Curiouser and curiouser: I ran across a disturbing news story today about the Virginia Tech gunman, Cho Seung-Hui, that boldly states;
Some news accounts have suggested that Cho had a history of antidepressant use, but senior federal officials tell ABC News that they can find no record of such medication in the government's files. This does not completely rule out prescription drug use, including samples from a physician, drugs obtained through illegal Internet sources, or a gap in the federal database, but the sources say theirs is a reasonably complete search. [story]
Um, excuse me? Since when has the government kept a record of all prescription drugs that an individual uses? What do they think they are going to do with that information? How did they get this priviledged information in the first place? I thought this was a priviledged part of a person's medical history and was therefore private unless the patient (who owns those records) signs a waiver to allow others to see them? Or am I grossly misinformed?
And of course, this assertion makes me wonder about the nature of our government: how can they accidentally "lose" five million emails regarding the dismissals of eight US Attorneys, but they can keep track of every prescription medicine that every resident of this country has ever taken??
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No, you're not grossly misinformed. I think this story must have gotten garbled somewhere along the way. I work for a major pharmacy benefit manager, and I'm quite sure we don't provide individual prescription details to the government. I don't think we even do that for the Medicare portion of our business--our billing is done in aggregate, not on an individual level. (I'm sure we didn't under the original Medicare plans; I'm not entirely positive about Medicare D, which I'm less involved with, but I can't imagine how providing these details could be legal under HIPAA.)
More information on drug reporting in a BoingBoing article:
http://www.boingboing.net/2007/04/17/va_tech_shootings_wi.html
Search for 'NASPER'
Your medical records are anything but private. Every significant visit (like one that would result in a prescription) is coded into a central database and swapped between insurance companies and information clearing houses. Often times, your records are not even kept in the United States. The only reason that you don't see Choicepoint advertising background medical records searches on the Internet is that they choose to be discrete about it... these searches *are* available for those who have been pre-screened (in much the same way that Lexus-Nexus searches aren't available to the general public... because of costs and searcher applicant screening).
You should pick up a copy of Database_Nation if you really want to understand were things were at even prior to 9/11.
HIPAA is a joke and if you think it actually does *anything* to protect your medical information for disclosure, you are sadly mistaken. I know that's not what you were sold, but that's reality in a capitalist democracy (not only are you ideals for sale... they've already been sold two or three times).
GS, Mike the mad biologist has more on this issue.
the types of prescriptions the feds are talking about are what are known as "schedule" drugs, mostly narcotics and the like... schedules 3 through 6 are mostly mild, and rarely require much in the way of fed intervention, but schedule 2s are your garden-varietal opiates, barbituates, codeines, etc...
schedule 2s, back in the 70s (when i was doing this for a living) required triplicate prescriptions: one stayed with the pharmacy, one with the doctor, and one went to the feds...
in the intervening 30 years, i can imagine bureaucracy going nuts and requiring more drugs to be reported in this fashion...
we won't even talk about schedule 1s (morphine, heroin, dilaudid (i think)), etc...