The Affordable Care Act and the Potential for Widespread Personal Information Sharing
A Political Conversion
Like many 20-somethings of my generation, I felt completely disenfranchised by the two terms of Bush II's administration, despite the circumstances of my birth and childhood. I come from a relatively backwards rural community, heavily stocked with hillbilly ignorance ranging from a perverse obsession with massive trucks to blatant racism. I grew up in an upper middle class household with definite Republican leanings, attended a Catholic elementary school, and my personal political beliefs basically mirrored those of my parents throughout my adolescent and teenage years.
However, George W. Bush's absurd response to the attacks of September 11th, his bungled tax cuts, and the influence of his faith on his politics, forced me to reevaluate my political beliefs. In short, since America sought publicly to reestablish herself as an imperial nation, and since I became more informed about the various social and political systems deliberately put in place to subjugate massive sections of the populations, my political leanings have taken a sharp turn toward the Left.
Therefore, as a Democrat, I was ecstatic when the Patient Protection and Affordable Care Act was passed. Finally, a form of universal health care that won't deny the poverty-stricken or children with preexisting conditions; a form of healthcare that insists that individuals cannot be dropped by their carriers once they become sick; a form of health care that is estimated to drastically reduce health care costs... HOORAY! Score one for Uncle Sam!
I've always felt that fair access to health care is an inalienable right, and this legislation seems to be a step in the right direction. However, in spite of my undeniable crush on the Patient Protection and Affordable Care Act, I do have one major concern with this piece of legislation: In the language of the individual mandate, there exists the potential for government intrusion into the private sector that is eerily reminiscent of the Patriot Act signed into law by Bush II.
In order to actually enforce the individual mandate spelled out in the act, there must be some way of tracing every individual's annual financial history. According to an article on the Americans for Tax Reform's website, there's no way around this for citizens who pay income taxes. The piece states that, "When Obamacare’s individual mandate takes effect in 2014, all Americans who file income tax returns must complete an additional IRS tax form. The new form will require disclosure of a taxpayer’s personal identifying health information in order to determine compliance with the Affordable Care Act’s individual mandate."
Therefore, along with the usual tax documents that crowd our mailboxes during the new year (W-2s, 1098s, etc.), we'll now receive an additional form that will require the filer to provide their health insurance information, including their health insurance ID number and whether or not the coverage was purchased at a health care exchange. Failure to purchase "qualified" health care will result in a tax of $95 or 1% of your family's annual income (whichever figure is higher). The only exemptions from this penalty are welfare recipients, illegal aliens, and those serving time in prison.
The information provided in these tax forms could potentially be worth their weight in gold for various public corporations and private sections of the state and federal government. Obviously, this idea is generating a lot of fear for potential healthcare consumers. There exists a definite possibility that the government, private employers, or insurance companies themselves could exploit the general public by using and manipulating these figures in any number of ways imaginable once they've established a database of IDs and corresponding medical records.
National Healthcare Information Database?
Three years ago, a physician named Edward Pullen wrote an article detailing an argument in favor of a national healthcare information database. He explained that having this information readily available for any physician that you might visit would expedite your care and keep overall costs lower, as it could eliminate duplicate testing. In wondering why a system like this hasn't already been adopted, he briefly touches on the idea that the information could potentially be corruptible by governments, corporations, or even internet hackers.
However, he fails to focus enough attention on this HUGELY important aspect of such a database, skipping over the issue with a surprising degree of flippancy, saying that, "The benefits are just too big, and these concerns are [sic] overblown. We just cannot afford not to have a system like this in place, both financially and to improve care." The man might have a point about how such a system could increase efficacy, but his urgency points toward the larger trend of the American government's long history of shooting first and asking questions later. Creating and maintaining a shared database with vital personal information could have severe consequences for every American, especially if it is quickly ushered through Congress without examining the long-term ramifications of such a move.
Where Do We Go from Here?
I usually don't like to project too far into the future with hypotheticals and suppositions, but let me borrow your imaginations for a moment. Your child has been acting out in class lately. He can't sit still, he constantly interrupts his teacher, and he can't concentrate on his homework. At your son's teacher's suggestion, you have little Billy screened by your physician for ADHD, and the results come back supporting such a diagnosis. Now what? Many parents ignore behavioral therapy, vitamin supplements, or dietary adjustments (not to mention the possibility that he has been misdiagnosed in the first place). Instead, they choose to go the pharmaceutical route, beginning their child on a regimen of stimulants like Ritalin or Adderall.
Now, fast-forward 15 years or so. Your son has received a degree from a prestigious university and is hunting for a well-paying job in the government sector. But wait! Stimulant medication for ADHD has been made illegal, and the stigma attached to it is even more than that of other hard drugs like heroin and cocaine. Thanks to a massive database with medical history information collected and shared by the United States government, Billy fails to meet the requirements of the job based on his "checkered" past. Jobless and depressed, Billy registers for unemployment and begins popping Prozacs at a healthy clip, making him the poster boy for Republican-fueled scorn.
History Casts a Long Shadow
My point is this: Times change, people change, truths change; hell, Einstein proved that even math can change. Nothing is eternal, but reputation can last a lifetime in the court of public opinion. If we allow our government complete and total access to every facet of our lives, how can we expect to maintain the illusion of privacy?
I believe that the Patient Protection and Affordable Care Act will succeed on many levels - enriching, strengthening, and lengthening the life of the average American. Unfortunately, the language of the document forces us to surrender a highly personal aspect of our freedom. It may seem harmless now, but history has shown us that even the smallest elements of our past can have negative consequences for our future. Government intrusion on the the lives of private citizens, whether it be well-intentioned or otherwise, can be a very slippery slope, and tax payers and their families shouldn't be condemned because of ailments beyond their control.
If you still don't know what I'm talking about, go watch the movie Gattaca... I basically just don't want America to turn into Gattaca. Seriously, go watch it. It's good.
Ellis, Ryan & Kartch, John. "New Obamacare Tax Form Mandates Americans Report Personal Health ID Info to IRS." Americans for Tax Reform. 1 Nov. 2012. Web. 16 Jan. 2013.
Pullen, Edward. "Why There Needs to Be a National Healthcare Information Database." Kevin MD. MedPage Today. 24 Jan. 2012. Web 16 Jan. 2013.