April 7, 1999
While the American people were trying to kill the FDIC Know Your Customer plan to
monitor our financial records, the Clintonites have been moving
steadily and craftily to grab access to our health records. Just as
local bankers were to have been coopted to spy on our bank accounts,
the Administration is using two groups, home health providers and
senior citizens, to spy on our medical records and forward all sorts of
personal data to government databases.
The pretext for these
overreaching regulations is to uncover "fraud and abuse." But the
methodology is to monitor all law-abiding citizens under the
supposition that any of us might be doing something criminal.
regulation to force 9,000 home health care agencies to collect and
report sensitive information about all their patients was issued by the
powerful federal agency called HCFA (Health Care Financing
Administration). OASIS (Outcome and Assessment Information Set) is the
cutesy name for this latest venture into Big Brotherism.
Under OASIS, home health providers must interrogate ALL their patients, not merely
those whose bills are being paid by the government through Medicare or
Medicaid, exempting only children under age 18 and pre- and post-natal
mothers. The government is thus reaching out to grab the medical
records of patients whose medical bills are paid by private sources,
i.e., not paid by the government.
The 12-page fine-print form that
home health care providers must fill out on each patient is
extraordinarily detailed, offensively privacy-invading to the patient,
and obviously exhausting and time-consuming for the employee conducting
the interrogation. Curiously, this mandatory government form carries a
copyright notice on every page, probably to prevent commentators like
me from making copies and alerting the public to this new evidence of
the Clintonites' efforts to collect information that is none of the
The questionnaire isn't just about medical
history, treatment and medications. Questions must be answered on
race, ethnicity, family, whether you own or rent your residence, whom
you live with, your finances, and your psychological attitude and
behavior, of course, all tied into your Social Security
There's much more. The questionnaire demands information on
your mental state, your depression, your tobacco and alcohol use, your
obesity, your bathing and eating practices, and your lack of
motivation, unrealistic expectations, indecisiveness, suicide attempts,
and life expectancy. The form asks if you make grammar mistakes, or
use "excessive profanity" or "sexual references," and it has 53
boxes to be filled out on toilet and "elimination" performance.
home health care interrogator is instructed how to win the patient's
trust before asking these nosy questions. If the patient refuses to
answer any questions, the home health care employee is told to insert
his own "observations."
There is no provision for voluntary informed
consent on the part of the patient, or that he be told that his
responses will be logged onto government databases. Home health
providers must obey HCFA directives under penalty of not getting paid
for their Medicare patients.
These forms must be filled out every time
a home health care provider enrolls a new patient, and then revised
every 60 days. Data are sent electronically to computers at state
agencies and then to HCFA's database.
It was the 1996 Kennedy-
Kassebaum Act (which Bob Dole bragged about passing) that legislated
the framework for a federal system of collecting and sharing medical
records identified by a unique number for each patient. The OASIS
regulation is another step to implement one of the original goals of
Clinton's 1994 nationalized health plan: global budgeting, i.e.
government management of all private, as well as public, health-care
When grassroots Americans found out about the Know Your
Customer Regulation, they flooded the FDIC with 300,000 negative
comments over a three-month comment period. But the comment period for
the OASIS regulation expired March 26, and major newspapers didn't
report it until 15 days before the deadline.
Administration's other campaign to gather medical records is a plan to
recruit all senior citizens to spy on their own physicians with the
goal of accusing them of fraud. Attorney General Janet Reno has made a
public-private partnership with AARP to offer senior citizens the
chance to collect a reward of up to $1000 if they file a report that
leads to a monetary "recovery" from their doctor.
If a senior
suspects that his doctor has billed Medicare too much for a service
rendered, the senior is supposed to call the toll-free "Fraud
Hotline'' and report the doctor as a possible thief and crook.
harassment potential is enormous when 39 million seniors start trying
to collect a bonus if the doctor's office enters the wrong payment code
number on a Medicare form. It is probable that most seniors believe
that everything they buy is overpriced because they grew up at a time
when prices were so much lower.
What a malicious scheme to harass
doctors and destroy any confidential relationship between doctors and