Welcome to the End of Doctor-Patient Confidentiality

When the “Patient Protection and Affordable Care Act” passed, the end of doctor-patient confidentiality was predictable -- but we could not have expected it to happen this soon. ObamaCare, with the aid of hospitals, insurers, banks, and private data managers, is initiating a program to track store and credit card purchases to see if people are telling the truth about their lifestyle choices.

Some troubling realities have been revealed in a recent Bloomberg article

First, the idea that the hospitals, at government direction, are doing it for our own good so it’s okay. It reminds me of Reagan’s most terrifying nine words in the English language, “I’m from the government, and I’m here to help.” There was a time when responsible journalists would not accept this so blindly.

Second, that the information retrieved without our knowledge or approval is subject to doctor-patient confidentiality. With ObamaCare it’s easy to assume that there is no such thing anymore. Now we have doctor-patient-government confidentiality -- and yes, “government confidentiality” is an oxymoron. 

So let’s get one thing straight: With the federal government takeover of the health care industry under ObamaCare, today Doctor=Hospital=Insurance Company=Government. By virtue of controlling the purse strings, the first three are beholden to the fourth.

The reality is that any personal physician can size up a person’s lifestyle choices in five minutes of face-to-face contact. A few simple questions and a good look a person’s body style, skin, face, hands, eyes, ears and mouth along with a quick check of heart rate, blood pressure, and the smell of their breath can tell a doctor everything about a person’s lifestyle that a government data dump and some computer algorithms might try to construe. The only reason for the government to be doing this is so that they can make financial decisions independent of the physician. 

ObamaCare prevents insurers from denying coverage because of pre-existing conditions or charging patients more based on their health status, meaning the data can’t be used to raise rates or drop policies. But it doesn’t guarantee that everyone will have equal access to medical services or the timing of those services based on that data. 

By this I mean, for example, that a healthy person who has made good personal lifestyle choices as determined by government computers, who happens to have liver failure, will have a better chance of receiving lifesaving treatment sooner than someone who the algorithms determine has been a chronic drinker based on his/her alcohol purchases recorded on their grocery store rewards cards or credit card charges at bars or liquor stores. 

A doctor or hospital has the obligation to treat both patients the same, but a government computer hasn’t taken the same oath. A bureaucrat in Washington can refuse payment or allocation of resources based on the data only. The caregivers will be subject to financial and professional penalties if they refuse to comply with the government determination.

These financial decisions are already being made to some degree as individuals obtaining insurance through the exchanges are being denied access to specialists and medications previously offered under private insurance plans.

While this is all scary and somewhat speculative, when you consider the trouble that ObamaCare and its exchanges have had making the various government computers talk to each other, I find it hard to believe they could glean much valuable information from private corporate and banking computers and then reliably match it up with the individual medical files. 

That said, if true, it tells us that the government has been a lot deeper into our personal records for a lot longer than we can imagine.

My recommendation is that you pay cash for your alcohol and tobacco purchases and anything else that may reflect negatively on your lifestyle choice algorithms (i.e. guns and ammo, ATV and motorcycles, extreme sports, etc.). 

You can lie to your doctors but you can’t lie to the government computers and nothing about you is confidential anymore.

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