Blue Cross Blue Shield of Massachusetts, the largest health insurer in the state, plans to collect detailed personal information on enrollees seeking mental health treatment, the Boston Globe reports.

The insurer previously required psychiatrists and therapists to file progress reports on patients. But in 2007 it will ask patients to answer 58 personal questions (on paper or through a secure website), including questions about their moods, feelings, and sex lives. [The questionnaire is online: http://graphics.boston.com/business/pdf/test.pdf] Patients will be asked to complete the questionnaire after every eight counseling sessions—or more often if the insurer wishes. Patient participation is supposed to be voluntary. However, if enough patients don’t comply, their doctors or therapists could be denied annual increases in reimbursement.

Some psychiatrists and mental health-service organizations have already voiced concern over the policy. Dr. Marc Whaley, a psychiatrist and president of the Southeastern Massachusetts Psychiatric Society, asked, “Who in their right mind would fill out such a form?” Bruce Mermelstein, president of Comprehensive Outpatient Services, told the Globe, “We generally don’t feel positive about sharing any information with an outside source. That’s a legitimate worry.” He stressed that patients should be concerned about their privacy. Even so, for the past two years the state’s second largest insurer, Harvard Pilgrim Health Care, has distributed similar forms to mental health patients, and about 60 percent of patients have filled them out.

It’s clear that as health-care costs continue to rise insurers will increasingly manage access to treatment in their attempt to curb costs. In doing so they will continually expand their access to patients’ personal information.

Perhaps it’s time for Massachusetts residents—and all citizens across the country—to put health-care decision-making power back in the hands of consumers to ensure the right to privacy. One step to achieve this important goal would be to reduce state and federal income tax rates for all citizens, and simultaneously eliminate the federal tax advantage employers receive for purchasing health insurance. This policy change would empower consumers to pay out-of-pocket for routine health-care services, thereby increasing their privacy (while maintaining catastrophic insurance for major expenses).

Citizens in a free country should have the liberty to seek the treatment of their choice and pay for it privately, without having to go through an insurance bureaucracy or having their privacy invaded.

Source: “Insurer Seeks Personal Details on Mental Health Form: Experts Question Plan by Blue Cross,” by Christopher Rowland, Boston Globe (online), November 11, 2006: http://www.boston.com/business/globe/articles/2006/11/11/ insurer_seeks_personal_details_on_mental_health_form/