But what if you don't consent?

The most personal of personal information about you -- your health records -- will soon be online, in the form of what the government calls an "EHR" (short for "Electronic Health Record"):

New federal regulations issued this week stipulate that the electronic health records--that all Americans are supposed to have by 2014 under the terms of the stimulus law that President Barack Obama signed last year--must record not only the traditional measures of height and weight, but also the Body Mass Index: a measure of obesity.

The obesity-rating regulation states that every American's electronic health record must: "Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient's height and weight."

The law also requires that these electronic health records be available--with appropriate security measures--on a national exchange.

Appropriate security measures my ass! Anyone who wants to peruse them -- including college professors doing studies (along with their students) will be able to become a "user" so long as the appropriate bureaucrat says so.

The CNS news article seems more concerned about BMI information than anything else. Sorry, but the issue is not whether the federal government can access my body mass index so much as whether it should be able to access anything at all about my medical records without my consent. And, even the briefest perusal of the "law" (if it's fair to dignify such a monstrosity with such a name) reveals that the BMI is only a small part of the mandated EHR database.

The Secretary adopts the following general certification criteria for Complete EHRs or EHR Modules. Complete EHRs or EHR Modules must include the capability to perform the following functions electronically and in accordance with all applicable standards and implementation specifications adopted in this part:

(a) Drug-drug, drug-allergy, drug-formulary checks.

(1) Alerts. Automatically and electronically generate and indicate in real-time, alerts at the point of care for drug-drug and drug-allergy contraindications based on medication list, medication allergy list, age, and computerized provider order entry (CPOE).

(2) Formulary checks. Enable a user to electronically check if drugs are in a formulary or preferred drug list in accordance with the standard specified in §170.205(b).

(3) Customization. Provide certain users with administrator rights to deactivate, modify, and add rules for drug-drug and drug-allergy checking. (4) Alert statistics. Automatically and electronically track, record, and generate reports on the number of alerts responded to by a user.

(b) Maintain up-to-date problem list. Enable a user to electronically record, modify, and retrieve a patient's problem list for longitudinal care in accordance with:

(1) The standard specified in §170.205(a)(2)(i)(A); or

(2) At a minimum, the version of the standard specified in §170.205(a)(2)(i)(B).

(c) Maintain active medication list. Enable a user to electronically record, modify, and retrieve a patient's active medication list as well as medication history for longitudinal care in accordance with the standard specified in §170.205(a)(2)(iv).

(d) Maintain active medication allergy list. Enable a user to electronically record, modify, and retrieve a patient's active medication allergy list as well as medication allergy history for longitudinal care.

(e) Record and chart vital signs.

(1) Vital signs. Enable a user to electronically record, modify, and retrieve a patient's vital signs including, at a minimum, the height, weight, blood pressure, temperature, and pulse.

(2) Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient's height and weight.

(3) Plot and display growth charts. Plot and electronically display, upon request, growth charts for patients 2-20 years old.

(f) Smoking status. Enable a user to electronically record, modify, and retrieve the smoking status of a patient. Smoking status types must include: current smoker, former smoker, or never smoked.

(g) Incorporate laboratory test results.

(1) Receive results. Electronically receive clinical laboratory test results in a structured format and display such results in human readable format.

(2) Display codes in readable format. Electronically display in human readable format any clinical laboratory tests that have been received with LOINC® codes.

(3) Display test report information. Electronically display all the information for a test report specified at 42 CFR 493.1291(c)(1) through (7).

(4) Update. Enable a user to electronically update a patient's record based upon received laboratory test results.

(h) Generate patient lists. Enable a user to electronically select, sort, retrieve, and output a list of patients and patients' clinical information, based on user-defined demographic data, medication list, and specific conditions.

(i) Report quality measures.

(1) Display. Calculate and electronically display quality measures as specified by CMS or states.

(2) Submission. Enable a user to electronically submit calculated quality measures in accordance with the standard and implementation specifications specified in §170.205(e).

(j) Check insurance eligibility. Enable a user to electronically record and display patients' insurance eligibility, and submit insurance eligibility queries to public or private payers and receive an eligibility response in accordance with the applicable standards and implementation specifications specified in §170.205(d)(1) or (2).

(k) Submit claims. Enable a user to electronically submit claims to public or private payers in accordance with the standard and implementation specifications specified in §170.205(d)(3).

(l) Medication reconciliation. Electronically complete medication reconciliation of two or more medication lists by comparing and merging into a single medication list that can be electronically displayed in real-time.

(m) Submission to immunization registries. Electronically record, retrieve, and transmit immunization information to immunization registries in accordance with:

(1) One of the standards specified in §170.205(h)(1) and, at a minimum, the version of the standard specified in §170.205(h)(2); or

(2) The applicable state-designated standard format.

Etc. Not only is my BMI none of the government's business, but neither are my medications, my shots, my growth records, my "smoking status" nor any of the other stuff listed above (along with whatever will be in the amended regs which are sure to come).

This is the most monstrous invasion of privacy I have ever seen.

And the people on the left who put it over continue to hide behind the smokescreen that they value "privacy." As if allowing you to have an abortion or do what you want to do in the bedroom gives them license to create and maintain files on every last aspect of your life.

This EHR database mandate was part of another massive unconstitutional legal scheme called the "2009 Economic Stimulus Bill":

...the bills that passed both the House and Senate created an "Office of the National Coordinator for Health Information Technology" and called for the coordinator to create a national database and a plan for "the utilization of an electronic health record (EHR) for each person in the United States by 2014."
Got that? Invading your privacy and putting your medical records online is being done under cover of stimulating the economy. Few words exist in the English language to properly characterize such supreme arrogance.

Think you can opt out if you want?


This is law. Your health records. Online.

Back in the 60s, there was a term for people who wanted to invade people's privacy and tell them what to do.

They were called pigs.

I'd call them that if I thought that a 1960s term might persuade them, but I don't think anything will. This stuff is about pure, raw, power, and they are not going to back down. They believe they have a right to invade our privacy and tell us what to do.

For our own good.

Absent a new congressional majority willing to vote to stop this thing in its already-laid tracks (and any such majority would have to be strong enough to override a presidential veto), the only thing that people can do is massive civil disobedience. Refuse to consent to the creation of any government-accessible "EHR" from your medical files. JUST SAY HELL NO! Maybe doctors can get involved too. They still take an oath to do no harm, and this would do great harm. For starters, this violates the physician-patient privilege. Some things are personal. I'm not fat, but fat is not the issue. Nor is whether I am "obesogenic":

The new regulations also stipulate that the new electronic records be capable of sending public health data to state and federal health agencies such as HHS and CDC. The CDC, which calls American society "obesogenic" - meaning that American society itself promotes obesity - collects BMI scores from state health agencies every year to monitor obesity nationwide.

"Electronically record, retrieve, and transmit syndrome based public health surveillance information to public health agencies," the regulations read.

With the spread of electronic health records, the CDC apparently will be able to collect such data more efficiently and with greater accuracy because the electronic record keeping systems can send the data automatically, eliminating the need for government - both state and federal - to keep, send, and process physical records.
Fuck the CDC, the FBI, the CIA, Homeland Security, and the rest of the bastards who think they have a right to rule by administrative fiat. Unless they get a warrant based on probable cause that I'm involved in crime, they have no right to look at my health records or anyone else's. Health records are between me and my doctor.

Fat is not the issue. Does anyone really think they'll stop there?

MORE: Since the election of Barack Obama, federal health officials are trotting out the old "guns are a health issue" meme. (Anyone remember the campaign to have doctors ask patients whether they owned guns?)

And if you think linking gun ownership to health is bad, just how long do you suppose it will be before citizen's EHRs are integrated into gun buyer's background checks?

These people are relentless. (Unfortunately, blog posts cannot stop them.)

posted by Eric on 07.19.10 at 12:39 AM


Hahahaha, Eric, it's not a good idea to post anything after a day of gin and tonics.

But seriously, an excellent rant. This is exactly what will happen. But you forgot to add that the electronic part is being pushed by those fuckers at GE, who will make trillions off the centralized electronic information. And think of the fraud, scam, and advertising potential. Wait until the 'scooter store' providers can sniff thru the data and direct mail all the fatties and crips, or pre-diabetics, and helpfully just bill Medicare for their chairs and cookbooks.

dr kill   ·  July 19, 2010 7:59 AM

Almost no one, especially on the Left, who claims to care about privacy has taken exception to the requirement that citizens send their financial information to the Federal and State governments every year. Their support for the principle is, shall we way, intermittent.

I believe taxation should be administered by less intrusive means.

I imagine few on the left will complain about this invasion of privacy. An individual's medical records should be in his own possession and shared with medical personnel at his own discretion. The government should have zero access to them.
To those in any faction who claim that privacy is not a constitutional right, I refer the Ninth amendment, which renders most legislation illegal.

Brett   ·  July 19, 2010 8:03 AM

DK you are absolutely wrong! I hate gin and tonics.


Brett, I think the difference in the case of financial records is that the 16th Amendment (especially as it was interpreted) gave Congress at least theoretical power to demand citizen accounting. And the 18th Amendment gave them power to raid breweries and distilleries.

But in the case of health records, where is the amendment?

Eric Scheie   ·  July 19, 2010 9:02 AM

Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.
...--C. S. Lewis

John S.   ·  July 19, 2010 10:57 AM

(3) Customization. Provide certain users with administrator rights to deactivate, modify, and add rules for drug-drug and drug-allergy checking.

Did you notice that some people will be allowed to change your record? Suppose you are allergic to sulfas and penicillin (rather common)? And some helpful administrator decided to delete that information from your files (clerical error). If this then becomes the standard medical record the government could have just given you a death sentence.

Who ya gonna sue?

M. Simon   ·  July 19, 2010 12:02 PM

In the New Progressive Paradise, consent will be mandatory.

filbert   ·  July 19, 2010 12:56 PM

Quite right, Eric. My point was that those who claim to believe in a right to privacy should be demanding repeal of the 16th amendment and related state law.

Brett   ·  July 19, 2010 2:09 PM

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