Yeah, plastic is definitely, definitely out. Information is in. Got any? Want some?
Just as plastic raises concerns regarding negative environmental consequences, information raises, metaphorically speaking, similar environmental concerns as individuals and corporations stress over who controls access to information.
Health Care Information Technologies (HCIT) is an area that offers seemingly “low hanging fruit” in terms of immediate individual and societal benefits. Namely, more reliable information exchange between care providers will significantly reduce errors, thus lowering cost while increasing the quality of care. Yet, despite bipartisan support for the outcomes of adopting electronic healthcare information systems, the pace of adoption is extremely slow.
Today, a NYT article highlights the difficulties President Obama will face as he pursues the deployment of HCIT. Here is one part of a very tough challenge:
“Health I.T. without privacy is an excellent way for companies to establish a gold mine of information that can be used to increase profits, promote expensive drugs, cherry-pick patients who are cheaper to insure and market directly to consumers,” said Dr. Deborah C. Peel, coordinator of the Coalition for Patient Privacy, which includes the American Civil Liberties Union among its members.
And, here is another:
In a letter to Congressional leaders, Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group for insurers, expressed “serious concern about privacy provisions being considered for inclusion in the economic stimulus bill.”
She criticized, in particular, a proposal that would require health care providers to obtain the consent of patients before disclosing personal health information for treatment, payment or “health care operations.”
Which leaves us with this pithy summation:
Such a requirement, she said, could cripple efforts to manage chronic diseases like diabetes, which often require coordination of care among many specialists.
“Health information technology will succeed only if privacy is protected,” said Frank C. Torres, director of consumer affairs at Microsoft. “For the president-elect to achieve his vision, he has to protect privacy.”
As an area of policy, one could ascribe the lack of progress to market failure, public failure, or both. Multiple public values can be identified within this discussion. Privacy, quality of life, and economic concerns are just a few of the values inherent to this debate.
The core topic of this debate, as portrayed by the article, is the quality of privacy. How good is it? Who controls it? More importantly, who defines what “privacy” is?
So, who wins the debate? Whose definition of “public value” carries the day? In sum, whose values does policy represent?