Final Stimulus Bill Creates Government Database that Will Hold Every American’s Personal Medical Records

By Fred Lucas | February 12, 2009 | 2:39 PM EST

President Barack Obama at his first prime-time news conference on Monday, Feb. 9, 2009, in the East Room of the White House. (AP Photo/Ron Edmonds)

( - The final version of the stimulus bill, negotiated by the Democratic leaders of the House and Senate, includes a provision creating a federal database that will hold the personal medical records of every American, Katie Grant, spokeswoman for House Majority Leader Steny Hoyer (D-Md.) told Thursday.
The full language of the final package had not been released as of press time. But the bills that passed both the House and Senate created an “Office of the National Coordinator for Health Information Technology” and called for the coordinator to create a national database and a plan for “the utilization of an electronic health record (EHR) for each person in the United States by 2014.”
Asked if the provision for the “utilization of an electronic health record for each person in the United States by 2014” was in the final bill agreed to by the House-Senate conference committee, Grant said, “It is.”  She later said “correct” when asked a second time if this language was in the final bill.
The legislation called for creating a National Coordinator for Health Information Technology and said that this person “shall perform the duties under subsection (c ) in a manner consistent with the development of a nationwide health information technology infrastructure for the electronic use and exchange of information.”
Part 3 of this “subsection ( c )”--as spelt out in the bill the originally passed the House--is entitled “Strategic Plan.”  It says: “The National Coordinator shall, in consultation with the other appropriate federal agencies (including the National Institutes of Standards and Technology), update the Federal IT Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to the following: (i) The electronic exchange and use of health information and the enterprise integration of such information. (ii) The utilization of an electronic health record for each person in the United States by 2014.”
The bill listed a number of things the “nationwide health information technology infrastructure” should do, including ensure “that each patient’s health information is secure and protected,” reduce “health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information,” provide “appropriate information to help guide medical decisions at the time and place of care,” and improve “coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information.”

According to the language of the House bill, it also is supposed to help “health and clinical research” efforts and “efforts to reduce health disparities.”
A fact sheet from the office of House Speaker Nancy Pelosi (D-Calif.) summarizing the conference committee report says the bill will spend $19 billion on health information technology.
The final bill “provides $19 billion to accelerate adoption of Health Information Technology (HIT) systems by doctors and hospitals, in order to modernize the health care system, save billions of dollars, reduce medical errors and improve quality,” the Pelosi summary says.
Further, the bill “strengthens Federal privacy and security law to protect personally identifiable health information from misuse and abuse.”
The Congressional Budget Office estimates this proposal will generate billions of dollars in “system-wide savings,” according to the summary. Meanwhile, the summary boasts this provision “creates hundreds of thousands of jobs – many in high-tech sectors – by promoting the adoption of HIT (health information technology).”

A statement on the website of Senate Finance Committee Chairman Max Baucus (D-Mont.) says the HIT provisions of the bill will not invade privacy. 

“Under this bill, the National Coordinator of Health Information Technology will set minimum standards for the technology systems your doctor may choose to store and maintain your medical records making sure, for instance, that the systems are configured to keep your information from getting loose to the public, but still allowing your various doctors to share the information easily and confidentially,” the statement said. “The coordinator will also work to support doctors and hospitals as they transition to electronic records.”
The Frequently Asked Questions section on Baucus’s Finance Committee website goes on to say that the information will not be used to influence treatment. And in response to the question, “Will the government have access to my electronic medical record?” answers, “No. Federal law makes your medical records--whether they’re on paper or in a computer--confidential to you and your health provider.”
According to the language that was in the bill that passed the Senate, the secretary of Health and Human Services “shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use” by health care providers. The Senate bill also indicated that a doctor who accessed a patient’s records but who was not a “meaningful EHR user” could face penalties.
President Barack Obama had not specified whether he would insist on this being in the final version of the bill, a White House spokeswoman told Wednesday.
However, Obama touted health information technology as recently as the Monday press conference.
“We know that health care is crippling businesses and making us less competitive, as well as breaking the banks of families all across America -- and part of the reason is we've got the most inefficient health care system imaginable,” Obama said. “We’re still using paper. We’re still filing things in triplicate. Nurses can’t read the prescriptions that doctors have written out. Why wouldn’t we want to put that on an electronic medical record that will reduce error rates, reduce our long-term cost of health care, and create jobs right now?”