According to Porter, the goal of the legislation is to reduce medical errors, improve the quality of health care, and cut costs. But it would have the serious unintended consequence of eroding employees‚ privacy. That's because it would require compliance with the Health Insurance Portability and Accountability Act (HIPAA), which eliminated the freedom to forbid the sharing of one's health information with some 600,000 entities.

A representative of the Government Accountability Office (GAO) testified on H.R. 4589, noting that "According to the Office of Personnel Management, it is planning to use its position as one of the largest purchasers of employee health care benefits to contribute to the expansion and use of electronic health records, electronic prescribing, and other health IT-related provisions." It's clear from the GAO testimony that the move to computerize federal employees‚ health records is part of the larger goal of establishing a national health-information infrastructure. Also, the GAO reported that grants from the U.S. Department of Health and Human Services to implement such a system included an $11.5 million grant in September 2005 "to assess and develop plans to address variations in organization-level business policies and state laws that affect privacy and security practices, including those related to HIPAA, which may pose challenges to interoperable health information exchange." (Emphasis added.) State medical-privacy laws that are much more stringent than the federal privacy rule stand in the way of the national infrastructure. Thus those working to establish the new system would need to eliminate the state laws that impede their effort to distribute patient data electronically without consent.

Many members of Congress and their staffs seem to be insufficiently aware that the federal privacy rule reduces the freedom to control access to personal health information (because it eliminates the need for patient consent). Until the consent requirement is fully restored, any proposal to computerize health records is a recipe for increasing the nonconsensual distribution of such information, and therefore for increasing privacy invasions.

Sources:

• To read the complete bill text of H.R. 4859, visit the congressional legislative database http://thomas.loc.gov and search for bill number H.R. 4859.
• Hearing on Improving the Quality and Delivery of Health Care within the FEHBP, Subcommittee on Federal Workforce and Agency Organization, Committee on Government Reform, House of Representatives, March 15, 2006: http://reform.house.gov/FWAO/Hearings/EventSingle.aspx?EventID=40278
• "Health Information Technology: HHS is Continuing Efforts to Define a National Strategy," GAO Testimony Before the Subcommittee on Federal Workforce and Agency Organization, Committee on Government Reform, House of Representatives, March 15, 2006: http://reform.house.gov/UploadedFiles/GAO-06-346T.pdf