There was a bit of an uproar recently when the U.S. Department of Health and Human Services (HHS) announced, then withdrew, a plan to hire your fellow citizens to pose as patients seeking appointments with thousands of medical practices, using a script of false symptoms–alternately pretending to have private insurance and Medicare. It seems the government is growing concerned that more physicians will not want to accept new Medicare patients as it slashes reimbursements for services to a level below the cost of providing them. Because some in Congress noticed the proposal and came down with heartburn, the authorities have withdrawn the proposed program, for the moment.
But it is still heart-warming to know that they will keep trying to get you to inform on physicians in your neighborhood. The next time you are on hold while trying to make a medical appointment, be forgiving: they may be talking to an informer seeking an appointment to treat their government script of false symptoms.
That is the good news. The bad news is that the government is also trying to get your physicians to inform on you. Broadly speaking, it does that to all medical patients. The regime for computerized medical records, which was set up at great expense by the Stimulus in 2009 (and which had nothing to do with the recession), mandated that all medical records be turned over to HHS.
Of course, the shift to computerized records had been going on for many years. The bill, however, mandated that they all be changed to a prescribed template and turned over to the government. Why? The stated reason was to ensure privacy. Never mind that the bill authorized the government to sell patient records to agencies and private firms without the permission of patients.
But the government wants to be informed of specific information. In New York City, when your blood sugar level is tested, results must be turned over to the city’s Department of Health. New York City, which does such a swell job managing everything else, wants to enforce how well individuals manage their diabetes.
The governor of Arizona wants physicians to inform on diabetics who do not follow treatment instructions, and on all Medicaid patients who are overweight or smoke. Our bodies belong to the government now, and we can be fined if we don’t follow government orders.
It is bad enough that the rapid growth of government’s share of medical care has grown to 50 percent or more, while spending has simultaneously escalated. It is another matter when the government encourages or pays patients to inform on their physicians, and physicians to inform on their patients.
Why would the government want everyone to inform on everybody? Must the government criminalize medical care in order to control it? It looks like we are about to find out.
Intrusion in health care now involves issues that transcend medicine or insurance. The growth of that intrusion represents the leading edge of a government that will consume all activity until it controls every aspect of our lives.
What do we call a government that encourages everyone to inform on everyone else? The Terror, as in revolutionary France? The Gestapo, as in Germany? The KGB, as in Russia? Big Brother, as in George Orwell’s 1984? We may need a new name for it.
For the moment, “Medicare” will have to do.