'bureaucratic nightmare'....8/28

An article in Modern Healthcare caught my eye as it related to HIPAA.

For many years I was a chief information officer. Time passed and I became a chief executive officer. The whole Health Insurance Portability and Accountability Act discussion has for years fascinated me. First of all, the database maintained by the insurance industry has for many decades violated patient privacy. Any person with private insurance—life and health—gave employers and insurers the right to view one's clinical history, drugs ordered, diagnoses and other personal data. HIPAA has done nothing to change that. When you sign the application form for the insurance, you allow this to occur.

HIPAA was passed in the 1990s and became a so-called privacy protection. Instead I think it has become a bureaucratic nightmare.

For four years I was the CEO of a hospital in Monterrey, Mexico, and am now CEO of a division to put primary-care clinics in supermarkets. Imagine this scenario. A person wants to know his cholesterol. He appears at one of our clinics and requests that a specimen be drawn for the tests. He is charged our retail rate for the test. With his receipt is a password. When he gets home, he dials into our Web site, logs on and enters his password. He sees his result. If he wants to consult a physician, he can return to the clinic and see a doctor. This person did not have to make an appointment in a doctor's office and therefore did not have to pay that fee before the test. He can appear at his convenience. There is free parking at the market. Another possibility is his physician ordered a number of tests. Again the patient comes to the clinic in the supermarket and has specimens drawn. He can see his own results, as can his doctor. None of this is possible in the U.S., and part of the reason is the HIPAA law.

What about quality? Our chief of pathology was named national pathologist of the year. We are in the process of seeking accreditation from the Joint Commission and the College of American Pathologists.

As a longtime healthcare worker in the U.S., I began as a chemist. I always felt every system, technology and service was superior. When I saw the quality in Mexico and then understood the costs, I was truly surprised. I think the reason people are seeking care in other countries is based on price. However, without quality, this trend would surely die. I think an exploration and comparison of morbidity and mortality figures would amaze the American public. Disparaging other countries in the long run will not work. If healthcare in the U.S. represents 16% of the gross national product, and it is half of that in Japan with better outcomes, something must change. One of those things is the ridiculous HIPAA law.
David Libenson

Santa Engracia Hospital

Mexico