Privacy rules

Sunday's NYT article touched on so many issues it was hard to address them at one sitting. The article asserts that concerns about privacy and security are the major obstacle blocking passage of pending bills on health IT. I wish that was true because it would mean that privacy concerns had become a higher priority than they have been up until now, and that there was agreement on all of other vexing issues in this area. Alas, I don’t think either is true.

Privacy and security are clearly important considerations on lawmakers’ minds, but equally if not more important barriers are:

1. lack of budget
2. blurry policy options, stemming from the complexity of health care delivery and little to no understanding at the federal level of the complexity of these issues
3. disagreement (mostly ideological) on the role of government generally, and the divvying up of power between federal- and state-levels specifically
4. lack of awareness among the public (or more specifically, voters) of the urgency of taking steps to improve the quality and efficiency of our care

The following commentary from iHealthBeat is indicative:

"Prospects look pretty good" for the 110th Congress to pass health IT legislation in 2007, Michael Zamore, a policy adviser for Rep. Patrick Kennedy (D-R.I.), said in an interview for an iHealthBeat special audio report. According to Zamore, health IT is a "great candidate" for bipartisan efforts because "it's teed up, it's kind of ripe, it's been kicked around, it's had a false start or two," and the "ideas have been percolating and vetted.

"David Merritt, project director at the Center for Health Transformation, said the opportunity still exists to pass a bipartisan conference bill during the 109th Congress' lame-duck session codifying the Office of the National Coordinator for Health IT and allowing hospitals anti-kickback exemptions to provide physicians with health IT equipment.

"Let's not throw away all the progress we've made up to this point simply because of the change in power," Merritt said. However, Zamore and Merritt agree that identifying funding for health IT initiatives with current budget deficits will be a challenge (Rebillot, iHealthBeat, 11/15).

The Democrats on the Hill (especially Ed Markey) do place a greater emphasis on privacy concerns than do the Republicans (outgoing Connecticut Republican Congresswoman Nancy Johnson's bill was silent on the issue, for example), so maybe this will rise in importance in the new Congress. In this environment though, I think cash (or lack thereof) will still be king......