you??

What I think you are not saying... is...well...that you are afraid they are going to somehow use this information against you. And the answer is YES they are. But in the way you imagine. They are not oing to herd up the smokers and social drinkers and execute them. What they will do is make you pay exponentially more for your healthcare because you are participating in risky behaviors that can cause your health care needs to be more than a person who doesnt do those things.

Honestly, why would the government care who has PTSD? or who has a phych illness? or who has epilepsy? or migraines? or PMS? or had hernia surgery last week? The only care MEdicare has in this is providing you the consumer the best care it can when you go to the doctor by having your entire history available to the provider who is treating you. It cuts costs and the need for unnecessary tests as I stated before.

I do not know why the government would care otherwise. Please do not think I have drank the medicare koolaid, I assure you there are many things I do not agree with in this imperfect system. Namely benefits being given to 20 somethings who can work but choose to use anything they can to get disability to avoid working. But that is another thread.

Please explain your concerns because I do not understand the big deal.

reply to post by DarthMuerte

Why wouldnt you? You paid into it.

reply to post by k21968
I guess you did not understand my post. I have not and will not pay into this travesty. I will have nothing to do with it. In case you still do not understand, I no longer pay income taxes. I refuse to do so.

This is just one more reason to get off the grid.

We'll never get rid of this.

Obamacare record keeping will be based on the VA medical record keeping system.

Just watch out for them asking non medical questions like the VA does.

Case in point them asking if you own guns.

Or the other little trick of giving out free gun locks to veterans. then putting on your records that you own one or more guns based on the number of gun locks you get.

www.mrconservative.com...
johnrlott.blogspot.com...

reply to post by DarthMuerte



Do you not worry they will seize your assets and bank account and home???

I pay my taxes even though I dont like too. I am on a payment plan with the IRS now. It really does stink.

reply to post by ANNED

My husband receives 100% of his medical care from the VA and NEVER has been asked those questions and he has severe PTSD. Just sayin..I dont know who the guy that has the blog is, but maybe he gave them reason to worry by his actions or words. I know it is not a common practice. My husband has received care at the VA since he retired in 2010 from active military service.

reply to post by k21968


Well, my concerns are based on something I believe I see happening, but has not yet been completed or come to be fully realized yet. As explained above, that has to do with the ever increasing ways of mining us for data. All forms of Data. Every bit, about every thing we do or think or dream. All of it. A good part by Obamacare. Another by every arrestee anymore, in some states (and growing) being DNA printed for State databases. Some other states still hold that as Felony or conviction based..but those states are under increasing pressure to 'get with the program' and drop that down in terms of covered persons.

We have things like REAL ID, where in the state of Missouri we specifically and 100% BY DESIGN passed state law prohibiting our state license bureau from working with or accepting equipment for the implementation of that program here. Low and behold? We all discovered earlier this year, our Governor ignored and totally disregarded our state laws and had allowed the BANNED equipment on in to be installed covertly and without fanfare. It was quite a barnburner around here when discovered. The most recent fallout being the State removing all CCW issues from what Washington CAN ever access that way, let alone what REAL ID was, in part, about centralizing records for. (snap) Just like that? Sheriff's departments TOOK the program from state hands into local..and the Gov can go get stuffed. That's how Missouri deals with it.

(We have OUTLAWED any form of cooperation, on any level whatsoever with the Affordable Care Act Exchanges...in ANY form whatsoever.....and we passed it by serious voting majority in 2012.)

So it's the efforts I see in every direction and at every level to increase...ALWAYS increase..centralized record keeping. ALWAYS to Washington. ALWAYS pushing the outer limits if not clear outside what is appropriate to any one application being looked at in the moment.

Frankly, you're so close to the Medical industry, you see this for the benefit it represents and little or nothing beyond that...and well you should. Others are counting on it, too. Betting everything that people like you DO see the outward reasoning and become cheerleaders for pushing it ahead. The wider implications notwithstanding.


Ultimately...Time will tell. If they are *JUST* looking for what has *ALWAYS* been collected? Why would anyone care? Do you drink? Smoke? Those have 100% and direct relation to health as cause and effect. Gun ownership? They can kiss my butt sideways for even asking....as many reports are carrying that question as becoming near standard. Local reports here have advised us to expect it in routine medical exams in the future. MEDICAL social info is one thing.... GENERAL Social background to fill in a digital life history? Not in this life will I ever cooperate beyond what I already have.

You see a great screen of information for a patient. I nothing more than a tab on a super-record for each of us marked 'Medical/Other'....and many other tabs from many other similar programs, consolidated to form that Holy Grail I spoke of above.

reply to post by wrabbit2000


In 99% of these instances information is provided anonymously for statistical purposes. What age groups are apt to smoke? Or which age range has the highest rate of STDs etc. With the federal government...far more than private corps like FB and Google which collect this type of data voraciously...the Fed has a tonnage of privacy laws, as do the doctors.

Were you able to determine whether this data will have any identifiers associated with them? Or should I hunt that info down?

reply to post by wrabbit2000


Starting to dig into this.

First important note...electronic medical records were part of the Stimulus bill (American Recovery and Reinvestment Act ), Not Obamacare...So Obamacare is not related to this directly. Put another way...repealing Obamacare would not change this.

Second...They are commissioning research studies on whether they should do this and if so, how. we are a good ways off before we will see actual proposals on IF and HOW this will be done.

They plan on doing an 18 month study before even making proposals...

Phase 2

Project Duration: 18 months

The approximate start date for the project is July 15, 2013.

The committee will consider the following questions:
1.What specific measures under each domain specified in Phase 1 should be included in EHRs? The committee will examine both data elements and mechanisms for data collection
2. What are the obstacles to adding these measures to the EHR and how can these obstacles be overcome?
3.What are the possibilities for linking EHRs to public health departments, social service agencies, or other relevant non-healthcare organizations? Identify case studies, if possible, of where this has been done and how issues of privacy have been addressed.

www8.nationalacademies.org...

Given the strict HIPPA laws in place protecting this information, I strongly suspect this will be anonymous data for health policy.

It is also voluntary.

And "Social and Behavioral" data from everything I read pertains to drug use, criminal history, poverty, ethnicity etc. Anything that might make certain demographics a higher risk for certain diseases.

reply to post by Indigo5


So you figure all this has notihng to do with the Electronic Records Mandate that was part of the PPACA and passed into law along with it?

Other changes include requiring fast food restaurants to post nutritional information and allowing adult dependents to remain on their parents' insurance plans until age 26. One PPACA change largely overshadowed by the mandate requirement was the electronic medical records mandate. Mandates put in place under the Health Insurance Portability and Accountability Act (HIPAA) were reaffirmed and strengthened in PPACA

That covers the first reference, and they go on with a bit more detail...

Under PQRI and PPACA, $27 billion will be directed toward the adoption of EMR technology. The funding for this electronic medical records legislation will be expended over the course of 10 years. At the end of that span, the hope is that the majority of, if not all, practices will have improved efficiency and service through the implementation of electronic medical records.

Source

It's one of those things..where this is far from the first or even most offensive application of the new electronic records mandate. It's one of the more visible at the moment though, so it caught my eye to share a bit.

I'm not sure how much of the foundation for the ACA may have come from Bush and his work prior to Obama coming to Office. Whatever was done by 2009 though? Got a shot of steroids after the ACA passed...and the dramatic change in consolidated record keeping in central databases for Federal control and use is a core part of the PPACA. As the above link explains.....

Quite a Jalopy we all got sold on here. Quite a wreck indeed. The page linked also explains some of the financial incentives to recording more, better and with wider use of the Fed's 'suggested' framework/system.