From a political vantage point, one novel feature of Sen. Hillary Clinton's health care plan is that it's the first Democratic proposal framed by the language of choice -- a significant departure from the framing that accompanied her 1993 plan, which touted "health security" for Americans. A lesson learned: the political elites focused on insuring the uninsured; voters worried that a new bureaucracy would constrain choices. Clinton's plan is titled "American Health Choices."
Speaking to reporters this morning, Clinton predicted that her critics would have a much more difficult time demagoguing her proposals. She was blunt:
"It's not a government run health care system. It creates no new bureaucracy. People are going to have the same health care choices as members of Congress, and so it's going to take quite a bit of contortion to come up with that sort of misrepresentation."
"Americans from all walks of life," Clinton told us, "aren't going to be fooled again."
In 2000, Democratic intellectual Andrei Cherny wrote "The Next Deal," which described what he called "the Choice Revolution." Cherny challenged Democrats to envision government not as a guarantor of rights and security but also as a guarantor of, a provider of, a facilitator of, choices.
Clinton and other Democratic presidential candidates have read the book; at one of those fancy Washington book parties the bloggers love to hate, I once saw Clinton and Cherny chatting about it.
The Clinton plan incorporates universal coverage but does not define itself by that goal. It incorporates cost-cutting but does not define itself by that goal, either. Instead, the freshest fruit of Clinton's plan is that it secures universal choices.
By the way: the plan wins important and substantive plaudits from three of the most influential voices in center-left cognoscenti.
The New Republic's Jonathan Cohn wondered: "Would she be vague, figuring she had the least to prove on the matter and that details could only come back to haunt her? Would she settle on something less than universal coverage, figuring the political support for it was too weak? Would she kowtow to the insurance and pharmaceutical lobbies, which had started donating to her campaigns? The answer seems to be no, no, and no."
Ezra Klein, who is even harder to please, calls the policy proposals "very, very, sound."
The only question is how serious of a proposal it is, i.e, whether it's what she plans to fight for from her first day in office, or whether it's to keep Edwards and Obama from opening up an advantage on her left flank. For now, there's no way to know. But given how smart she's been about neutralizing the other candidates' potential advantages -- including, with this plan, cutting their legs out on health care -- we're likely to find out.
And my colleague Matthew Yglesias writes that Clinton is "is drawing close to checkmating her opponents."
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For Immediate Release September 17, 2007
Contact: Deborah C. Peel, MD or 512.970.9007
Will Hillary’s New Health Care Plan Ensure That Americans Control Access to Their Health Records?
Will Senator Clinton display a newfound respect for every American’s right to health privacy? Or will Senator Hillary Clinton’s new health care plan violate patient privacy like her 1993 plan? 2,400 years ago, Hippocrates realized that patients would not seek medical treatment unless doctors swore never to share any information they disclosed without consent. Health systems that do not preserve the privacy of the patient-doctor relationship will fail, because patients will not be willing to participate in a system that allows employers and corporations to steal and use personal health information to harm them.
Dr. Deborah Peel, of the Coalition for Patient Privacy asserts, “HMOs, the insurance industry, employers, marketing firms, the drug industry, banks and financial institutions, and the data aggregating industry all view health care “reform” as a golden opportunity to strengthen and extend the authority HIPAA granted them to steal every American’s sensitive health data. The primary use of electronic health records today is for sale or use by corporation for purposes that do nothing improve health.”
Will the citizens of New Hampshire support Senator Clinton if she doesn’t end prescription data mining? In 2006, New Hampshire passed a law to stop prescription data mining. The state was sued by two data mining corporations and a judge blocked the new law. One of those corporations reported revenue of $1.75 billion in 2005. Not a dime was used to help a single sick person.
Consumers should beware of health plans advanced by Senator Clinton and the other presidential candidates if their plans do not adhere to the 2007 privacy principles developed by the Coalition for Patient Privacy:
Recognize that patients have the right to medical privacy*
Recognize that user interfaces must be accessible so that health consumers with disabilities can individually manage their health records to ensure their medical privacy.
The right to medical privacy applies to all health information regardless of the source, the form it is in, or who handles it
Give patients the right to opt-in and opt-out of electronic systems
Give patients the right to segment sensitive information
Give patients control over who can access their electronic health records
Health information disclosed for one purpose may not be used for another purpose before informed consent has been obtained
Require audit trails of every disclosure of patient information
Require that patients be notified promptly of suspected or actual privacy breaches
Ensure that consumers can not be compelled to share health information to obtain employment, insurance, credit, or admission to schools, unless required by statute
Deny employers access to employees’ medical records before informed consent has been obtained
Preserve stronger privacy protections in state laws
No secret health databases. Consumers need a clean slate. Require all existing holders of health information to disclose if they hold a patient’s health information
Provide meaningful penalties and enforcement mechanisms for privacy violations detected by patients, advocates, and government regulators
* Definition: Health information privacy is an individual’s right to control the acquisition, uses, or disclosures of his or her identifiable health data. (Report of the NCVHS to Sec Leavitt dated 6/22/06)
About Dr. Deborah Peel and the Coalition for Patient Privacy
Dr. Peel is known for her straightforward and fiery advocacy, ranking number #4 on Modern Healthcare magazine’s 2007 list of the 100 Most Powerful People in Healthcare.
Patient Privacy Rights and Dr. Peel earned the attention of Congress by working cooperatively to form the bi-partisan Coalition for Patient Privacy in 2006. The Coalition includes over 40 organizations from across the political spectrum, including the Family Research Council, the Christian Coalition, the Electronic Privacy Information Center , the California Medical Association and the ACLU. Collectively, the Coalition shares the vision that Americans should control all access to their health records.
Patient Privacy Rights and the Coalition continue to educate Congress about the need for ‘smart’ legislation to ensure the right to health privacy is guaranteed and protected in federal statute. Patient Privacy Rights also promotes the use of ‘smart’ technologies that ensure consumer control of personal health information such as consent management systems and health record banking or trusts.
Patient Privacy Rights is a national consumer watchdog organization based in Austin , TX. The mission of Patient Privacy Rights is to guarantee that all Americans
control access to their health records. Web site: www.patientprivacyrights.org
Interviews with Dr. Peel about the privacy implications of the health care plans advanced by the presidential candidates can be arranged by contacting Ashley Katz: akatz@patientprivacyrights.org
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Posted by healthprivacyadvocate | September 18, 2007 11:42 AM