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Old August 17, 2012, 06:14 AM   #51
zukiphile
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Quote:
Originally Posted by Aquila Blanca
Glenn mentioned a few posts above that conspiracy theories don't help, but perhaps they don't hurt, either. I think we need to at least be alert to and aware of nuances and possibilities.
I didn't read Bill as offering a conspiracy theory.

The issue presented by an expansion of government authority isn't whether one group or another have conspired to acheive a dangerous end, but whether that expansion would enable a group to acheive that sort of end.

My experience with government is that if people in government have an authority, they will not leave it unused. Occassionally they use it even if they don't have it.


About the ACA, there is a good bit of poor information circulating (judging from my email inbox) for several reasons not the least of which is that it is a lot of text. What is clear is that the ACA gives the federal government a larger role in shaping insurance coverage and influencing what services are paid and why they are paid. What is paid must necessarily influence providers.
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Old August 17, 2012, 10:44 AM   #52
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To add some hydrogen to this particular fire....

Suppose you doctor does ask if you own firearms, and your answer is to say "none of your business" or to not answer at all. How do you know that you are NOT being put in the category of a firearms owner? It could well be that any answer other than a clear "no" would put you in that category!

It has happened before with othe statistics. Race, for one. People who have not answered clearly on a "which race" question have been statistically "assigned" a racial group.

Or so I have heard........
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Old August 17, 2012, 12:22 PM   #53
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Well, I'm in trouble as I've discussed related health issues and firearms with all my doctors. When they put me in the ambulance, probably going to take me to Bloomberg's Hall of Justice.

Most TX doctors seem ok with the issue. My wife's cardiologist has gun magazines (read type - not clips - haha) in the waiting room. So does our eye doctors, dentists, etc.
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Old August 17, 2012, 12:38 PM   #54
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What could happen to me that I might want a doctor to keep secret?

Is this thread telling me that if I get shot, I shouldn't go to a doctor?
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Old August 17, 2012, 01:00 PM   #55
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Originally Posted by BlueTrain View Post
What could happen to me that I might want a doctor to keep secret?

Is this thread telling me that if I get shot, I shouldn't go to a doctor?
Some docs are perfectly fine. I did some work on a medical records system once for a guy, and he made me take the gun question out of the survey. He complained that the AMA was becoming too invasive.

So not all docs share the feeling. But there are a lot who do.

So it's situational. If your doc is ok with it, then there's no issue. But if your doc is interested in the social engineering then it isn't ok.
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Old August 17, 2012, 05:57 PM   #56
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Quote:
Originally Posted by 44 AMP
Suppose you doctor does ask if you own firearms, and your answer is to say "none of your business" or to not answer at all. How do you know that you are NOT being put in the category of a firearms owner? It could well be that any answer other than a clear "no" would put you in that category!
I share that concern. And this is why if I should ever encounter the question I will simply answer "No." I don't consider myself under oath when filling out a patient intake form in a doctor's office.

I am more concerned about pediatricians getting access to kids and coaxing the kids into ratting out the parents. Fortunately, my daughter is nearly an adult and won't be seeing any new pediatricians until she has her own kids, but I worry about my younger friends who iown guns.
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Old August 17, 2012, 08:21 PM   #57
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Wasn't this originally an issue in Florida because a doctor refused to treat a patient who had firearms, leading to the law that was overturned by the court ?
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Old August 18, 2012, 04:11 AM   #58
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Quote:
What could happen to me that I might want a doctor to keep secret?

Is this thread telling me that if I get shot, I shouldn't go to a doctor?
Not at all.

It's a matter of providing relevant information to your doctor and not providing him with information that is generally irrelevant to your treatment. As a for instance -- suppose you go to the doctor with a nasty cold that you are worried will turn into bronchitis. The form his office asks you to fill out asks questions such as do you live alone?; does your home have an alarm system?; do you store your valuables in a safe?; is there a surveillance system in your home? You'd wonder just what that has to do with treating you for any kind of illness or ailment. It's just none of the doctor's business.

As someone (Glenn?) pointed out earlier, there are times when asking about guns in the home might be appropriate. The example given was when someone or a family member is seeking treatment for depression. Or perhaps the doctor wants to administer a certain drug to a teenager with psychological "issues". Firearms in the house, along with large knives, axes, etc. could be potential weapons should the treatment not work or if they suddenly stop taking the drug.

However, I'd suggest that asking about guns is possibly the wrong approach. Instead the doctor should explain the dangers of the condition & treatment approach to the patient and/or family. He can recommend any dangerous tools be locked up or removed from the home at the discretion of the family.

The theoretical danger is that a doctor who records the fact that you have firearms and one or more persons in the household suffer some kind of "mental illness", may in the future, be required to report this combination separately to a government agency.
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Old August 18, 2012, 09:49 AM   #59
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I don't recall what was on the form the last time I filled in one with medical history, although I don't remember any questions like this. I don't like to think of having to find another doctor either. Our present one, who is an Iranian woman, is getting on in years.
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Old August 18, 2012, 12:31 PM   #60
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This is a situation where you should simply lie. Ask them, "Why would I have a gun? Guns are bad". Next question.
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Old August 18, 2012, 01:54 PM   #61
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I almost hate to bring this up, but if the doc's forms become Federal forms (nationalized healthcare) then might not lying on the forms become a Federal crime? (like on the 4473 form?)

Of course, if this did come to pass, they would have to imform you (on the form), so read all the fine print, folks!

About a decade ago, the husband of a coworker was seeking treatment from the VA for some kind of PTSD (not privy to more details than that), but I was told by his wife that the VA told them he had to get rid of his guns, or they would not treat him.

I believe they felt he was an at risk individual. Rock and a hard place, he sold his two guns.

Now, what if your doc told you that?
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Old August 18, 2012, 02:09 PM   #62
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Originally Posted by 44 AMP
I almost hate to bring this up, but if the doc's forms become Federal forms (nationalized healthcare) then might not lying on the forms become a Federal crime? (like on the 4473 form?)...
Pretty doubtful. Currently, medical records, including such things as a Medical History form filled out by a patient and made part of the medical chart, for Medicare or Medicaid patients aren't considered government forms.
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Old August 18, 2012, 06:02 PM   #63
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Quote:
I almost hate to bring this up, but if the doc's forms become Federal forms (nationalized healthcare) then might not lying on the forms become a Federal crime?
Hence my previous comment: backdoor registration.

Quote:
Currently, medical records, including such things as a Medical History form filled out by a patient and made part of the medical chart, for Medicare or Medicaid patients aren't considered government forms.
"Currently" .
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Old August 18, 2012, 06:27 PM   #64
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Originally Posted by Silver Bullet View Post
.. ..."Currently" .
Provide some solid evidence that a change could seriously be considered a real possibility. Without solid evidence you're just having a tinfoil hat fantasy.
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Old August 19, 2012, 06:33 AM   #65
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Consider the current use of the Social Security number....

Where data exists, data will be used
Depend on it.

(No tinfoil req'd)
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Old August 19, 2012, 10:42 AM   #66
Frank Ettin
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Originally Posted by mehavey
Consider the current use of the Social Security number....

Where data exists, data will be used
Depend on it....
Why don't you then provide us with some [well documented] examples of the misuse of all the data that current does exist in folks' medical records.

Quote:
Originally Posted by mehavey
...(No tinfoil req'd)...
Well, we'll see if you can document you contentions.
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Old August 19, 2012, 10:57 AM   #67
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Quote:
Provide some solid evidence that a change could seriously be considered a real possibility.
How could it NOT be considered a real possibility?

Quote:
Without solid evidence you're just having a tinfoil hat fantasy.
I guess if you don't have an argument, you resort to mockery.
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Old August 19, 2012, 11:54 AM   #68
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Quote:
Originally Posted by Silver Bullet
Quote:
Provide some solid evidence that a change could seriously be considered a real possibility.
How could it NOT be considered a real possibility?
First, it appears to be your contention that the current, robust protection for the confidentiality of medical records may very well change. If it's your contention, it's your burden to come up with the evidence to support it.

On the other hand, over the last 20 or so years we have seen a continual tightening and strengthening of statutory and regulatory protection of the confidentiality of medical information.

Quote:
Originally Posted by Silver Bullet
Quote:
Without solid evidence you're just having a tinfoil hat fantasy.
I guess if you don't have an argument, you resort to mockery.
You've made no argument, nor have you supplied any evidence to support your vague fear that current robust protections of medical information privacy will be obviated. On that basis, my comment was sound.
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Old August 19, 2012, 12:45 PM   #69
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Like a lot of things, the question is not what they are doing today, or next month, but what they might be able to do much further down the road.

Lay the basic groundwork, and then let us go back to sleep so they can build on that foundation 5 or 10 years later. Dismissing a concern as "tin foil hat" stuff may be factual today, but 20 years from now, it might be both policy and the law, if we do nothing.

I'm not saying we should get all freaked out, or anything like that, but these things bear watching. Constant vigilance is the only thing we can, or should do, until and unless people in govt put forth specific proposals limiting our rights and our liberty.

One should always consider the potential possibility, however remote it seems today, for abuse, both intentional and unintentional. Mission Creep is endemic to any bureaucracy, and there is always the law of unintended consequences to consider.

We have laws on the books right now, that, if extended far enough would do all kinds of things, from banning revolvers to requiring travel permits to move from state to state. They aren't being used that way now, because we are watching and would not permit such a huge abuse of power. But it is not outside the realm of possibility that someday, someone might try to do it.

After all, who would have thought, 20 or 30 years ago that there would be a law mandating we all have health insurance? Or that one could be virtually stip searched in order to board an airplane?

Hope for the best, but plan for the worst, and one is seldom disappointed....
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Old August 19, 2012, 12:45 PM   #70
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Frank, unusual though it is, I'm going to disagree with you on this one.

Do I think there's a conspiracy afoot for the government to go after gunners via HIPAA? No.

But do I dislike the potential for the system to be abused by some Mike Newell type? Most definitely.

It doesn't require a vast conspiracy for a system to be easily exploited by an overzealous bureaucrat. It just requires access, and the wrong type of person.

I am not a fan of centralized records.

(Edit: As I think about this, how many of us have received "Possible release of personal information" warnings from the VA, a hospital, a bank...? Probably most of us. The only saving grace to the massive amounts of info out there may be that there is just so much of it that exploiting it can be a challenge.

But I am still not a fan of centralized records.)
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Old August 19, 2012, 02:39 PM   #71
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Quote:
Originally Posted by 44 AMP
...One should always consider the potential possibility, however remote it seems today, for abuse, both intentional and unintentional....
The possibility of abuse always exist, no matter what. If a question is asked, there's always a possibility to abuse the answer. If a question is not asked there is always the possibility to abuse the resulting ignorance (What could I have done? I didn't know?).

Quote:
Originally Posted by MLeake
...do I dislike the potential for the system to be abused by some Mike Newell type?...
And there is no system that can possibly be devised that can't be abused by somebody.

Quote:
Originally Posted by MLeake
... As I think about this, how many of us have received "Possible release of personal information" warnings from the VA, a hospital, a bank...? ...
The only reason we have received those notices is that the various confidentiality laws enacted, at both the state and federal levels, have required the sending of those notices.

But no more information is being collected than was collected before those laws were adopted. The risks of improvident disclosure may have increased somewhat because to the sheer volume of information created by an increasing population and the increased, and necessary, reliance on electronic records management. But the information collected and maintained is no less necessary to the performance of the various services provided by those institutions than it was years ago.

Quote:
Originally Posted by MLeake
...I am still not a fan of centralized records...
I'm not sure what you mean by "centralized records." If you mean combining all records from various private sources in one data base, that doesn't exist; and there has been solid resistance to anything of the sort.

But also, as is so often the case some things are neither all bad nor all good. The electronic management of claim and medical records by providers, insurance companies and Medicare/Medicaid payment intermediaries, while of course having a potential to be abused (anyone have any documented examples of actual abuse), there are also benefits.

Medication errors are a serious issue. Many of those error arise from a lack of access to other available medical information on a patient. Electronic management of medical records has helped ameliorate the problem. And audits of prescription drug claims records by payors have identify patients at risk of adverse drug interactions.

Quote:
Originally Posted by 44 AMP
...I'm not saying we should get all freaked out, or anything like that, but these things bear watching. Constant vigilance is the only thing we can, or should do, until and unless people in govt put forth specific proposals limiting our rights and our liberty....
And that's the point. Constant vigilance and taking action when something concrete to act upon or against shows up is one thing. Gnashing of teeth and rending of garments over mere, undefined vague possibilities in another.

If something is a threat, act. But if one can't articulate why or how, in real life, something is an actual threat, stand down and watch.
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Old August 19, 2012, 03:30 PM   #72
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Originally Posted by Frank Ettin
The only reason we have received those notices is that the various confidentiality laws enacted, at both the state and federal levels, have required the sending of those notices.
No.

As a veteran who has received notices from the VA, I can attest that the reason we receive such notices is that our super-secret, uber-confidential personal information HAS BEEN COMPROMISED and they are locking the proverbial barn door after the theft of the proverbial horse by telling us that we might want to watch our entire financial lives for the next six months because some person or persons unknown is/are now in possession of our name, address, social security number, and complete (VA) medical history.
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Old August 19, 2012, 03:52 PM   #73
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No.

As a veteran who has received notices from the VA, I can attest that the reason we receive such notices is that our super-secret, uber-confidential personal information HAS BEEN COMPROMISED and they are locking the proverbial barn door after the theft of the proverbial horse by telling us that we might want to watch our entire financial lives for the next six months because some person or persons unknown is/are now in possession of our name, address, social security number, and complete (VA) medical history.
But the information might well have been compromised in the past as well but you didn't get the notices because the law then didn't require them.


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Old August 19, 2012, 06:20 PM   #74
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While that may be true, I am MUCH more interested in not having the information compromised in the first place than I am in a basically useless "We screwed up" letter after the fact. And if the data are provided (or available) to the .gov pursuant to changes in the law at some future time, we won't even get a "We screwed up" letter.

The best way to prevent data from being compromised is to not allow it to be collected in the first place.
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Old August 19, 2012, 06:37 PM   #75
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Originally Posted by Aguila Blanca
...The best way to prevent data from being compromised is to not allow it to be collected in the first place.
Yet much of the data can be necessary for the services provided.

This can be especially true when dealing with medical matters. I've seen many bad medical outcomes in which the sad result was caused or contributed to by a lack, or inaccessibility, of information in a medical record.

It would perhaps be nice to go back to a time when we lived our whole lives in one small town being treated for all medical problems by the same doctor who attended our birth, while keeping our money in the local bank under the charge of a banker who has known all his customers by name since they came into the world. It ain't like that no more -- if it ever was.
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