Mandated health insurance threatens freedom, privacy

Politicians, lobbyists and activists have made all sorts of claims about the health care "reform" plans now taking shape in Washington. What many of these claims indicate is that they haven't read or don't understand the legislation. But it is the details, not the speeches and press conferences, that are important.

The proposed mandate that all Americans purchase health insurance, for example, will deny us the freedom to choose our health coverage. That's because Washington, guided by special interests, will decide what we must buy.

The leading House bill (H.R. 3200), for instance, forces all Americans to buy "acceptable" health insurance. The federal government will decide what that means.

In a nutshell it means that people who prefer to carry catastrophic insurance only will lose that freedom and will be forced to buy much more comprehensive _ and expensive _ coverage for services they don't want. The secretary of Health and Human Services would effectively serve as America's health insurance agent, having the final say on what benefits must be included in "acceptable" insurance plans.

A federal "commissioner," meanwhile, would oversee the new health insurance "marketplace" established by the bill. The commissioner would decide which plans qualify to be sold.

In other words, our choices would be limited to plans offering government-mandated benefits _ sold by companies OK'd by Washington. Individuals who don't comply with the mandate to buy "acceptable" coverage from federally "qualified" companies would face a hefty fine of 2.5 percent of their income.

The health-reform bills also require qualified insurance companies to exchange financial and health-related data electronically, without patients' consent in most cases.

Both H.R. 3200 and the Senate Finance Committee's recently released plan require insurance companies to abide by "Administrative Simplification," a system of linking and exchanging electronic health data nationwide. Section 163 of H.R. 3200 would "enable the real-time (or near real-time) determination of an individual's financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card."

The Senate Finance Committee's plan would create "unique health plan identifiers" and require health plans to comply with HHS Administrative Simplification rules. Health plans that don't comply with the rules to exchange data electronically would be penalized.

Both the House and Senate plans say that patients' privacy would be protected under federal medical privacy rules promulgated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA privacy rules, however, actually permit personal health information to be shared with more than 600,000 organizations _ often without patient consent.

Without patient authorization, HIPAA also gives the HHS secretary legal access to every citizen's personal health information, including psychotherapy notes.

So by requiring every qualified insurance company to abide by "Administrative Simplification" and HIPAA privacy rules, and requiring every American to buy a qualified insurance plan, the health "reform" plans are essentially paving the way for everyone's most personal health information to begin flowing legally over the Internet without their consent.

The president and Congress plan to fund this new scheme, they say, primarily by requiring everyone to buy insurance, taxing high-end insurance plans and reducing Medicare waste. But is this realistic? If history is any indication the answer is no.

When Medicare was being debated during the Johnson administration advocates assured Americans that seniors could easily be covered with only a small increase in payroll taxes. The federal government's lead actuary in 1965 projected that the hospital program (Medicare Part A) would cost approximately $9 billion by 1990. The actual cost was more than $66 billion that year. Costs are so high the hospital insurance "trust fund" faces insolvency during the coming decade, according to the 2009 Medicare Trustees' report.

It's time for Washington to be honest with the American people about the details of health care "reform" and how they plan to pay for it. Americans deserve to know how the bills will affect their right and ability to choose the insurance coverage that best suits their needs, and their medical privacy.

Let's be sure to uphold the precious rights of patient choice and privacy as we reform the nation's health care system.

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ABOUT THE WRITER

Sue A. Blevins is president of the Institute for Health Freedom, 1875 Eye Street NW, Washington, D.C. 20006. The Institute for Health Freedom does not receive funding from the health-care industry; for information on its funding, send an e-mail request to Feedback@ForHealthFreedom.org.

This essay is available to McClatchy-Tribune News Service subscribers. McClatchy-Tribune did not subsidize the writing of this column; the opinions are those of the writer and do not necessarily represent the views of McClatchy-Tribune or its editors.