The so-called "stimulus" President Obama signed Tuesday is so unwieldy it had to be posted in two PDFs on the House Appropriations Committee's Website along with another two containing an "explanatory statement."
The law totaled 1,071 pages; the explanation, 421.
Yet, 216 of the law's 1,071 pages deal with a project not directly aimed at short-term economic stimulus, and these 216 pages were themselves divided into two distinct parts (139 pages in "Division A" of the law and 77 pages in "Division B").
Together, these 216 pages provide the legal framework for collecting every American's personal medical records into a federally coordinated electronic system.
As first pointed out in a Feb. 9 Bloomberg.com commentary by former New York Lt. Gov. Betsy McCaughey, it is reasonable to assume that this electronic-records system, together with a provision that creates a "Federal Coordinating Council for Comparative Effectiveness Research," sets the stage for the creation of a nationalized health-care system that engages in British-style rationing.
But even if Congress and the president restrain themselves and pass no further law in pursuit of socialized medicine for the United States, the provisions already enacted in this law raise significant questions about the right to privacy and the right of doctors to practice medicine according to their best judgment.
Division A includes a section called "Title XIII -- Health Information Technology," which provides for "the development of a nationwide health information technology infrastructure."
In the law's jargon, this infrastructure is supposed to allow for the "enterprise integration" of the "qualified electronic health record" of "each person in the United States by 2014."
What do "qualified electronic health record" and "enterprise integration" mean? A "qualified electronic health record," the law says, "means an electronic record of health-related information on an individual that -- (A) includes patient demographic and clinical health information, such as medical history and problems lists; and (B) has the capacity -- (i) to provide clinical decision support; (ii) to support physician order entry; (iii) to capture and query information relevant to health care quality; and (iv) to exchange electronic health information with, and integrate such information from other sources."
This mandate that your "electronic health record" (EHR) be able to communicate with "other sources" goes to the definition of "enterprise integration." This term, the law says, "means the electronic linkage of health care providers, health plans, the government and other interested parties to enable electronic exchange and use of health information among all the components in the health care infrastructure in accordance with applicable law."
The law directs an existing bureaucracy created by President Bush (the "Office of the National Coordinator for Health Information Technology") to put together a plan for building this system so that it achieves the "utilization of an electronic health record for each person in the United States by 2014."
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