Kevin, MD links to a post at DB’s Medical Rants that epitomizes the unintended (and often bizarre) consequences that inevitably attend federal meddling in health care. The post recounts an incident in which fear of transgressing against HIPAA outweighed any sense of responsibility to the public:
My most recent [horror story] involved a patient who came in for a drug related problem. My resident recognized that the patient was a known most wanted criminal. So I called security, who told me that because of HIPAA we could not notify the police. She eventually left the hospital with IV in place to avoid arrest.
In other words, given a choice between incurring the wrath of CMS and endangering the public by allowing a wanted criminal to walk, the people in question decided that arousing federal dudgeon was the scarier alternative.
Before I get into the implications of that, I’d like to point out that HIPAA contains no provision forbidding a hospital from calling the police when a wanted criminal appears on its threshold. This is an example of what the NYT accurately calls “overzealous” interpretation:
New studies have found that some health care providers apply HIPAA regulations overzealously, leaving family members, caretakers, public health and law enforcement authorities stymied in their efforts to get information.
But the actual contents of HIPAA are not what caused this bizarre behavior. What brought it about was the fear of angering our masters at CMS. This fear is at the root of all “overzealous” applications of HIPAA, and it constitutes a very significant and wholly unintended consequence of the legislation.
So, think about this: If fear of CMS is already distorting our thinking to the degree that it actually makes sense not to call the cops on a wanted criminal, what will it be like if we give Washington complete control over the entire health care system? If that prospect doesn’t give you pause, you aren’t paying attention.
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