NCPA - National Center for Policy Analysis

Medicare To Collect Data For Big Brother

April 9, 1999

Under the pretext of regulating prices and assuring "quality" services, reports Robert E. Moffit of the Heritage Foundation, the Health Care Financing Administration (HCFA), the powerful bureaucracy that runs the Medicare program, has proposed a rule that would force 9,000 home health care agencies to collect and report sensitive personal information on their patients -- without their consent or knowledge.

The data collected will be transmitted to an evolving federal database, the Outcome and Assessment Information Set (OASIS).

  • The information will include each patient's Social Security number, demographic characteristics, living arrangements, and financial resources, as well as information on sensory, respiratory, and elimination status, mental state, behavioral characteristics, range of activities, medication, productivity, and "quality of life" characteristics.
  • The psychological profiles will note whether the patient had expressed "depressive feelings," a "sense of failure," or "thoughts of suicide," or used "excessive profanity" or made "sexual references."
  • This information eventually would be made available to state governments.
  • Moreover, data would be collected on patients who are not being treated under Medicare and for whom no Medicare payment is being made or sought.

HCFA's proposed data collection is only the latest in a disturbing pattern of government intrusion into personal liberty and privacy, says Moffet. For instance,

  • In the Health Insurance Portability and Accountability Act of 1996, Congress enacted the framework for a federal data collection system, including the storage and sharing of patient records.
  • In Section 4507 of the Balanced Budget Act of 1997, Congress imposed unprecedented restrictions on private agreements between doctors and Medicare patients even where no federal tax dollars are involved.
  • And in HCFA's recent regulations setting up the "Medicare+Choice" program, medical records of seniors can be disseminated without the voluntary and informed consent of those patients.

Source: Robert E. Moffit, "HCFA's Latest Assault on Patient Privacy," Executive Memorandum No. 580, March 22, 1999, Heritage Foundation, 214 Massachusetts Avenue, N.E., Washington, D.C. 20002, (202) 546-4400.


Browse more articles on Health Issues