Thursday, August 6, 2009

National Health ID Promotes Patient Health and Savings

This article was first published at NowPublic.Com and is reprinted here by the author, me.

NowPublic participant Peter.Sande has pointed out in an article here today that one of the health bills moving through the US Congress 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'

I agree with the idea of a national health care card. I had one when I lived in France, and now I have one while I live in Brazil. I just show it to the person at the desk of the medical clinic or hospital I visit and they give me the medical care I need.

It is a tremendous waste of our nation's medical professional resources for a nurse to do a new intake form for every visit to a new doctor, when that information could easily be stored and brought up on a computer screen, just like we do at banks and with our cars at Midas Muffler.

However, the MOTIVE for this card - determining an individual's financial responsibility - is strictly prohibited by law in Brazil, where Government health workers at Government clinics and hospitals are forbidden from asking for payment for services provided. In the private market in Brazil, such a card is already used to cut down intake time, determine which tests have already been done and what the results were.

In France, the Carte Vitale allows health professionals to bring up the patient's information on any computer and determine how much the co-pay should be, what tests have already been done and what the results were.

People who oppose keeping medical records on a computer should instead keep all of their medical records in their wallet, including X-rays, and old vials of urine. The absolute waste that comes from starting from scratch at every medical visit is waste that ALL OF US have to pay for. We pay for it with higher premiums and we pay for it with a chaotic system that can't afford medical care for everyone because it wastes so much time searching drawers and wastebaskets for the medical records of the few who have medical insurance.

And moreover, if you don't want your information recorded on a centralized computer, then:

  • * Don't get credit (your information goes to the credit bureaus);
  • * Don't take your car to Sears, Midas Muffler or Firestone, because they keep national databases on what has been done to your car, how much it cost and how much you still owe;
  • * Don't apply for college, because you have to put your academic data and financial data on three or four national systems just to be admitted to college.
  • * Don't apply for a job, because your prospective employer is going to Google your name and find every public mention of you in a public record or published newspaper;
  • * Don't register to vote or respond to the National Census Bureau, because your name becomes part of a public "street list" that shows the names and ages of everyone living in your home, and may even identify you by party affiliation, as well as provide information on the elections in which you did and did not vote, and "street list" tells whether you are registered to vote for not;
  • * Don't ride in an airplane or buy a bus ticket, because they often keep permanent records of passengers names and ID.
  • * And don't get a Social Security card, because your name goes in a national database that identifies you by name and number.
  • * And don't get a driver's license, because your every driving infraction is digitized and saved;
  • * Don't apply for any security clearances, since the information developed in the process is stored and digitized.
  • * Don't have pizza delivered to your home, because pizzerias enter your information into their databases, and then caller ID tells them who you are, what kind of pizza you want, where you want it delivered, and the form of payment you usually use.

In other words, forget about privacy that comes from avoiding digital databases. That toothpaste has been out of the tube for decades. The only question is whether we're as willing to use digitalized information to maintain our health as we are willing to use it to maintain the mufflers and the brake shoes in our cars. I think staying healthy and rapid access to medical information in an emegency is at least as important as all of the other reasons we allow our information to be digitized and readily accessible.

However, if you enjoy the one hour intake procedure that you go through every time you check into a hospital or see a new doctor, then by all means call you Congressman and INSIST that doctors, nurses and hospitals start from scratch every time you need medical help. And don't complain about the long waits at the doctor's office. The nurse is budy filling out intake forms with a pen and paper, which will then be filed where no one can find them. And your doctor is on the phone with your insurance company, trying to determine whether you have insurance or are eligible for the help you need.

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