Tuesday, February 10, 2009

Lobbying War Ensues Over Digital Health Data

According to the health-care and drug-industry lobbies, they don't do anything nefarious with our medical records...Scouts Honor! This of course contradicts the fact that literally armies of their high priced lobbyists have been descending on SUBCOMMITTEE hearings being held to determine what kind of privacy protections should be applied to our electronic medical records.

The massive transition to e-health records is a key component of both President Obama's health care proposal as well as the stimulus package itself. The problem seems, just as with the Senate's watering down of all kinds of important stimulus spending in the Recovery Act, so too are they weakening the privacy standards established by the House. The good news is Obama initially supported the privacy measures introduced in the House. The bad news is he hasn't officially endorsed either version to date.

Just one aspect of this privacy debate centers around an issue we at CFC know very well: the selling of prescription records to third party marketers. In fact, we helped torpedo legislation last year designed to allow this insidious practice to become legal in California.

The Washington Post Reports:

The effort to speed adoption of health information technology has become the focus of an intense lobbying battle fueled by health-care and drug-industry interests that have spent hundreds of millions of dollars on lobbying and tens of millions more on campaign contributions over the past two years, much of it shifting to the Democrats since they took control of Congress.

At the heart of the debate is how to strike a balance between protecting patient privacy and expanding the health industry's access to vast and growing databases of information on the health status and medical care of every American. Insurers and providers say the House's proposed protections would hobble efforts to improve the quality and efficiency of health care, but privacy advocates fear that the industry would use the personal data to discriminate against patients in employment and health care as well as to market the information, often through third parties, to generate profits.

Resolving these competing visions will be the task of House and Senate negotiators. The outcome could determine, for example:

· whether a hospital or doctor can make a profit by selling people's medical data, without their consent, to pharmaceutical companies for research;
· whether a hospital or other provider must obtain patient consent before sending them fundraising letters.


Consumer advocates assert that the health industry is already reaping billions by gathering, mining and marketing personal health data and is mainly worried that the privacy provisions would threaten that income stream.

"When a patient walks in the door of a hospital or a pharmacy, that hospital or pharmacy sees not just one dollar sign, but two," said Tim Sparapani, senior legislative counsel for the American Civil Liberties Union. "The first dollar is what they earn from treating the patient. The second is the ability to sell the information about the patient." The risk, he said, is that Americans could face difficulties getting health insurance or a job because of the information available in "for sale" medical records. Industry officials say that they fully comply with federal privacy regulations, which they contend are adequate.

Sparapani said that in the 16 years he has worked on the Hill, he has never seen lines of lobbyists for subcommittee hearings -- let alone votes -- like those on this issue. "There's so much money invested in this and so many corporate entities that are touched by this legislation," he said, "that the lines reminded me of those of the inauguration."

One provision that has generated a great deal of lobbying on both sides would, for instance, bar a drug company from paying a pharmacy to send marketing letters to patients unless the patient consents. The National Association of Chain Drug Stores, which represents CVS Pharmacies and Walgreen's, among others, and which doubled its lobbying spending in 2008 to $1.4 million, opposed the provision. It sent a letter to lawmakers arguing that the restriction might block pharmacists from sending refill reminders.


...when Democrats on the House Ways and Means Committee saw the language, they became concerned it would maintain a loophole that allows drug companies to pay pharmacists to send letters -- at up to $4.50 per letter -- pitching more expensive alternative drugs to their customers. They revised the language to close the loophole. Blunt tried once more to amend the bill to the pharmacists' liking but failed.

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