Jen McCabe Gorman at Health Management RX brought attention to a new House of Representative Bill (HR 6898) focused on electronic health information introduced in the 110th Congress by Congressman Pete Stark. The bill was introduced on September 15, 2008, and is currently referred out to committee.

Jen provides some great analysis and brainstorming on the impact of the draft bill in her post, “Breaking News: Congress Wants to Create National eHealthNetwork, Legislate Who Owns Health Data.” Well worth a read for anyone interested in health information technology, electronic health information, personal health records, health 2.0 or the future of our health care system.

Jen highlights those sections dealing with who owns the electronic health information. Should it be the government? the provider? the consumer? This key legal concept - ownership of health information — is a key question to discuss and debate. As I have mentioned in the past (here and here) the consumer health movement may force a change in the traditional legal notion of health information ownership rights.

The draft bill also addresses a variety of other areas - including the regulation of non-covered entities under HIPAA (many of which weren’t even contemplated when HIPAA was enacted) who create or handle health information, codification of ONCHIT under HHS and empowering them with various tasks, creating Medicare related incentives for adoption and modifying other sections of the current HIPAA privacy standards. I haven’t had a chance to read through the full bill and spend time reading the related materials but look forward to further analyzing.

For more information about HR 6898 (The Health-e Information Technology Act of 2008) check out Congressman Stark’s website information about the legislation:

• Summary
• Introduction Statement
• Press Release
• Section by Section Analysis
• Privacy and Security Provisions
• Incentives

To locate the current status of the bill check out Thomas. I suspect that there will be little movement on the bill this Congressional session - but it does give insight into what might be coming down the road.

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“I recently inquired about another treatment center, Cancer Treatment Centers of America, which has a lot more available options to treat my cancer that my current hospital does not provide. I was informed that because I have an HMO, I cannot pursue treatment outside my network.  If I had a PPO, insurance would most likely cover the cost of me going to the Cancer Treatment Center of America though.

“Since the insurance I have is through my husband's work, we were only given two options to choose from for insurance for the 2008 year - Advantage HMO or Anthem PPO. For obvious reasons, we had to take the Advantage HMO route because it was more than half as cheap than the Anthem PPO. Why should we have to choose in the first place and why only these two types of insurances?

“But they finally did allow me to go to another hospital to have my final major surgery, and I was grateful for this since this last surgery was the one that probably ended up saving my life. I had 65 percent of my liver removed that had cancer on it.

“I don't know if the insurance company would have eventually allowed me to go to the Cancer Treatment Center of America.  They might have if I would have continued to pursue it, but I guess that's part of the problem - why should I have to justify my intentions of going somewhere else where better treatment is offered that could save my life?

“It simply is not fair that we have to choose between ‘affordable’ healthcare versus ‘not-so-affordable’ healthcare and only being given limited choices of insurance plans to choose from. These choices obviously can make a difference between life and death. I'm sick to death with increasing premiums year after year and receiving less coverage, year after year.”

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Sponsored by the California Nurses Association/National Nurses Organizing Committee

Eighty-two percent of Americans think the U.S. healthcare system should be fundamentally changed or completely rebuilt (Commonwealth Fund, Aug. 7, 2008). America's nurses know that only single-payer, improved and expanded Medicare for all will fix our broken system and the tragedy of our devastated families. HR 676, by U.S. Rep John Conyers, is the most comprehensive, cost effective way to achieve guaranteed healthcare for all.

For more information, or to contact this patient: Liz Jacobs, RN 510/273-2232.

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For introverts like me, email’s a godsend. While I don’t have an aversion to face-to-face conversation, I’m much better at formulating my thoughts “on paper” (translation: electronically) where I can mull them over, than assimilating them on-demand on the spot. (This also explains why I can’t live without email, Facebook and text messaging!)

Maybe it’s just the writer in me—or the fact that, alone with my computer, I can actually hear myself think. But I divert slightly.

We all know human beings suffer emotionally and socially without interaction. But the way we establish and maintain connections socially and in business settings is an even more interesting topic of study.

While my own preference for electronic communication sets me apart from others my age, most of whom prefer connecting in person and eye-to-eye, today’s young people prefer to forge relationships electronically (like me). Because 92 percent of people between the ages of 18 and 29 are online, they prefer to keep in touch with friends and meet new ones online. And when they need something, the internet is the first (and often only) place they go to find it.

These communication preferences also spill over into shopping habits. When teens and 20-somethings need to find insurance for their cars, they tend to ask their friends for advice or hop online to find an insurance agent and get online car insurance quotes. Why? Because it’s quick, easy, and doesn’t require a lot of time or fuss.

Older Americans, on the other hand, tend to look to their “good neighbor” insurance agent down the street—or the business pages of their phone books—to find an insurance agent who can provide what they need. Having been raised in a time when people conducted business face-to-face across the dinner table or sitting on the living room sofa sipping coffee, they prefer building relationships in person—and sealing business deals with a handshake.

How do you make connections? Do you prefer the ease and speed of electronic means or the security and tradition of human contact? Please weigh in and share your thoughts.

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On its own, that’s not an indictment of the health insurance industry because so many businesses – if not most businesses – are losing money on Wall Street right now.

While the financial services industries were the first to the trough for bail-out, they won’t be the only private interests standing in line for some of our taxpayers’ funds.  But when the private, for-profit health insurance industry comes calling, it will do so by raising premiums, denying claims and seeking to cover more Americans who won’t actually need to use many medical services.  There are limited ways for the health insurance giants to recoup losses, and we are the way – our money, our ability to get the care we need and our lives depend on getting healthcare out of this folly.

We all know it.  Healthcare isn’t like widgets or tires or hammers and nails.  Healthcare is a human right.  When we are sick, when our neighbor is sick, when our parent is sick, when our child is sick, and yes – even when our enemies are sick – we must have access to medical care. To see a doctor or other healthcare professional when we need it (and before it has become a crisis) is the way a humane and just society behaves. 

But under the current, market sensitive and market driven pressures, healthcare morphs into a sort of odd blend of wealth-care for those who can still afford it as approved by for-profit insurance companies with enough resources to pay the claims.  We can argue all we want to about the art of medicine, but when Unitedhealth Group drops nearly 30 percent in value in just one month, there isn’t any art to what they’ll be doing to the practice of medicine.

As a patient, I do not want my healthcare subject to the whims and the momentary fortunes of the stock market.  I do not want to gamble on my healthcare or my children’s or my grandchildren’s.  And I certainly don’t think the CEOs of those big corporations will want to take reductions in compensation or allow shareholders to suffer.  Ronald Williams at Aetna, Edward Hanway at Cigna, Michael McCallister at Humana and Stephen Hemsley at Unitedhealth Group surely want to retain their millions in compensation even if that means denying me my prescription or my treatment or raising my premiums.

Any corporate losses resulting from the massive drops in value to the private health insurance industry in the current stock market environment will be absorbed by policy holders.  You and me.  Our employers.  Our neighbors.  Our families.  Our health is in the hands of the stock market not those of our doctors and other healthcare professionals. And right now, my healthcare is worth a lot less than it was on Labor Day.

The only alternative to gambling with our healthcare in this volatile way is to make sure public funding backs up the healthcare system. 

And I don’t know about other taxpayers – but I suspect many will feel as I do – I don’t want the funds I earn and the funds my taxes put in the public coffers to be used to pay for yet another corporate bail-out at my expense.  I’ll gladly pay for my healthcare through a public fund but not their wealthcare.  How does the saying go?  Been there. Done that.

I do not want to pay monthly premiums and on top of those premiums to fund a bail-out to shore up health insurance company CEO compensation or shareholder dividends.  And I cannot invest in the stock market by paying my health insurance premiums on time and wait for the market recovery in the estimated five to 10 years to recoup the investment.  I might get sick and need actual healthcare.

I want the funds I contribute to healthcare to be used for healthcare.  Period.

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