EMRs Introduced as a Bill in Congress

U.S. Representative Pete Stark has struck a blow for electronic medical records by bringing the issue to the floor of congress, and just as importantly includes language that allows patients the right to sue for wrongful use of those records.

One of the consistent bugaboos facing the acceptance of EMRs has been that of privacy. In an era of data aggregation and the widespread harvesting of any and all sorts of demographic info, the worry about misuse of the data is a continuing concern to most people. Stark's bill would allow patients to request and audit trail of their data and its use. In addition, the Health-e Information Technology Act of 2008 also contains provisions requiring notification within 60 days if any sort of breach in privacy of these electronic records has occurred.

The general concept is the leveraging of Medicare and creation of financial incentives as reported by Medical News Today:

Rep. Pete Stark (D-Calif.), chair of the House Ways and Means Health Subcommittee, introduced a bill Monday that aims to create a national system of electronic medical records that would use Medicare reimbursement to encourage hospitals and physicians to adopt new technologies, CongressDaily reports. The measure would create a series of incentives for physicians and hospitals that utilize an approved health information technology system. It also would encourage adoption of the new technologies by providing funds through a matching grant program geared toward those who provide care in low-income, rural and medically under served areas, not-for-profit facilities and providers who receive little or no Medicare incentives.

SOURCE: "Rep. Stark Introduces Bill To Create Electronic Medical Records System, Strengthen Privacy" 09/17/08
photo courtesy of ArtNow314, used under its Creative Commons license

I.T. is It!

John Engler, President and CEO of the National Association of Manufacturers and former governor of Michigan, has a wonderful piece up on The Hill right now about the importance of health care Information Technology and the legislation supporting its implementation.

As the immediacy of skyrocketing gas prices and the economic instabilities of 2008 seem to have overshadowed health care in much of the political discussion surrounding the race for the White House, Mr. Engler reminds us of the importance of the long view.

We have covered the reasons why electronic medical records and other forms of health care IT are a necessary part of the overall equation on many occasions. What Mr. Engler reminds us is why it is imperative to push legislation through Capitol Hill immediately:

On Sept. 8, over 100 associations, businesses, unions, patient and provider groups signed a joint letter to Congress urging passage of health information technology legislation this year. Health IT has overwhelming bipartisan support in both the House and the Senate, and yet the American people are still waiting for Congress to act. [...]

The life-saving, cost-reducing benefits health IT legislation can deliver to the American public make its passage imperative this year. Next year, a new administration will take office and, in the shuffle, health IT legislation could stall, forcing Americans to wait even longer.

Once the transition to a new administration begins, many things will be in flux. One thing that will not change is our moral imperative as a nation to ensure access to health care and coverage to our fellow citizens.

Please take a moment and read Mr. Engler's piece and refresh your knowledge of exactly why this is such an important issue.

SOURCE: "Don’t let health IT legislation flatline " 09/11/08
photo courtesy of Paolo Margari, used under its Creative Commons license

Dateline Illinois: New Bipartisan Legislation

Senator Dick Durbin has allied himself with a variety of business and labor groups to co-author legislation to provide more affordable health care options for small businesses.

Via All American Patriots:

The bi-partisan legislation was introduced in partnership with Senators Olympia Snowe (R-Maine), Blanche Lincoln (D-Ark.) and Norm Coleman (R-Minn.). Nationwide, there are 47.1 million employees in 5.8 million small businesses and 14.1 million self-employed individuals.

The Small Business Health Options Program (SHOP) addresses the number one problem for many small businesses and the self-employed -- the high cost of providing health care for their employees -- by:

* Allowing small businesses to band together and spread the risk over a large number of participants in order to obtain lower premiums.
* Providing tax credits for small business owners to offset contributions to employee premiums.
* Banning health status rating in order to protect businesses from large rate increases simply because one employee gets sick.

Developed to help combat annual premium jumps that usually rank in the double digits, this bill is receiving praise from a number of concerned parties. From Charles McMillan, the President-Elect of the National Association of Realtors to Todd Stottlemyer, President and CEO of the NFIB, supporters are sanguine about the effects this will have for both independent contractors and employees of small businesses. The extreme nature of this burden is illustrated by McMillan's comment that for the average realtor, "the total cost of health insurance can rival or even exceed their monthly mortgage."

As an independent contractor myself, I understand the fears and the costs involved. I am consistently grateful for the fact that I have health insurance, which I only have because of my lovely wife's health care plan from her job. Even insured I often become the statistic as I put off health care that is not urgent due to the rising costs.

I can assure you that this is one piece of legislation I will be keeping a careful eye on.

SOURCE: "Senator Durbin Introduces Bipartisan Legislation to Provide Affordable Health Insurance Plan for Small Businesses" 08/05/08
photo courtesy of Larsz, used under its Creative Commons license

Native American Health Bill Passes Senate

Improved access to health care. Preventative screening. Mental health services. Thanks to legislation passed in the U.S. Senate last Tuesday, these things may be more accessible to the Native American Community soon.

Mary Clare Jalonick of the Associated Press tells us that the bill, approved 83-10, would have several effects. In addition to funding existing programs at the Indian Health Service, it would also fuel new construction and modernizing of health care facilities located on reservations, increase tribal access to Medicare and Medicaid, and attempt to recruit more native Americans into health care oriented professions. About $35 billion would be spent on these things over the coming decade.

There is no shortage of commentary on the Senate floor (Via a variety of sources listed at the bottom of this post):

• Senate Indian Affairs Committee Chairman Byron Dorgan, D-N.D., termed this legislation a first step in addressing a crisis in American Indian health care. He is reported as saying that the current system is underfunded and inefficient.


• Senate Majority Leader Harry Reid, D-Nev., said American Indians have access "to some of the least adequate health care in America. [...] Far too many native children are diagnosed with diabetes, suffer from abuse and neglect, or die prematurely because of accidents or illness that could be prevented or cured," Reid said.


• Sen. Tom Coburn, R-OK who is also a doctor, called for a much more comprehensive overhaul of the system and called the legislation "morally bankrupt." "Why are we putting off fixing the system?" he asked. "So we could tell everyone that we did something when in fact we did nothing."


• "Improving the delivery of health care services for American Indians is long overdue," said U.S. Senator Maria Cantwell, D-WA said. "Overall trends in the health of this population are simply unacceptable. American Indians and Alaskan Natives across the country are 400 percent more likely to die from tuberculosis, 291 percent more likely to die from diabetes complications, and 67 percent more likely to die from influenza and pneumonia than other groups. Passage of this bill in the Senate is a critical first step to strengthening health care services for American Indians, and living up to our long-standing trust responsibility to provide for their well-being."


• U.S. Sen Amy Klobuchar [D-MN] stated that this is the first time in 17 years they have been able to pass the Indian Health Care Bill.
  

One of the amendments included in the final version of the bill is an official resolution of apology for the federal governments long history of poor and negative policies regarding native American tribes. Other amendments include the exclusion of abortions at Indian health clinics and a prohibition against spending on programs that discourage gun ownership.

I am sure that there will be a similar variety of available quotes once this hits the U.S. House of Representatives.

SOURCE: "Senate Passes Bill on Indian Health Care " 02/27/08
SOURCE: "Senate approves landmark Indian Health Care legislation " 02/27/08
SOURCE: "Senate Passes Indian Health Care Bill " 02/28/08
photo courtesy of thivierr, used under this Creative Commons license

Deadlines Loom for Health Care Legislation

In Washington D.C., where the fiscal year ends on Sunday, September 30, President George W. Bush continues to threaten a veto of the State Children’s Health Insurance Program (SCHIP), while Democrats line up votes. Passage is expected in the U.S. House of Representatives early this week and in the U.S. Senate by the end of the week.

In an article for the Monday The New York Times blog, "The Caucus," journalist Carl Hulse explains why Democrats are not backing away from a showdown with the President:

Democrats like their position on this issue. They believe that the public supports making health insurance more affordable and that many families with middle-class incomes are struggling to provide coverage and care for their children. Some Republicans in both the House and Senate are expected to support the plan.

In California, compromise -- not confrontation -- is the top story. The San Francisco Chronicle reports that Governor Arnold Schwarzenegger is close to a compromise with Democratic leaders on a health care reform bill. Schwarzenegger wants to pass the bill before the end of the special legislative session. In a Sunday article outlining the financial interests of a dozen key players, Chronicle journalist Tom Chorneau comments on the surprising civility of the public debate at this late stage:

Absent from the airwaves are the attack ads from insurance companies and doctor groups that many feared would have materialized by now. Massive protests from labor unions or consumer groups intended to push the talks one direction or another have also been largely put on hold.

This should be an exciting week of twists and turns in the effort to pass health care reform legislation. Do you think the California bill or the federal SCHIP program will pass? Do you think President Bush will really veto SCHIP? Do you think the U.S. Congress will have the votes to override a presidential veto? We'd love to hear your comments.


SOURCE: "Democratic Leaders Close to Deal on Health Care Reform," Tom Chorneau, San Francisco Chronicle, 09/23/07
SOURCE: "Congress Tackles Child Health Care," by Carl Hulse, The Caucus, Political Blogging from The New York Times, 09/24/07
photo courtesy of U.S. White House