Your Doctor…Friend or Foe?

Everyone hopes that when they visit the doctor that they leave in a better state then when they arrived or at least have a plan to achieve a condition of better health. This is a reasonable expectation. It is also expected that conversations between a healthcare provider and their patient will be held in confidence as guaranteed by the Health Insurance Portability and Accountability Act of 1996. I understand the medical necessity to inquire about certain social habits. The amount of alcohol that a patient consumes or tobacco that they use can have a direct impact on their health and could even be the exact cause for certain medical problems. No one expects that their physician will be a spy for the government and have an agenda outside of the patients chief complaint.

This is exactly what some of the 23 Executive Actions that President Obama signed into law will see to if the President has his way. Let me be clear, my doctor asking me about whether I own firearms or not is not going to have even the slightest impact on what is causing my chronic cough. This is a separate issue from those suffering from mental illness. If there is a patient that presents with mental illness and verbalizes threats or acts in a threatening manner it presents a different set of circumstances and at that point it seems prudent that the doctor may incur an obligation to report a credible threat. What the recent Executive Actions are encouraging include:

1. Protect the rights of health care providers to talk to their patients about gun safety: Doctors and other health care providers also need to be able to ask about firearms in their patients’ homes and safe storage of those firearms, especially if their patients show signs of certain mental illnesses or if they have a young child or mentally ill family member at home. Some have incorrectly claimed that language in the Affordable Care Act prohibits doctors from asking their patients about guns and gun safety. Medical groups also continue to fight against state laws attempting to ban doctors from asking these questions. The Administration will issue guidance clarifying that the Affordable Care Act does not prohibit or otherwise regulate communication between doctors and patients, including about firearms.

2. Address unnecessary legal barriers, particularly relating to the Health Insurance Portability and Accountability Act, that may prevent states from making information available to the background check system.

3. Improve incentives for states to share information with the background check system.

4. Direct the Attorney General to review categories of individuals prohibited from having a gun to make sure dangerous people are not slipping through the cracks.

What seems likely to result from this in my opinion:

1. Physicians, Medical Groups, Hospitals, etc. will start to implement gun owner questionnaires into their patient screening processes. Further down the road, ObamaCare funding could even be limited based on inclusion of this questioning during patient visits. This leaves patients in the predicament of either answering questions unwillingly or being forced to lie to their healthcare providers to protect their individual freedoms that are supposed to be guaranteed by the Constitution.

2. There are not currently any “unnecessary legal barriers” in the Health Insurance Portability and Accountability Act of 1996. The President wants your medical information to be disclosed when you want to purchase a firearm. The HIPAA laws state that:

  • Health providers and health plans, INCLUDING government programs that pay for health care must comply with HIPAA laws.
  • The information protected includes information health care providers put in your medical record, conversations your doctor has about your health care with others, information about you in your health insurer’s computer system, billing information about you at your clinic, and most other health information about you held by those who must follow these laws.
  • Covered entities must put in place safeguards to protect your health information and must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.
  • The HIPAA Privacy Rule sets rules and limits on who can look at and receive your health information. To make sure that your health information is protected in a way that does not interfere with your health care, your information can be used and shared:
  1. For your treatment and care coordination.
  2. To pay doctors and hospitals for your health care and to help run their businesses.
  3. With your family, relatives, friends, or others you identify who are involved with your health care or your health care bills, unless you object.
  4. To make sure doctors give good care and nursing homes are clean and safe.
  5. To protect the public’s health, such as by reporting when the flu is in your area.
  6. To make required reports to the police, such as reporting gunshot wounds.
  • Your health information cannot be used or shared without your written permission unless this law allows it. For example, without your authorization, your provider generally cannot:
  1. Give your information to your employer.
  2. Use or share your information for marketing or advertising purposes.
  3. Share private notes about your health care.

Seems like a whole bunch of reasons to not share your medical information when you go to purchase a firearm.

3. Uncle Sugar, uh I mean Uncle Sam is going to offer a lot of money to states that are willing to do what he wants!

4. The AG will look at who else might be a good candidate to ban from owning guns. Maybe so that felons and those with convictions for domestic violence don’t feel so alone, military veterans and those who speak out about individual liberty and freedom will likely be added to the list of those who cannot possess a firearm.

I wouldn’t go so far as being paranoid but at the same time I would not make it a habit to tell your life story to the dude that you just met at the bus stop. At least take the time and consider if the questions that your doctor is asking you are actually pertinent to your medical care and if your healthcare provider is on your side.

Don’t worry…now that our doctors are against us, our kids will be next.

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