Today's news today, doctors, Peel, and individual insurance

By Matthew Holt

I just noticed that THCB today is all about last week and Sunday’s news—including Merrill Goozner and me jumping separately on the same magic quote in the NY Times CT piece. So how about three little pieces of news about stuff reported today.

First off, in a desperate attempt to keep the Republicans from losing all 33 Senate seats in November, CMS is freezing the cuts in Medicare fees which were due to go automatically into effect this week. Bob Laszewski has a just excellent explanation of how the Dems finally seem to have figured out how to play hardball with the Republicans and AHIP. Perhaps they’ve taken on Tom Delay as an advisor, now he’s not so busy. Meanwhile Bob thinks that the 7 missing Republican votes will return from July 4 and the Medicare Advantage and PFFS plans will get their comeuppance. Wall Street isn’t so sure, and those health plan stocks are trading higher today.

Second, in the category of things I couldn’t resist, self-appointed patient privacy advocate Deborah Peel has a letter in the NY Times telling us all that the reason that doctors don't use EMRs is because they’re concerned about their patients’ privacy. She claims that:

Doctors are loath to add sensitive records to a system that uses personal health information against patients. Americans’ personal health information is used to deny jobs, promotions, insurance and credit…<SNIP>…The data-mining industry makes millions selling our health information, claims data, prescriptions and genetic information to insurers, employers, researchers, drug companies and data aggregators.

Let’s assume that she’s right (which she’s not) and that identified data is being sold rampantly. What data is it that gets sold? It’s almost all claims data — as she points out. If doctors are so adamant that none of their patients data should leave their office because of privacy, presumably none of them would submit claims. Oh, hang on -- they all submit claims. So perhaps it’s not privacy concerns that are the problem. Hint to Dr Peel and the rest—doctors submit claims because they get paid by doing so.

Of course, Dr. Peel could join those of us who believe that it’s not the sharing of information that should be stopped, but instead we should ban the discriminatory practices of those who use it against patients after directly requesting it from them. Which is how they actually get that identified information, rather than buying it from mysterious middlemen. (Or perhaps Dr Peel has never filled in a health or life insurance application).

Third, talking of discrimination in the the individual insurance market, Hawaii has done something sensible. It’s calling sole proprietors a “group” and telling the insurers to give them the group deal and stop underwriting them. Massachusetts did something similar with it’s new plans. Now all they need is to mandate them to buy insurance (to stop adverse selection) and come up with a sensible way to pay for it. OK, I know that’s what we need the whole country to do. Maggie Mahar points to the Fuchs/Emmanuel plan as one way of doing that (although I get a little lost in the VAT versus income tax debate….)