The government pokes me in the eye. Again.

Remember HIPAA? That’s the “Health Insurance Portability And Accountability Act” of 1996, a fabulously convoluted and incomprehensible pile of stink that was supposed to make health information more private, while at the same time allowing individuals to more easily change health insurance plans. After numerous revisions, clarifications, and doodling in the margins, we’ve got a system in place that:

• Costs billions
• Prevents doctors, hospitals, and labs from communicating
• and creates (1.5 million links!) a Byzantine, sprawling industry of consultants, lawyers, and bureaucrats to monitor enforcement and create new rules. None of this improves health care in any way.

From the patient’s perspective, the only tangible impact of this monster is a steady stream of unreadable, paper-wasting lawyer-scribble in the form of “privacy notices.” Oh, and you get to sign a few more forms when you go to the doctor.

From my perspective, HIPAA is  a hugely expensive waste of time squatting uninvited between me and my patients, a hideous, stinking uninvited guest that only gets bigger and more stinking every year. (As an example—the current Economic Recovery Act includes tweaks that requires providers to track every disclosure of health information that’s been used for any purpose—for three years. See, that will help with the economic recovery by employing even more administrative pygmies and consultant-weasels. Not that I am bitter.)

But get this: HIPAA might just have been a preview for a whole new set of rules and regulations being foisted on the healthcare industry by the nameless rule-makers. You haven’t heard much about this—yet—but get ready for the “Identity Theft Red Flags Rule.” Since it lacks a snappy abbreviation like HIPAA, let’s call it the “Screwing Physicians and Empowering Weasels” Act, or SPEW for short.

The rule was announced in 2007 by the Federal Trade Commission (FTC) as a way to protect consumers against identity theft when dealing with financial institutions and creditors. Fair enough, those businesses handle zillions of dollars in increasingly complex transactions, and identity theft is a genuine threat. But after the rule was announced, and the period of public comment ended, the FTC told physician groups that it was going to consider the term “creditor” in a very broad sense, including any business that defers payment. That’s right—since doctors will allow you to leave without paying, while we wait for payment from your insurance company, that makes us a creditor. No matter that we don’t charge interest, or that we’re only extending “credit” to cover a medical bill for  a few weeks. We get the same rules and oversight and paperwork as the megabanks, though of course no bail-out money to pay for all of the consultants, employees, and time its going to take to do this. Since no one guessed that SPEW would apply to physicians and hospitals, we had no chance to review the rules or suggest any modifications to make them work in our industry.

The SPEW rules are so vague that no one knows what we are really supposed to do—a boon to the consultants and lawyers who leaped so happily into HIPAA-chummed waters a few years back, and are salivating over a new opportunity to make sure that even less of your health care dollar is actually spent on health care. The rule requires health businesses like mine to develop and conduct an identity risk assessment, followed by implementation of an identity theft program to identify, detect, and respond to potential risks. We’ve got to have a plan in place stating how we’ll respond to alerts of potential misuse of identifying information. What, exactly, does all of this mean? I found one example I could understand: The FTC suggests, among other steps, that to comply with this rule we should check photo ID at every encounter. I hope your baby has a driver’s license.

SPEW, like HIPAA, is a hugely misguided effort by your government run amok. It will add layers of complexity and cost to every medical encounter, further burdening physicians and distracting us from providing medical care. It’s one more completely unnecessary poke in the eye, one more straw on the back, and one more nail in the coffin for the few physicians left who still enjoy practicing medicine.

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Tags: health care finance, health care reform, health insurance, identity theft

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