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Issue #1722      March 9, 2016

Editorial

e-health: Privatising your medical history

When the Labor government introduced e-health in 2012, it was sold as a personal record of medical conditions, medications and medical history of individuals stored in a centralised data base. The government went to great lengths to reassure the public that the patient would have full control over what information was included and who had access to it.

The Australian Medical Association criticised the intention to allow patients to decide who would access their records and what was included, saying that medical practitioners would be unlikely to rely on the information contained in the records. The organisation considered that records with hidden information would be more dangerous than no records at all.

Patients, privacy groups and other organisations were suspicious whether the storage and sharing of personal data would be secure and where and how it would be used at a later date. Would, for example, private health insurance funds have access. Government bureaucracies are notorious for leaks and mishaps with personal records.

At the time e-health was being debated, the Guardian warned: “It could be highly beneficial for a patient’s medications and medical history to be accessible by doctors and other practitioners. Unfortunately, there are also a number of dangers associated with the scheme being introduced.

“Firstly, how voluntary is voluntary and for how long will it be voluntary?” (Guardian, “Warning: National ID card”, #1457, 02-06-2010) It appears it will not be long. Less than 10 percent of the population and very few medical practitioners opted in. Towards the end of 2015, the Minister quietly presented legislation to rebadge e-health as MyHealth and to change the system from opt-in to opt-out: last week, an opt-out trial was launched involving one million people from Western Sydney and northern Queensland. The legislation rules out access to the data by insurance companies and employers, but for how long before that is changed?

If the data collection is automatically linked to all medical practitioners’ computers, then there could be a reluctance on the part of some patients to record information relating to certain conditions such as HIV positive, depression or substance abuse. Would company doctors have access?

The same Guardian article warned: “Under a punitive social security system, which already seeks to control how recipients spend their income, there is the possibility of the government withholding payments from people whose medical records reveal substance abuse or other ‘undeserving’ behaviour.”

The government is also encouraging people to make their Medicare claims using their smart phone, rather than going online to the Medicare website or making a claim on paper. How secure is this data?

There were also concerns that this was another attempt to introduce a mandatory national identity system, along the lines of earlier attempts to bring in an Australia Card. It was decided to use a smart Medicare card for identification purposes. It was not clear at the time whether facial recognition, DNA or some other identifier would be used.

“Medicare Australia is developing the Healthcare Identifier service under contract to the National E-Health Transition Authority. This service will generate health care identifiers for patients, health care providers and health care organisations and is aimed at supporting the development of electronic health records in Australia,” the government said in the 2010-11 budget. The National E-Health Transition Authority had been set up in 2005 by the Howard government with an e-health system in mind.

More than 100 hospitals have already connected to the MyHealth Record system.

The real danger is when the management of the centralised data system for recording medical records is privatised. Where will the data be stored? Offshore? The government is in the process of privatisation of the management of the Medicare, PBS and aged care payments systems.

Patients have no way of knowing where their records are going.

The aim is privatisation and Americanisation of the public health sector with online data of patients centrally available to medical practitioners, hospitals, government agencies, and the private outfits that are contracted to carry out government functions.

Next article – Solidarity is infectious – Community Union Defence League launched in SA

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