Citizens’ Council on Health Care
CCHC HEALTH eNEWS
Monday, November 26, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* DIGITAL ANGEL’S BIO-TRACKING DEVICE TO BE LAUNCHED

* ONE MILLION MAY LOSE HEALTH COVERAGE IN RECESSION

* OIG TESTIMONY: SOCIAL SECURITY NUMBER IS NATIONAL ID

* PORTLAND MAINE PASSES UNIVERSAL HEALTH CARE RESOLUTION

* MAGNETIC STRIP HEALTH CARD REQUIRED IN S.C.; ADDS COST

* HOUSE BILL SEEKS ONE YEAR DELAY IN NATIONAL HEALTH CARE CODES

* NATIONAL JOURNAL: SHOULD GOVERNMENT HAVE
THE POWER TO FORCE VACCINATION?

* COURT RULING: PATIENTS CAN BE HELD RESPONSIBLE
FOR TREATMENT COSTS RECEIVED AS MINORS


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* CCHC Commentary included
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DIGITAL ANGEL’S BIO-TRACKING DEVICE TO BE LAUNCHED

On Monday, November 26, Applied Digital Solutions announced
that its wholly owned subsidiary, Digital Angel Corporation,
will launch Digital Angel. According to its press release:

”Digital Angel represents the first-ever combination of
advanced biosensor technology and Web-enabled wireless telecommunications linked to Global Positioning Systems
(GPS). By utilizing advanced biosensor capabilities,
Digital Angel will be able to monitor key body functions -
such as temperature and pulse - and transmit that data,
along with accurate location information, to a ground
station or monitoring facility.

”Applied Digital Solutions is exploring a wide range of
potential applications for Digital Angel, including:
monitoring the location and medical condition of at-risk
patients; locating lost or missing individuals; locating
missing or stolen household pets; monitoring the location
of certain parolees; managing livestock and other farm-
related animals; pinpointing the location of valuable stolen
property; managing the commodity supply chain; preventing
the unauthorized use of firearms; and providing a tamper-
proof means of identification for enhanced e-commerce security.”

Digital Angel has also announced a proposed merger with Medical
Advisory Systems, “a global leader in telemedicine that has
operated a 24/7, physician-staffed call center in Owings, MD for
nearly 20 years...Through a worldwide telecommunications network,
MAS provides health care to ships-at-sea and other remote locations, one-on-one “chats” with a physician via the Internet or telephone,
as well as medical and non-medical services for the travel industry.
MAS owns a 12% equity interest in Paris-based CORIS Group, which
provides it with the ability to offer its services in over 30
countries worldwide.”

Source: “Digital Angel Product Launch Scheduled for November 26^th,”
BUSINESS WIRE, November 7, 2001. http://www.bloomberg.com/fgcgi.cgi?T=marketsquote99_news.ht&s=AO_k4cRQbRGlna
XRh

-Citizens’ Council on Health Care
-11/26/01


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ONE MILLION MAY LOSE HEALTH COVERAGE IN RECESSION

According to the Commonwealth Fund, nearly a million
people in the United States are at risk of losing their health
insurance as a result of the economic downturn and the
September 11 attacks.

The spike in uninsured Americans is likely to put a strain on
low-income health care programs like Medicaid as
out-of-work Americans struggle to pay private health
insurance premiums on dwindling incomes, concludes a report
from Commonwealth. It also warns that:

o Medicaid rolls could rise by as many as 3.3 million people
(with and without health insurance through their jobs)
lose income.

o About 2.2 million Americans have lost jobs since November
of last year, including about 415,000 since the terrorist
attacks, according to federal labor statistics released
last week.

o Studies have suggested that as many as 37 percent of unemployed
persons lack health insurance.

The Senate version of the economic stimulus bill contains
provisions designed to help dislocated workers maintain health
coverage. It would spend $6 billion this year for subsidies that
would allow workers to continue buying health coverage for a
limited time after losing their jobs.

Source: “Close to 1 million in US may lose health coverage,”
Reuters Health, November 14, 2001; based on Jeanne M. Lambrew,
”How the Slowing U.S. Economy Threatens Employer-Based Health,”
November 2001, Commonwealth Fund.

For study text
http://www.cmwf.org/programs/insurance/lambrew_slowingeconomy_511.pdf

Source: Taken directly from Daily Policy Digest, National Center
for Policy Analysis, 11/19/01. http://www.ncpa.org


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OIG TESTIMONY: SOCIAL SECURITY NUMBER IS NATIONAL ID

Statement of the Hon. James G. Huse, Jr. Inspector General,
Office of Inspector General, Social Security Administration
HOUSE HEARING ON PREVENTING IDENTITY THEFT BY TERRORISTS
AND CRIMINALS, November 8, 2001

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Good morning, and thank you for the opportunity to appear
today to discuss the prevention of identity theft by
terrorists and criminals. While I have testified on the issue
of identity theft before various Committees in both the House
and Senate, the events of September 11^th lend a renewed urgency
to this issue.

Identity theft was already a significant problem facing law
enforcement, the financial industry, and the American public
before September 11^th. In the weeks since that terrible day,
it has become increasingly apparent that improperly obtained
Social Security numbers were a factor in the terrorists’ ability
to assimilate themselves into our society while they planned
their attacks. While this has heightened the urgency of the need
for Congress, the Social Security Administration, and my office to
take additional steps to protect the integrity of the Social
Security number, it has not altered the nature of the steps that
must be taken.

The Social Security number, no matter how much we avoid labeling
it as such, is our national identifier. As such, it is incumbent
upon those of us gathered here to do all in our power to protect
it and the people to whom it is issued. There are three stages
at which protections must be in place: upon issuance, during the
life of the number holder, and upon that individual’s death.

[...]
If we are to preserve the integrity of the SSN, birth records,
immigration records, and other identification documents presented
to SSA must be independently verified as authentic before an SSN
is issued. Further, if immigration records are to be relied upon,
the Immigration and Naturalization Service must be required to
authenticate those records...H.R.2036, introduced by the Social
Security Subcommittee, moves us closer to these protections

[...]

The second, and most difficult, stage of protecting the SSN
comes during the life of the number holder. Because the SSN has
become so integral a part of our lives, particularly with respect
to financial transactions, it is difficult to give the number the
degree of privacy it requires, but there are important steps we
can take. We can limit the SSN’s public availability to the
greatest extent practicable, without unduly limiting commerce.
We can prohibit the sale of SSNs, prohibit their display on public
records, and limit their use to valid transactions. [...]

Source: “Hearing on Preventing Identity Theft by Terrorists and
Criminals,” Testimony Before the Subcommittee on Social Security
of the House Committee on Ways and Means and the Subcommittee
on Oversight and Investigations of the House Committee on
Financial Services, November 8, 2001.
http://waysandmeans.house.gov/socsec/107cong/11-8-01/11-8huse.htm



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PORTLAND MAINE PASSES UNIVERSAL HEALTH CARE RESOLUTION

The Portland, Maine, City Council on Nov. 19 voted 6-3 to
pass a resolution endorsing universal health care in the
state, the Portland Press Herald reports (Bouchard, Portland
Press Herald, 11/20). Earlier this month, Portland voters
approved a nonbinding referendum, calling on the the city
council to send a resolution to the state Legislature in
support of universal health care (Kaiser Daily Health Policy
Report, 11/7). The approved resolution, which commits the
city to “work for efforts to develop a single-payer system,”
will now be forwarded to the state Legislature as a petition
from Portland residents.

The six council members who voted to pass the referendum said
they hope “it will encourage the passage of universal health
care in Maine and cut a path for the rest of the country to
follow.” Council members who voted against the resolution
questioned whether a single-payer system would “fix what’s
wrong with health care in the United States” (Portland Press
Herald, 11/20).

Source: Taken directly from “Portland City Council Passes
Resolution Endorsing Universal Health Care,” KAISER DAILY
HEALTH POLICY REPORT, 11/21/01


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MAGNETIC STRIP HEALTH CARD REQUIRED IN S.C.

To cut costs, South Carolina is replacing paper membership
cards for Medicaid beneficiaries with plastic ones starting
next month, the Charlotte Observer reports. Under the old
system, the state each month printed and mailed paper cards
to beneficiaries, at a cost of $1.6 million per year. State
officials say the new system will cut that cost in half during
the first year and should cost “a few hundred thousand dollars”
per year after that.

However, South Carolina doctors “aren’t particularly happy”
about the new cards, the Observer reports. Many doctors’ offices
will have to purchase special magnetic “swipe-through” devices to
process the new cards. Although some practices already have the
$400 device, which also processes credit cards, the “majority”
do not, the Observer reports. Doctors without the equipment can
call a toll-free number to verify Medicaid eligibility, but “that
will take up staff time,” Ron Fitzwater, chief operating officer
of the South Carolina Medical Association, said.

For their part, state officials say they are “aware of physicians’
concerns and lament that doctors see the plastic card system as
another financial drain” (Stobbe, Charlotte Observer, 11/18).

Source: Taken directly from “South Carolina Medicaid Beneficiaries
To Begin Using Plastic Cards Next Month” Kaiser Health Care Policy
Report, 11/20/01.


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HOUSE BILL SEEKS ONE YEAR DELAY IN NATIONAL HEALTH CARE CODES

H.R. 3323, sponsored by Rep. David Hobson (R-OHIO) would delay
requirements that all health care transactions be done using
national transaction codes, primarily in electronic format.
The Senate has similar action pending. The current compliance
date is October 16, 2002. (S. 1588 and S. 1684)

The Hobson bill would allow covered entities (health plans,
insurers, hospitals, practitioners) that send in a compliance
plan to have until October 16, 2003 to comply. All entities
not submitting a plan would be excluded from participating in
Medicare (receiving reimbursement from Medicare for caring for
Medicare patients). Given the regulatory burden of receiving
and approving compliance plans, it is possible that the bill
would be amended to provide the delay for all covered entities.

The American Hospital Association does not support the House
or Senate bills

Source: “Yet Another Push in Congress to Delay HIPAA
Transactions Rule,” November 21, 2001, http://www.healthdatamanagement.com/html/hipaa/NewsStory.cfm?DID=7195

-Citizens’ Council on Health Care
-11/26/01


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NATIONAL JOURNAL: SHOULD GOVERNMENT HAVE
THE POWER TO FORCE VACCINATION?

National Journal highlights the ongoing debate over whether
federal and state governments should have the power to
quarantine people or force them to receive a vaccination in the
event of a smallpox attack. The federal government will have to
decide whether to administer smallpox vaccine in advance of an
attack and whether to force Americans to take the vaccine in the
event of a smallpox outbreak. Some Americans do not want the
vaccine, which has a number of potential “serious side effects,”
National Journal reports. According to HHS Secretary Tommy
Thompson, the government will not offer smallpox vaccine “unless
there’s an outbreak.”

Quarantine, Privacy Issues

Meanwhile, many states will likely consider model legislation,
commissioned by the CDC, that would grant states “special powers”
to impose a quarantine in a public health emergency. Some states
have laws that allow them to impose a quarantine in the event of
an outbreak, but according to Center for Law and the Public’s
Health Director Lawrence Gostin, who helped draft the model
legislation, “they’re antiquated and there are no standards for
when quarantines should be put forward.”

However, Sandro Cinti, an infectious disease physician at the
University of Michigan medical center, said that the model
legislation would “raise many civil rights questions” and
questions about whether a quarantine would expose healthy
individuals to disease. Gostin said that the authors of the
legislation addressed civil rights concerns. According to the
legislation, “It is the policy of the state that the individual
dignity of any person isolated or quarantined during a state of
public health emergency shall be respected at all times.”

In addition, the legislation “seeks to ensure that quarantine
facilities are safe and hygienic” and “designed to minimize the
likelihood of further transmission of infection.” National
Journal reports that privacy also has emerged as a concern. The
model legislation “suggests a need” to place public health over
privacy issues in the event of a bioterrorist attack.

It would require pharmacists to report increased prescription
rates or “unusual trends” in pharmacy visits, which would include
a patient’s name,date of birth, sex, race and address. “Privacy
laws thwart data-sharing” between states, the federal government,
law enforcement, emergency teams and the private sector, Gostin
said (National Journal, 11/17).

Source: Taken directly from “National Journal Looks at Whether
Federal and State Governments Have Quarantine Powers To Respond to Bioterrorism,” KAISER DAILY HEALTH POLICY REPORT 11/20/01


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COURT RULING: PATIENTS CAN BE HELD RESPONSIBLE FOR
TREATMENT COSTS RECEIVED AS MINORS

Hospitals can bill patients for emergency care they received
when they were minors if their parents “refused to pay” at the time,
the Maryland Court of Appeals ruled Nov. 15, the Baltimore Sun
reports. In a 4-3 ruling, Maryland’s highest court said hospitals
have three years to file suit to recover payments for emergency
medical care that went uncompensated. The three-year statute of
limitations will “largely affect” people who turn 18 within three
years of receiving uncompensated medical care, according to Herbert
Thaler, a lawyer for the hospitals. In the majority opinion, Judge
Glenn Harrell wrote that the ruling was “sound public policy,” even
though it may “seem harsh on a patient.” He added that the judges in
the majority did not want to put hospitals in a position where they
could not recover their costs from “apparently financially able
individuals.” The ruling is based on a case in which a 16-year-old
St. Mary’s County girl was treated at Prince George’s Hospital Center
after a 1997 car accident (Siegel, Baltimore Sun, 11/16).

Source: Taken directly from “Hospitals Can Hold Patients Financially Responsible for Treatment Received as Minors, Maryland Appeals Court
Rules,” KAISER DAILY HEALTH POLICY REPORT Friday, November 16, 2001.


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NOTE: These news items have been taken directly
from email received by CCHC or from Internet
newspaper publications. Titles in ALL CAPS are
CCHC creations except for those heading articles
from the National Center for Policy Analysis,
the Health Law Pulse, PrivacySecurityNetwork,
and LIST.HEALTHPLAN. Credit to the sending
organization or news service is listed at the
end of each article.
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CITIZENS’ COUNCIL ON HEALTH CARE
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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.