Citizens' Council on Health Care
CCHC HEALTH eNEWS
Monday, September 24, 2001


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Providing news and commentary on health care policy,
health insurance issues, and medical confidentiality.
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* DATABASE-MAKER ORACLE SEES OPPORTUNITY IN NATIONAL ID CARDS
- Participate in poll/petition on National ID

* AZ TAXPAYERS BAIL OUT HOSPITALS FOR CARE OF ILLEGAL IMMIGRANTS

* CALIFORNIA REFUSES TO PERMIT EUTHANASIA OF RESPONSIVE MAN

* HHS: ARKANSAS PARENTS ALLOWED TO CHOOSE "MIDDLE-CLASS MEDICAID"

* AETNA TO OFFER QUASI-MEDICAL SAVINGS ACCOUNTS IN 2002

* FAMILY VIOLENCE: IOM WANTS DOCTORS TO FILE MORE POLICE REPORTS

* ONLINE MEDICAL RECORDS PUSHED IN AFTERMATH OF TERRORIST ATTACKS
- CCHC Commentary


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DATABASE-MAKER ORACLE SEES OPPORTUNITY IN NATIONAL ID CARDS

Oracle's Chairman and CEO, Larry Ellison is willing to donate to
the U.S. Government the software to create national IDs,
resplendent with fingerprints and digital photographs.

"We need a national ID card with our photograph and thumbprint
digitized and embedded in the ID card," Ellison said in an interview
Friday night on the evening news of KPIX-TV in San Francisco
according to Mercury News.

"We need a database behind that, so when you're walking into an
airport and you say that you are Larry Ellison, you take that card
and put it in a reader and you put your thumb down and that system
confirms that this is Larry Ellison," he said.

Oracle, based in Redwood Shores, California is the world's leading
maker of database software. The CIA was Oracle's first client. In
fact Oracle grew out of a CIA idea to build data systems.

Constitutional attorneys are concerned. Robert Post at the University
of California-Berkley says a National ID is an overreaction and
cautioned that any ID system can be haked, faked or evaded by
intelligent criminals.

However, seven out of 10 Americans in a Pew Research Center survey
favored a national ID card, with strong support from women. The
ACLU is certain to fight the proposal.

Source: "Oracle boss urges national ID cards, offers free software,"
Paul Rogers and Elise Ackerman, San Jose Mercury News, September 23,
2001. http://www.siliconvalley.com/docs/news/svfront/ellsn092301.htm

TAKE A POLL ON NATIONAL ID:
http://www.worldnetdaily.com/polls/index.asp?cookies=bchfgjmd344kmv59dk4kmfdkv95m95mv9095kmmcsd

PRIVACY PETITION FOR PRESIDENT BUSH AT: http://www.DefendYourFreedom.org

-Citizens' Council on Health Care
-September 24, 2001


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AZ TAXPAYERS BAIL OUT HOSPITALS FOR CARE OF ILLEGAL IMMIGRANTS

The Arizona Legislature this weekend met in a special session
to reinstate an emergency medical services program that will cover
$20 million in unpaid medical bills for emergency room treatment of
undocumented immigrants, the Arizona Republic reports.

Although the state "traditionally" pays for such services, state
officials removed the program from this year's state budget after
the Centers for Medicare and Medicaid Services said it would "take
over" funding. The Republic reports that CMS, "after taking a
closer look ... balked" and only offered to provide coverage for
limited categories of immigrants, including children, pregnant
women and the elderly.

Although federal law requires hospitals to care for any emergency
case, the state will only reimburse hospitals for the care of
undocumented immigrants if the patient gives an address or proof of
residency. According to Sheri Jordan of the Arizona Hospital and
Healthcare Association, Arizona hospitals are already responsible for
"millions of dollars" of unpaid bills.

Gov. Jane Hull (R) has suggested using federal money intended for
indigent health care, which has no restrictions on how it is spent,
"to keep hospitals afloat" (Sherwood, Arizona Republic, 9/22).

Source: Taken directly from: "Arizona Legislature Plans to
Designate $20M for Emergency Care for Undocumented Immigrants,"
Kaiser Daily Health Policy Report, 9/24/01.


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CALIFORNIA REFUSES TO PERMIT EUTHANASIA OF RESPONSIVE MAN

The California Supreme Court raised the standard for withdrawing
life support from patients who are not necessarily dying. The case
involved Robert Wendland, who was in a truck crash in 1993
leaving him "conscious, but with severe mental and physical
disabilities. He was able to respond to simple commands, although
inconsistently, according to court documents. He needed
artificial nutrition and hydration."

The California Supreme Court refused the request to withhold
nutrition and hydration, stating "the decision to treat is
reversible. The decision to withdraw treatment is not."
(Reading: "California court raises standard for withdrawing life
support," American Medical News, 9/3/01,
http://www.ama-assn.org/sci-pubs/amnews/pick_01/prsc0903.htm)

Source: Taken directly from Communique', Judie Brown, American
Life League, September 21, 2001.


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PARENTS CAN CHOOSE "MIDDLE-CLASS MEDICAID" OVER TRADITIONAL MEDICAID

The Arkansas Democrat-Gazette today reported that the Centers
for Medicare and Medicaid Services will not enforce a Clinton
administration directive requiring the state to enroll Medicaid-
eligible children in ARKids A. However, a CMS spokesperson
said that while the Clinton policy is still effective, the agency
is "satisfied" with the program and will continue to allow parents
to make enrollment decisions (Darryl Drevna, Kaiser Daily Health
Policy Report, 9/20).

According to the Democrat-Gazette, a senior CMS official at a
conference in Little Rock, Ark., said the Bush administration
would not enforce the policy. Speaking at a "Medicaid Horizons"
conference, Dennis Smith, the director of CMS' Center for Medicaid
and State Operations, indicated the Bush administration "approves"
of how Arkansas is managing the program (Rowett, Arkansas
Democrat-Gazette, 9/20).

In July 2000, the Clinton administration ordered the state to
enroll all Medicaid-eligible children in ARKids A, the state's
traditional Medicaid program, instead of allowing parents to
select to enroll their children in ARKids B, a Medicaid waiver
program intended to cover children with higher incomes. The
waiver program requires a "small" copayment and offers fewer
services than the traditional Medicaid program. Saying that free
coverage under the ARKids A program carries a "stigma," Gov. Mike
Huckabee(R) wanted to allow parents of Medicaid-eligible children
to choose between the two programs (Kaiser Daily Health Policy
Report, 8/7).

Huckabee and state Medicaid Director Ray Hanley "resisted" the
Clinton directive, and the Democrat-Gazette reports the "impasse"
has been solved now that the Bush administration has indicated it
will not enforce the Clinton administration order. [...]

Source: Taken directly from "CMS Allows Parents to Choose Between
ARKids A and B, Despite Clinton Directive," KAISER DAILY HEALTH
POLICY REPORT, Thursday, September 20, 2001.


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AETNA TO OFFER QUASI-MEDICAL SAVINGS ACCOUNTS IN 2002

Aetna Inc. next year will offer an insurance package that
combines a preferred provider organization with a health savings
account, making it the first managed care organization "to offer this
type of policy on a national basis," the Florida Times-Union reports.

The company announced yesterday that it will offer the Aetna
HealthFund product to self-insured employers with 300 to 3,000
employees. Under the plan, employers will establish health savings
accounts to cover all health care costs, including PPO deductibles.
These will range from $1,500 to $3,000 annually, while the
"employer-funded health savings accounts" will range from $500 to
$1,000, depending on the type of arrangement negotiated by Aetna and
employers.

Companies will also be able to allow employees to set up flexible
spending accounts on a pre-tax basis to pay for any health
costs that exceed what is covered by the employer. While funds
in these accounts will "roll over from year to year," those in the
employer-sponsored accounts will not.

According to Steven Wojcik, director of public policy for the
Washington Business Group on Health, as costs rise, employers are
increasingly looking to place a greater burden of health care
spending on employees. "These types of products are definitely
being explored. What companies have to ask themselves is 'How do
the costs of people who choose that product compare to those who
choose a traditional plan?'" he said (Skidmore, Florida Times-Union,
9/20).

Source: Taken directly from "Aetna to Offer Combined PPO/Health
Savings Plan in 2002," KAISER DAILY HEALTH POLICY REPORT
Thursday, September 20, 2001.


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FAMILY VIOLENCE: IOM WANTS DOCTORS TO MAKE MORE REPORTS TO POLICE

Health care professionals are not adequately trained to deal with family
violence cases and confront challenges in balancing patient privacy
concerns with mandatory reporting requirements, an Institute of Medicine
report concluded in September. In a critique of healthcare training on
domestic violence, the IOM found that accreditation, licensure and
certification requirements "do not consistently and explicitly address
family violence and thus do not encourage training to address it."

Confronting Chronic Neglect: The Education and Training of Health
Professionals on Family Violence focused on six groups of health care
professionals: physicians, physician assistants, nurses, psychologists,
social workers and dentists.

Source: Taken directly from: "Providers Need Training On Balancing
Privacy With Mandatory Reporting of Domestic Violence Cases," PRIVACYSECURITYNETWORK Site Update for the week of Sept. 24, 2001.


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ONLINE MEDICAL RECORDS PUSHED IN AFTERMATH OF TERRORIST ATTACKS

Last week's attacks on the World Trade Center and the Pentagon
may lead to a greater push in the health care community for
increased use of electronic medical records that could "help save
lives" by "instantly supply[ing] a person's blood type, allergies and
past treatments" over the Internet, the Wall Street Journal reports.

John Halamka, chief information technology officer at Boston's
CareGroup hospital system, said, "In a mass casualty system, we
need to be able to rapidly access information. We don't have the
time or luxury of taking a medical history."

According to the Medical Records Institute, a proponent of electronic
medical records, only 5% to 10% of U.S. providers currently use
paperless record systems, and the financial difficulties faced by
hospitals nationwide largely preclude them from investing in new
technology.

Patient privacy concerns also complicate the use of electronic records,
as new federal rules set to go into effect in 2003, which establish comprehensive standards on medical data use and other privacy issues,
have made hospitals wary about any possible breaches of privacy.
Joy Pritts, senior counsel at the Health Privacy Project at Georgetown University, said that the new rules make exceptions for the use of
patient data in emergencies.

While widespread use of electronic records in the near future
remains unlikely, several government advisory groups are looking for
ways to create a "national health-data network" through which
patients could voluntarily submit their medical records to a secure
Web site. In addition, the CDC is developing programs that could be
used in emergencies to link emergency rooms and public health
departments through the Internet (Landro, Wall Street Journal, 9/21).

Source: Edited from "Online Medical Records Could Save
Lives in Emergencies, WSJ Reports," KAISER DAILY HEALTH
POLICY REPORT, September 21, 2001.

CCHC COMMENTARY: There will undoubtedly be a rush to the public
trough for taxpayer funding of public and private electronic medical
record systems and smart cards. The medical smart card may also be
pushed as a National ID card, as is the case with the federal
government's pilot project, the Health Passport Program, now running
in Cheyenne, Reno, and Bismarck through the Western Governors Assn.

Combined with the newly acquired permitted disclosures of the
"Medical Privacy" Rule, the Centers for Disease Control and
Prevention, and the National Committee on Vital Health Statistics,
which is leading the charge to build a National Health Information Infrastructure, must see the people's new apparent acquiescence to
government surveillance as an enormous leap forward toward their
goals for health care surveillance, tracking, lifetime longitudinal
linking of medical records and health care and public policy research.

Twila Brase, R.N.
President, CCHC

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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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