Bush administration attempts to keep Medicare database away from patients

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Lawsuit appeal may further prohibit consumer access to health data.
Source: Lewis-Clark State College

The administration of President George W. Bush is appealing a court ruling that would permit disclosure of Medicare billing records which would allow patients to compare doctors’ expertise and efficiency.

Consumer groups, employers and the health insurance industry are advocating for the release of the database, but the ruling is opposed by organizations representing doctors, according to the Los Angeles (LA) Times. Consumer and business groups have expressed disappointment by the administration’s appeal.

With information on more than 40 million patients and 700,000 doctors, the Medicare claims database holds the most healthcare data in the United States, much more than the individual computer banks of the big payors, the LA Times reported. It could reveal, for example, how often a doctor has performed a given procedure, considered to be a key indicator of how good a physician is likely to be.

However, the LA Times reported that the release of such details has been limited by government policy, based partly on a court ruling in the 1970s that sought to protect the privacy of doctors’ financial information.

In the current course case, a group called Consumers’ Checkbook sued the government for data on doctors in four states and Washington, D.C.

At the conclusion of that case in the summer of 2007, U.S. District Judge Emmet G. Sullivan ordered the release of the data, saying the information would provide “a significant public benefit,” according to the LA Times.

At the time, the Health and Human Services Department (HHS) released a statement endorsing the objectives of the consumer group that was suing, but also said that it wanted a higher court to clarify the lower-court rulings.

Robert Krughoff, president of Consumers’ Checkbook, told the LA Times that the government could have simply accepted Sullivan’s ruling and left it to doctors’ groups to try to overturn the decision on appeal. He added that releasing the data would be consistent with positions previously taken by President Bush and HHS Secretary Mike Leavitt favoring transparency in healthcare.

However, the American Medical Association has joined that request for an appeal, arguing that the Medicare information could be misleading because the raw numbers do not take into account differences in patients treated by different doctors, the LA Times reported.
Krughoff said the information sought by his group was more detailed and would be provided to consumers through an independent source.

“The government advises consumers to check this kind of information, but the patient is now at the mercy of asking the doctor, and maybe challenging the doctor, as opposed to going to an independent source and finding out,” he told the LA Times.