The Health Insurance Portability and Accountability Act (HIPPA) was signed into law by Bill Clinton in 1996. It was originally called the Kennedy-Kassebaum Act based on the two senators who drafted it- Ted Kennedy (D) and Nancy Kassebaum (R). Now, most people who follow politics realize that it does not get much further left than Ted Kennedy. When he was alive, one would have had to practically travel to Moscow to find a more stringent leftist (that is until Barack Obama showed up). Nancy Kassebaum, despite being a Republican, is described in Wikipedia as, “…a moderate-to-liberal Republican…” So you have three left-of-center politicians converging on a bill, which should have been a red flag to everyone (no pun intended).
HIPPA was written for several reasons. First, it was enacted to make sure that people who change jobs could continue their insurance without fear of preexisting conditions exclusions. Removing these exclusions is like requiring that insurers sell fire insurance on a house that is burning. The intent may be good, but the unintended consequences are another thing. What is that old saying about the road to hell being paved with something? By blindfolding insurers, other policyholders end up being forced to absorb the additional costs associated with covering “high-risk” individuals (i.e., overall premiums will increase substantially for everyone).
Another of the original intentions of this bill was to standardize and simplify information transmissions thus reducing costs. However, compliance initiatives to protect privacy became front and center of everyone’s attention, and implementation in this regard sent costs skyrocketing. So rather than reducing health care costs, there have been dramatic increases in administrative costs as well as complexities for clinical practice.
Protected Health Information (PHI) is a big part of HIPPA. The idea, of course, is to provide privacy protections for patients. However, the legislation does provide for a central, government-controlled data base for medical records, thus the Secretary of Health and Human Services would have a system at his or her disposal with unique health identification numbers for every provider, patient, and health plan. These ID numbers make it possible to track every person vis-à-vis their every encounter with the overall health care system. This seems a tad antithetical, and the potential for abuse is abundant. Every diagnosis and treatment of every patient will be “on file”, accessible to insurers and/or government agencies.
The penalties for non-compliance, especially in regards to patient’s personal information, is severe and extreme. Penalties can be as high as $250,000 and/or prison terms of 10 years for those who sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm. If a patient suffers serious injury from the violation, the penalties could increase to 20 years imprisonment or life if the patient dies. If only we as a society were this tough on rapists, murderers, and pedophiles…
There may be one more purpose to the Kenney-Kausebaum bill that no one has recognized, or at least is admitting. HIPPA severely ties the hands of those health care providers who are on the front lines, so to speak. Imagine a pharmacist who is filling a prescription for someone who he recognizes to be a Ten Most Wanted subject. Well, according to this law, if he or she were to snap a picture of this person with their smart phone and send it to someone for verification, then they’re facing a mega storm of retribution for doing so. Suppose this same pharmacist is filling a prescription for someone who cannot spell their own name, does not know their own date of birth, and is clearly an illegal immigrant. HIPPA prevents any action on his or her part. What if the pharmacist is convinced that Medicaid or Medicare fraud has been committed? How do you report the person without getting in trouble?
It is similar to lawyers who know their client is guilty yet, because of the attorney client privilege confidentiality agreement, cannot say so and have the duty to defend them, and get them off no matter what. Or a priest who hears a confession from a criminal but is bound by the rules of his faith to remain silent. Or a psychiatrist who feels his patient is becoming unstable and potentially violent but may get sued for defamation or breaking the doctor patient confidentiality law if he or she says something. HIPPA does the same thing to pharmacists who are the only retail oriented health care providers.
If the general public could see what retail pharmacists witness multiple times per day every single day vis-à-vis rude or vile customers, then there would be a storming of the Bastille in Washington, D.C. This is particularly true regarding the sort of people who come in on Integral, Staywell, Medicaid, Workers Compensation, Disability Insurance, etc. The general public, if the fraud and abuse regarding these programs was exposed, would voice a massive outcry for reform regarding welfare and entitlements that would resonate in Cuba.