Comments on: U.S. stimulus bill pushes e-health records for all

commentary A large chunk--about 140 pages of 800--of the Senate bill creates electronic health records for "each person in the United States by 2014," with no clear way to opt out.

[trueyou]

What the H**** does all that junk have to do with restarting the economy. That junk is why noone believes people in washington.

[macworkerbee]

All that "junk" is money, in the billions in this case, being spent to create work (jobs to set up the database infrastructure, digitize the records, set up the systems, etc.) for thousands if not more employees while updating the countries medical records system.

Just because the title doesn't read "E-medical Records to Create 1000s of Jobs" doesn't mean that it won't do just that.

Jobs = people with money to pay bills, buy things and put more money back into the economy.

At least that is how this thing is supposed to go, let's hope.

Oh yeah, and Cnet, how about a bit less bias. I mean come on, the title says 'Stimulus' in quotes and you use "convoluted legislation", a term that often times has negative connotations.

[declan00]

"macworkerbee": It's characterized as a "stimulus" bill because it may or may not actually prove to be one. Time will tell. As for convoluted, I dare you to read it yourself, all ~800 pages, and try to understand it.

[CoffeeZombie]

And where exactly is that money going to come from, praytell? Well, there's really only two options:

1) It comes from our pockets, meaning each of us will have even <i>less</i> money than we do now to spend on things that *actually* stimulate the economy.

2) The Federal Reserve prints more money, which contributes to inflation, ultimately destroying the value of our money.

This is not a stimulus bill. This is socialism. Plain and simple.

[rcrusoe]

"Jobs = people with money to pay bills, buy things and put more money back into the economy"

I wish that were true. But me, my children, and my grandchildren will be sending the majority of our paychecks to the IRS to pay for these "stimulus" bills. I fear the days of iPhones, HDTVs , and other extras for most folks are over.

Here's hoping I (and hundreds of economists) are wrong.

[LuvThatCO2]

Very well said, CoffeeZombie. A lot of people dont understand that the money has to come from somewhere. Rather, it *will* come from somewhere whether we like it or not. Either it comes out of people's pockets, or via the loss of value in the dollar due to inflation.

[honoraflynn]

Does it seriously not bother any of you that this is a huge violation of our privacy? Have you not heard about the security breaches with the FAA, the Pentagon, and more?

And even if the information remains "secure," do you want junk mail based on your medical history? Do you really want the Secretary of HHS and anyone they deem necessary to have access to such private information? Your family can't access it without your consent - but the government can? What happens when this is used to determine your ability to get insurance, qualify for government assistance, get a job? How can we be outraged over the Patriot Act and say nothing about this?

[IGARA4]

Some jobs may be created (temporarily) to build the system, but what about all the jobs that will be eliminated (permanently) due to the increased "efficiency" and less need for handling of paper records?

[cjwall67]

Well, just because it's called a "STIMULUS" bill in the tiltle doesn't mean it will do that, either. Regardless of your party affiliation (yours is fairly clear), you would have to admit that when the government mandates anything, it will cost more, run less efficiently, and fail in most of its objectives when compared to a similar entity in the "real" world. By the Obama administration's own figures, each job created or "saved" by the "STIMULUS" will cost about $275 000.00. That is only because most of this bloated travesty consists of spending that has nothing to do with the economy, other than creating a tax and debt burden for U.S. taxpayers that is unprecedented. There is a clear difference between true "job creation" and "make work" projects such as this. "Change we can live with" does not mean change for change's sake, and "Yes we can!" does not necessarily mean Yes, we should, especially in the hurried, headlong rush to oblivion that appears to be taking place in Washington right now. Almost a TRILLION dollars?? Look at that number for a second: $1 000 000 000 000.00. The term "too many zeros" falls short here. In fact, if people would get over worshipping at the feet of the new president, they might see that this administration consists of a good many of the same old tired, arrogant, hypocritical politicians from past failed administrations, people who spend without examining consequences beyond their re-election, and try to force their particular personal agendas on everyone else. If any of these non-stimulating and costly measures have merit, let them be introduced on their own, in the clear light of day, with enough time devoted to examining them before they are enacted. It's curious how they are being buried within this huge bill, which is being rushed through under the guise of a dire emergency, and when the light of concern or question is shone on them, the cockroaches of the political system are seen scurrying to hide in the shadow of empty slogans and vain rhetoric.

[CherylMASS]

All the privacy laws (HIPPA) are out the window if this goes through as described. Also the new jobs will mean that thousands will have access to our personal information. Not happy with that prospect.
On another note:
If you watched C-Span yesterday, you would have seen Sen. Chuck Schumer (D) state that "the people don't care" about the pork.
I don't think many of the politicians we put in office believe we're smart enough to understand what's going on.

[CoffeeZombie]

@CherylMASS Sadly, we have consistently proven them right about the pork. Of course, the main problem is that we never hear about it. Seriously, I think we'd fix a lot of problems if we could make it so that a bill can't be modified in this fashion.

[ross1776]

The mind boggles at how this system could be misused or expanded to include just about anyone on a trumped up "need to know" basis such as lawyers, employers - you name it. It isn't the government's job to "create jobs" at the taxpayer's expense. Nor to dole out sums to the universities to keep them in business, since few Americans can now afford the cost of higher education. Obama's spending bill will create jobs alright, jobs that the taxpayers will be paying for, thus simply "government jobs," in expanding government. Insurers could now deny health care coverage based on chronic illnesses, or you could be barred from shopping around rates since these industries have associated and price fix. If you are HIV positive, would you want that information in the government's hands, or a potential employer's. Soon there will be "health" discrimination which will put more and more then on welfare. The Patriot Act was bad, but the Democrats have actually gone one step further. And this is "change?"

[hoopla]

This is really awful. It basically looks like forcing health care providers to adopt something that may not be any good, and will be a privacy disaster.

Privacy protections should be the first priority in every element of this, not an afterthought as it appears to be. I don't just want notice of breaches; I want my data encrypted so that it can only be accessed with my direct approval. Individuals should also have to give approval for any transfer or usage of their data.

We have a terrible record of protecting data that gets into electronic form in this country. We clearly need a data protection law similar to what they have in EU countries.

[curph]

Editorials should be in a "views" section, not in a "news" section.

[rreigle]

not exactly an editorial.

it just exhibits a bit of healthy skepticism regarding a bill for which the mainstream media is merely acting as unquestioning cheerleader.

thanks cnet for an insightful article that's truly newsworthy.

[michaelo1966]

I agree, but Declan's "stories" are almost always like this: opinion pieces written around a nugget of information.

An example how a real reporter would write this story for this audience would focus on the fact that MS and Google already have extensive health records software. A real reporter would call both, then call some Congresspeople and maybe some people at HHS, and ask if they could bolt together these already existing systems. A good reporter might then call some major hospital chains and insurance companies and ask what it'd take to get them to use it, then call Google and MS back and ask them if they'd go along. Of course, that wouldn't leave room to insert long and irrelevant opinions about the merits of government spending.

[alleyg]

This news item is clearly labeled as Commentary, not News.

Can you not read 'commentary' at the beginning of article? If not, then how can we expect you to read the 'bill'.

[curph]

Was the commentary label added after the fact without the article timestamp being updated? I would swear it wasn't there originally.

[curph]

Also the original title of the article had "Stimulus" in quotes. Search for it in Google if you want. So why is CNet making changes to articles without marking them as revised?

[rmva]

I understand this has been implemented in less developed countries, such as Taiwan, with remarkable success in reducing the number of medical errors and lowering the number of redundant tests.

[alleyg]

Then this policy should be debated on its merits, and proposed its own legislation. Not stuck in a "must-pass emergency bill" with no discussion.

[himprofessional]

Exactly! yet the moment I mention how well other countries have been able to adopt this kind of technology people want to gripe at me that I should be more patriotic, that US is Number 1 in everything.

Privacy is an issue in paper and in electronic records. Data IS encrypted. People in my profession work hard to maintain privacy and security while trying to build a system that will help the people of this country get better healthcare and it really bothers me to see so many take for granite that it is a bad idea without knowing ANYTHING about it. And this article only mentions gloom and doom prospects. It doesn't mentioned how many people are saved b/c of the REDUCTION OF MEDICATION ERRORS!

[himprofessional]

I did mean for granted by teh way! not granite! haha

[martalli]

Electronic records sound like a slam-dunk, an obvious proposition, at least from a technical standpoint. However, there are currently hundreds of EMR software packsges available, none of which are compatible with each other. That means the effort to digitize patient information is completely lost whent he information goes from one doctor? office to another, since at that point, the information is printed, faxed, and then scanned into the second EMR - often hundreds of pages at a time. At that point, the second EMR is completely unaware of what happened...it is just a grainy bitmap, without data like when you had a colonoscopy, what your labs were, and so on. Consider flipping through hundreds of grainy scanned sheets and you will see how useless this could be.

If we are asked to move en masse to an electronic medical records system, there should be a caveat that these systems must be compatible with each other. A simple suggestion is that all the EMRs have the same underlying database system, even if the front ends might be varying products, commercial or otherwise. The underlying database product could be a basic open source project that would receive update suggestions from the commercial vendors, public, etc. With a single database format, all of this printing/faxing/scanning could be avoided.

[bookshire]

well, there's a difference between how many there are and how many are actually used. When Allscripts and Misys Healthcare merged into one company last year, they took a third of the American EMR market with them, and I doubt they're going to be content with that just a third. With this stimulus as the technology grows and small companies merge into bigger companies across the board, competition will tighten up. Cross compatibility is certainly important, but I think it'll become less of a roadblock over time.

[jaxstephens]

Martalli,

This is one of the most intelligent posts/analyses I've read in a long time. You are *exactly* right about the many programs/many incompatible formats problem. Without that being solved, everything reduces to paper and crappy scanned images of paper. It's virtually useless from a portability perspective and a data-centered systems design approach.

[himprofessional]

This is what ONCHIT at least originally existed for. To help the myriad of vendors to include standards that would allow the different applications to talk with each other. I agree about the underlying database system. This is an area I woudl LOVE to work with the government on.

[Endbringer]

Where in the our Constitution does it give Congress and the federal government the power to control our medical records? I guess that pesky 10th amendment just doesn't mean anything anymore. I mean, we can never violate the 1st, we can ignore the 2nd, and trample the 5th, but let's just pretend that the 10th doesn't exist anymore, OK?

[toddemiles]

We already have many of the safeguards in place as a result of HIPPA. These were laws enacted for the privacy of records and took many years to hammer out and implement. Any new legislation must comply with HIPPA. So in the moving of records from paper to electronic no such breach of trust should occur. It may mean reminding congress of the HIPPA regs already in place to bring this into focus.

[Endbringer]

No, the new laws don't have to comply with HIPPA. New laws always trump others until the "supreme" court states it violates something in our forgotten Constitution.

[himprofessional]

Endbringer,

That is simply BS. Electronic records have to comply with HIPAA just like paper records and if you have ever read HIPAA which I HAVE you will see that parts of it apply to electronic information as well as paper information.

[Joetwopointoh]

Recent frauds committed against certain high profile institutions should serve as huge red flags against such an undertaking. It seems we've collectively developed selective memory and are simply choosing to ignore them and press on no matter how doomed the prospects.

[basraw]

If your read daschle's book this is just a prelude to the government running all aspects of the health care, from determining which treatments are approved, which tests are necessary, no more 2nd opinion or tests.. they will be in control! not your doctor.

If you thought HMO's were bad.. you are in for a new treat!

GOD HELP US!

[photog_7]

THIS IS TRUE! What the bill does is create an un-elected, bureaucracy (not staffed by medical doctors) that will have the authority to ration treatments (similar to England)! What they learned under the Clinton administration is to keep their mouth shut about what the bill contains. Socialistic medicine will not help our economy.

[Willy Wonker]

I thought Amercian is about being independent from Europe. Well. That didn't really last long did it? Thanks for the Rothschild.

[JEngdahlJ]

This HITECH Act -- and $20 billion down-payment ? is a grand first act toward establishing pervasive electronic health records throughout the U.S. Salting the mine with incentives for Medicare and Medicaid patients surely gets providers using HIT and building an EHR infrastructure (along with streamlining care for seniors and uninsured.)

But, will that Medicare/Medicaid dose be enough to change the system for everyone else, most especially those in their teens, 20?s and 30?s who will benefit most from wellness, preventive care, and complete medical records over their lifetimes? How will such efforts expand beyond rural areas and selected populations? Are we ready to start creating portable records for uninsured children, or are we going to let them slip through the cracks in our imperfect information environment? The goal of comprehensive care first requires comprehensive records.

Learn more: www.healthcaretownhall.com

[inachu]

Best way is to never sign up unless Uncle Sam makes it compulsatory for companies to make employees to sign up.
So if you stay off the grid then no need to sign up.

[Reno Deano]

Can you imagine the infrastructure to maintain the database! My wife was almost killed, except for my intervention, when Kaiser failed to maintain her prescriptions updated in their computers. Can you imagine giving a patient 12 drugs, when only 4 were current. I personally had to show the ER Attending the current list I maintained and what the computer showed. The nurse would not believe me.

[jjh536]

For people who don't understand whats going on in the health care industry, the reason for modernizing our medical records to electronic medical records systems is to increase SAFETY by reducing medical errors. It isn't socializing medicine. Government isn't taking over health care by giving money to encourage EMR systems. People just don't realize how many preventable errors occur in our hospitals and medical offices because of outdated medical record keeping. Implementation of physican order entry, bar coding medication delivery, electronic prescribing in your hospitals and doctors offices will ultimately benefit you the patient! Have you ever tried to read the prescription from you doctor? Look, we will all get sick some day. Don't you want to be in the hospital with the best, error-free health care possible?

Everything in the current stimulus package is using tax dollars for not only stimulating the economy, but also invests towards improving America's future. It's a far better way of spending than the 1 trillion dollars we already blew away from a war we shouldn't have ever started or 325 billion for banks who just gave billions to their CEOs. Spend the money for the people! tax cuts, infrastructure, modernize EMR systems, affordable housing, health care and education. This is a step in the right direction by investing for the American people.

[lionfish3126_522]

Tell them again. I totally agree with you.The Bush days have left persons so afraid, I say get with the program America, Let Go!!!!! It's a NEW DAY!!!!

[cjwall67]

What tax cuts?? If you don't actually pay taxes, you can't really cut them any further than zero. Those people who will shoulder the burden of trying to pay for this will get the least benefit. Jobs are created as a result of economic activity. You will not see any useful improvements by trying to reverse that relationship. The government is doing nothing more than setting up "make-work" programs, and shifting income between different groups in society. They would be better off sending cheques to everybody, it would cost less. As to the war, you will see Obama and company doing some backtracking in the next while. Things become a lot clearer when you are privy to the information from the inside, rather than relying on what you get observing from the outside, spoon-fed by the media. EMR systems are already being implemented from within the medical system. Nothing more is needed than a system to oversee security and compatibility, but unfortunately the government has proven many times in the past that they are pretty much incapable of creating or maintaining either one of those. Instead of working with what is already in place, the government once again will attempt to create and force the implementation of something completely new and different at a horrendous cost, probably designed by a group of people who have no clue about the systems they will affect, and essentially punishing those who invested the time and money to start it on their own. Why is it that I can go on the internet and my information can be easily secured and backed up at little or no cost, but the government has to spend billions to try and do it for me? Thanks, but no thanks!! If any of these initiatives that are buried in this bill can stand on their own merits, they don't need to be rushed through on the coattails of this "Emergency Stimulus". Such sweeping changes need to be thoroughly examined before it's to late to fix them, and it's definitely not productive to label caution and valid concerns as "foot-dragging" as has been the case recently.
By the way, this bill is not paid for by "taxpayer dollars". That term insinuates that the money is already there, or will be soon. It will actually be money borrowed from countries that most definitely do not have the best interests of the U.S. at heart, at least economically.

[Endbringer]

You must not have read the bill. In it the HHS department will be allowed to create a panel of un-elected bureaucrats to dictate if a medical procedure is "efficient and economical". That is political speak for rationing of health care. Once the government gets in charge of your health records and actual health care, then they will want to cut the costs because it'll be too great for them to handle. The way they'll cut costs is just like what every other western government with socialized medicine has done; they'll tell older Americans that the hip surgery they need is "inefficient" since you're more likely to die sooner than a younger person. Tough luck! You now can't get your surgery because YOU let the IMPERIAL FEDERAL GOVERNMENT take over your health care....your very LIFE.

Socialized medicine is unconstitutional and immoral. It takes life and property from one group of people to give to another. That is an undeniable fact.

[jjh536]

I stand partially corrected. It isn't just tax dollars paying for the war, bailouts, and stimulus package, the money will also be printed and/or borrowed as well. And yes, the stimulus package includes tax cuts to appease republicans who think its the only solution to help the economy. EMR is slowing being phased into for those hospitals that can afford it right now. But many hospital don't even have plans or arent even considering it for a long time because of cost. This will expedite things by providing funds. There is a world of difference of health care between those who use EMR and those who don't. Yes I know this for a fact first hand. I'm sure why people think government will dictate our health care or medical procedures with EMS. Thats not it's main purpose of EMR. Private insurance co. and PBMs already dictate what is covered, so does government with Medical actually. This initiative does not change things to socialized medicine. All it does is bring modern technology to our aging facility and health care systems!

[Endbringer]

@jjh536

So let me get this straight. You complain about our government doing what is mandated in our Constitution, provide for the defense of the country, saying it costs too much, but then when the government wants to do what is UNCONSTITUTIONAL according to the 10th amendment, it's OK and in fact spending/borrowing more just fine? What's wrong with you?

Your right, this doesn't create socialized medicine. It's a fascist system where the government dictates how a private company will use it's funds and operate. And that's exactly what the liberals of this country want.

[pokiri]

Seems people are scared of computers and records .

[kehandley]

No, people are scared of a government with data.

[LuvThatCO2]

No, its pretty clear from the comments that they're 'scared' of the government essentially mandating that your personal medical records be placed online and under government control, without a clear indication that you can opt out.

[cjwall67]

Given the government's stellar record at maintaining security and compatibility, I'd say they have reason to be scared of this particular measure.

[CoffeeZombie]

I used to work at a company that contracted with the VA Hospitals and integrated their software with the existing VistA (the VA's medical records system) system. I am a big, big, big proponent of more electronic medical records. In fact, I feel more comfortable if I'm at a medical facility where they use electronic record systems.

And, yet, I am scared ******** at this development. So, sorry, your ad hominem fails.

[commsoft]

The purpose of this is simple - for insurers, employers, and the government itself to use as a basis for adverse decisions.

They will scour your medical records from birth to death every time you make a claim for anything to claim "pre-existing condition," or that you didn't do as much as you could have to improve yourself, or any other reason they can come up with to deny coverage, employment, or other benefits.

Count on it - if you tried a cigarette when you were 13 and told your doctor, you will be labeled a "smoker" for life and denied coverage for lung cancer caused by exposure to asbestos at your employer 50 years later. If you sought family counseling, or therapy after traumatic events, or other mental health treatment, you will be labeled mentally ill and this will be held against you in background checks and otherwise.

When do the government or insurers or most companies ever use information about people other than against them? Come on - when your W-2 is submitted, this isn't for your BENEFIT, it's so that they can TAKE from you. This is no different, and anyone telling themselves otherwise is deluded.

[memadmin]

Don't you guys know we are living the high life right now? If spending a whole bunch more money "stimulates" the economy then everything must be hunkey dorey due to George W. Bush increasing spending by 35% during his administration. I for one say that we have all of the "stimulation" we need and it is time to let the market signals and the power of the invisible hand to work as they should.

In terms of government medical database. You must be joking. I do not ask or welcome anyone to be involved in my medical care (or that of anyone I care about) except myself and my doctor. If you can't keep track of the drugs you are taking and your own medical conditions then expecting a federalized bureaucracy to do it for you is beyond idiocy.

[cjwall67]

No kidding. The problem is partisanship. The Democrats try to come across as centrist, thereby attempting to hide the radical leftist views of many of their membership. Republicans trumpet their conservatism in spite of evidence that they are sliding dangerously close to the shaky middle ground already occupied by the Democrats. If one applies the slightest degree of common sense to the issues facing us, alarm bells should be going off everywhere. We are being governed by people who generally lost touch with the real world a long time ago. Government's role is to diligently oversee, enforce the rule of law under their jurisdictions, protect the rights afforded to people by the constitution, and other than that, stay out of people's lives. If they had done this before, we wouldn't be in the situation we are in now.

[pentest]

Economics is a man made creation.

An "invisible hand' and 'self-correcting' markets are MYTHS designed to allow corporations and investors to do anything to make money.

The results of this lie are now bared to the world.

[lionfish3126_522]

Who cares where it's coming from? We need a change in this country. And if you are an American, just do it.. too much squabbling. Get a grip. Everything won't be free, if that's what you want, move to Paris, France. They have free health care, for every citizen, and so does Cuba and a few other countries. Go to Michael Moores website and click on his movie "Sicko".

[CoffeeZombie]

Free, yes, and unavailable.

Seriously, people in Canada who can afford it come to the USA for health care; especially for time-critical operations. Why? Because the waiting list is so long thanks to Canada's "free" health care that they couldn't wait.

[pentest]

Way to stretch the truth coffee zombie.

[cquick01]

The government has NO business knowing anything about my health records. Besides, this is just the beginnings of socialized healthcare in America.

We need to take note of the senators and representatives that allowed this bill to pass into the hands of our new socialist president and vote them out at the next available term. We also need to find ways to get this bill thrown out as unconstitutional by the Supreme Court of our Nation -- that is if the activist judges will do their duty and protect our constitution.

[chuckwh]

What part of the Hipaa laws does the author not understand?

http://personalinsure.about.com/od/health/a/aa041806a.htm

[Endbringer]

Whenever Congress passes a new law, it'll trump any older ones. So if anything in this new one violates HIPPA, then the new one will override it. Because this porkulus bill was passed without anyone ever paying attention to the consequences of it little things like HIPPA will just have to be fixed later, if at all.

Thank you liberal democrats and President Obama for this "Change we can believe in!".

[pentest]

Endbringer,

You are irrational. Unless a new law SPECIFICALLY states that it supersedes an older law, it does not invalidate it.

There is nothing in there saying that some mysterious board now makes decisions.

There is plenty to fear from government, but when wackos like you start exaggerate it makes it difficult for sane watchdogs to do their work.

Idiots like you are the reason Bush was able to marginalize his opposition and destroy our country.