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Business, Free Enterprise and Constitutional Issues; Pro-Life and Pro Second Amendment. Susan Lynn is a former member of the Tennessee General Assembly. She served as chairman of the Government Operations Committee and the Commerce Committee. She holds a BS in economics and a minor in history. She is the Chairman of the American Legislative Exchange Council's Commerce Task Force.

Sunday, May 17, 2009

All Payer Claims Database

What is the All Payer Claims Database? That is the name of the system the Governor’s administration wants to put in place to collect all of the data on your healthcare transactions - whether you are private pay, insurance pay, Medicare or Medicaid.

The government claims it needs your information to;

“Improve the accessibility and affordability of patient health care and health care coverage”

“Identify health and health care needs and inform on health and health care policy”

“Determine the capacity and distribution of existing health care resources”

“Evaluate the effectiveness of intervention programs on improving patient outcomes”

“Review costs among various treatment settings, providers, and approaches”

“Provide publicly available information on health care providers’ quality of care”

I asked a few public policy groups to take a look at the legislation. They responded with alarm. Some of their comments are that “…this is an avenue to centralized control over medical decisions...and the building of a brand new expensive bureaucracy that will use the data to issue reports to further secure their control over medical decision-making.” And, “Whoa. This bill is very scary. Not only is there no opt-out provision, but looking at claims data is the way to implement price controls.”

The administration claims through all of this your identity will be safe because the government will give you a unique encrypted patient identifier. Your doctor will receive a unique health care provider identifier as well. But wait, if the government is giving you the identifier wouldn’t that mean they know who you are or else how can they give it to you…and why?

What if you should want to opt-out? Well, you can’t. And should your doctor refuse to comply with giving over your information he or she will receive a $100.00 per day fine from the state.

Recently a similar plan was instituted in Minnesota. The cost was $1.2 million for the databasing of claims data on all Minnesotans for just the first 18 months. Additional costs for analyzing the data are $3.0 million dollars per year. The next phase of educating physicians was another $100,000+, and about $45,000 per year in expenses for the state’s health dept. Of course the cost to the doctors for sending the data has never been calculated.

But the state claims that this bill will cost little more than $10,000 per year.

I hope that you are concerned about this bill because your voice does make a difference. This is one bill that should go away. We do not need to collect such data, and some believe that such collection may violate the Fourth Amendment.

1 comment:

Anonymous said...

Are you sure that doctors will have to submit anything? I thought the point of claims data is that is requires cooperation from the health insurance companies, but that doctors don't have to do anything differently.