Let us judiciously inhale that small gasp of reprieve granted us on Nov. 8.
Obamacare is, or will soon be, over.
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This is our opportunity to salvage our health care freedom — the ability to buy health insurance that best fits our personal needs and wants from a robust offering of low-cost plans. It’s our chance to choose doctors we like. It’s our chance to access the most innovative, state-of–the-art treatment options and medications for our individual conditions.
This opportunity must not be squandered.
We’ve experienced the loss of health insurance we liked and doctors we loved (and who loved us). We’ve been through exorbitant increases in premiums, copays, and deductibles; the government-coerced purchase of products that violate our deeply held beliefs; and severely restricted access to hospitals, specialists, and medications as a result of Obama-era policy.
The ONC, an executive branch agency, has access to your protected health information, including all your medical history, past and present.
Most Americans are also relatively unaware that we have had our privacy and civil liberties violated, not just through Obamacare but through the Medicare Access and Chip Reauthorization Act of 2015 (MACRA) and the rules that the CMS (Center for Medicare and Medicaid Services) wrote for MACRA implementation.
It is through this rule-making process that executive branch agencies like CMS became what many regard as a fourth branch of government — expanding their powers, allocating money, and effectively changing the law through the rules and regulations they create.
As a physician grounded in the confidential and sacred patient-physician relationship, Hippocratic Oath, and Fourth Amendment, I dissent intensely to both the MACRA and the CMS MACRA rules.
The latter affords the ONC (Office of the National Coordinator for Health Information Technology) unblocked access to your protected health information, including all demographics; all medical history past, present, and future; all diagnoses; and all medications ever taken. MACRA and the CMS rule also expand CMS power to include all data and all patients regardless of payer and all payers, including commercial insurers — not just Medicare.
That the federal government grants itself access to all data from all patients and all payers in the U.S. is shocking and dangerous at best.
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Yet, in the last days of Obama’s administration, the acting administrator for the CMS, Andy Slavitt (the founder and former executive vice president for United Health Group data analytics and technology subsidiary Optum) has been putting posts on the CMS blog about how much more access and federal government control he and others still feel is needed.
In one post, Slavitt applauded the 21st Century Cures Act, enacted in December 2016, for overcoming obstacles to data sharing. He stated: “The Act advances interoperability through several provisions including the prohibition of information blocking and authorization of penalties of up to $1 million per violation.” Wow.
The law also gives the ONC vast new authority over health IT developers through certification requirements. Further, Slavitt supports massive growth of third-party entities to meet data collection, access, and reporting needs.
The last thing we need is the growth of third-party entities, loss of medical privacy, and the expansion of government control to all patients, all data, and all payers. There is no money for this. There is no constitutional basis for this.
Fortunately, Slavitt will soon be replaced by a new CMS administrator of Donald Trump’s choosing.
The American people, from both sides, must now take a deep breath, take our power and money back from D.C. — and fix what ails us.
Kristin S. Held, M.D., is co-founder of AmericanDoctors4Truth.org and on the board of directors for the Association of American Physicians and Surgeons.