Obamacare to Restrict Drug Choices -- Patient Safety at Risk

September 04, 2011 | September 2011 Bond Updates

Behind-the-scenes deal making by health systems, government agencies, and the makers of electronic record systems will prove the death knell for patient safety and consumer protections.

(1888PressRelease) If left unchecked, patients should fear the potentially disastrous implications of the Obamacare law in areas where they may least suspect. The most concerning of these areas falls under the heading of 'health information technology' (HIT). Under the HIT provisions of Obamacare, there are machinations underway to effect significant changes to the way doctors write prescriptions and prescribe treatments for patients.

One area of interest to patient and medical safety advocates on both sides of the political aisle is the nature of electronic prescription platforms. These computer screen platforms are software programs that display the available medical treatment options which are available to doctors to, in turn, make available to their patients. If a given drug or treatment does not show up on a doctor's computer screen (or is buried ten 'clicks' away from the homepage), physicians may never see the full range of choices available to treat their patients.

Says Doctor Adam Dorin, medical leader and founder of America's Medical Society, "the erosion of freedoms in healthcare for patients and their physicians will be insidious and very difficult to reverse--look to the manipulation of 'Health Information Technology' (HIT) and 'Electronic Medical Records' (EMR) by HMOs and Accountable Care Organizations (ACOs) as the beginning of the end for consumer safety in health care."

Unbeknownst to most observers today, there is frantic activity underway by certain players in the healthcare market to capitalize on the impending and evolving changes implicit to the 'Affordable Care Act' (Obamacare) legislation. Soon patient advocacy groups will be up in arms fighting the secret deals that are being made, but by then it may already be too late. Those who stand the most to gain by manipulating patient treatment options are health insurers (both government and private).

The Medicare Improvements for Patients and Providers Act of 2008 authorized the Centers for Medicare and Medicaid Services (CMS) to pay bonuses to physicians for successful e-prescribing. In 2009 and 2010, doctors who implemented e-prescribing became eligible to receive bonuses equal to 2% of their overall Medicare reimbursement. The bonuses for years 2011 and beyond will be scaled down, but, to insure adoption of the regulatory HIT dictates, there will be a penalty for not e-prescribing beginning in 2012; the penalty reductions in pay for not using government/health plan provided electronic prescribing will be a reduction of Medicare reimbursement of 1% in 2012, 1.5% in 2013, and 2% in 2014.

Proponents applaud the potential and arguable savings and reduction in mistakes achieved by using EMRs; however, there is a grave risk of abuse by health insurers which could not only prove deadly to patients, but could also result in Uncle Sam gaining even more control over the independence of physicians.

According to Doctor Dorin, "unregulated HIT electronic platforms for e-prescription writing would be ripe for protocols that virtually eliminate the majority of choices patients have available to them in the form of restricted prescription and treatment options."

"What this country needs," adds Dorin, "is urgent legislation to protect physician autonomy and patient choice." As Doctor Dorin explains, "the new legislation needs to address the following areas: clinical decision making (which should remain solely within the domain of physician choice--with no treatment exclusions); quality of care (which should be paramount over profit making by insurers); privacy issues (which should be re-examined in light of electronic forums that make it much easier for large blocks of data to be exposed/stolen); electronic prescription writing platforms (which should be open and neutral)."

On the last point, Doctor Dorin emphasizes that eRx software programs should not be allowed to exclude products or advance the commercial interests of any one particular pharmaceutical company or health system pharmacy manager.

"There is no existing law regulating e-prescribing on the state or federal level in America," notes Dorin.

"Imaging a scenario in the not-too-distant future where a patient with cancer is deprived of essential chemotherapeutic options because of closed-door schemes and deals that take some medicines off of the electronic platform entirely. This would put the United States squarely in the arena of European-style socialized medicine--something that will likely lead to earlier and unnecessary patient morbidities and deaths."

In the absence of proper guidance from federal and state policymakers, health insurers will be able to manipulate (exploit) HIT platforms for economic gain.

To learn more, see www.AmericasMedicalSociety.com

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