Big Brother Is Tracking You.

• Author: Vliet, Elizabeth Lee
• Position: MEDICINE & HEALTH

Three events portend serious danger to medical privacy, but it may be hard for patients to connect the dots because they seem unrelated, involve different sectors of the economy, and occurred several years apart.

The first threat arose from the 2008 financial crisis. Buried in the major legislation that passed quickly in February 2009--the "Troubled Asset Relief Program" (TARP), aka "Stimulus Bill"--were two provisions unrelated to the regulation of financial markets. Apparently no one asked why, but then few read the bill before voting to pass it.

In order to maintain their existing level of Medicare and Medicaid payments, all U.S. physicians were required, by 2014, to use electronic medical records and to send electronically generated medical records directly to the Federal health coordinator, or "health czar," without patients' direct permission. Most patients do not know that their information can be shared with the Federal government without the need for further consent.

Until the TARP legislation was passed, patients were the owners of their medical records, which could not be shared without their knowledge and permission. Physicians who generated the medical records were the custodians and entitled to keep their originals, but were required to provide copies to patients if formally requested.

This new mandate to share all electronic medical records with the Federal government's health coordinator violates two provisions of the Constitution: the Fourth Amendment's protection against unreasonable searches and seizures and the Fifth Amendment's Takings Clause. Your property--your medical information--is taken by the government without just compensation.

TARP also set up the National Coordinator for Health Information Technology to create a national database of electronic medical records for each person in the U.S. by 2014. The medical information compiled in the database then would be used by the Independent Payment Advisory Board (IPAB) to decide which treatments would be allowed based on such factors as age, weight, health condition, life expectancy, and "quality-adjusted life years" (QALYs). In effect, this set up the medical care rationing mechanism similar to those operating in the British and Canadian single-payer, socialized medical systems. Your own medical data thus is used against you to deny medical treatment you may need but the government decides is "unnecessary" or too costly.

Two additional threats to your medical privacy...