Under the ACA certain mental health and substance abuse services are essential benefits. The ACA is also attempting to make mental health services more affordable to individuals through financial parity which is a means of preventing unequal insurance company treatment in terms of required co-payments and co-insurance among other things that may contribute to making mental health services unaffordable. But, there is a cost for all this progressive-looking commitment to mental health services access and that cost is patient privacy.
Today puts another nail in the coffin of patient privacy and further stigmatizes any person suffering from any mental health issues (or maybe NOT suffering from mental health issues) from the hazards of being reported as a mental health risk as SUBJECTIVELY determined by mental health professionals based on what they think a patient MAY do at some future time.
This is what the President has done with his 23 Executive Orders as well as Congressional advice in his efforts to improve gun control.
Already, for those consumers who have ever consulted with a mental health professional, privacy is significantly reduced because in order to obtain insurance company reimbursement, patients must sign away their doctor-patient confidentiality and authorize insurance companies to see their patient records, oftentimes including doctor’s notes.
Now, the President’s Executive Orders include a mandate for a clarification that Affordable Care does not prohibit doctors from asking patients about guns in their homes, and the release of a letter to healthcare providers that no federal law prohibits reporting threats of violence to enforcement authorities.
In addition, the President provides for better sharing of information with Federal background check systems by providing “incentives” for states to share such information. The Attorney General is assigned the task of reviewing who is not allowed to have a gun to make sure no one “slips through the cracks.”
Making HIPAA even more useless, the President has authorized addressing “unnecessary” legal barriers (including those in HIPAA law) that may prevent states from making information available to the background check system.
There are also orders requiring the release of a letter to state health officials requiring a clarification of mental health services that Medicaid must cover, and regulations clarifying essential health benefits and parity requirements under the ACA.
By providing executive orders that authorize physicians and healthcare professionals to ask about gun ownership and by mandating the removal of unnecessary legal barriers created by HIPAA that might currently make information unavailable to background checkers, in conjunction with Federal authorization for healthcare providers to report patient threats of violence to law enforcement, the new standards are clearly intended to PROTECT any reporter of a mental health situation that is used to deny a gun license.
Much like current violations of patient privacy laws, absent the proving of at a minimum gross negligence, and usually absent proof of intentional breach of patient privacy, there are few to no consequences for healthcare providers for their breaches of patient privacy.
As the healthcare system becomes entwined with the gun control authorities and background checkers, information about side effects of other medications that could influence patient behavior should rightfully be reported by physicians for gun background checks as well. Every patient prescribed a drug that warns of mood changes or mental changes, or that impacts their ability to operate machinery should arguably be reported to authorities in addition to subjectively determined mental health issues.
In my opinion, in his efforts not to address the availability of certain types of guns head-on, the President has chosen to address guns by adopting one of the most popular mottos of the NRA, “Guns don’t kill people, people do.” Unfortunately, for gun owners and non-gun owners alike, by making PEOPLE the problem, we’ve made PEOPLE the scapegoat for solution to gun crimes, and for government that means reducing access by PEOPLE to guns through any means available, including raiding their rights to privacy concerning health records.
For my proposal, which is requiring a mental health exam by a licensed professional as part of the necessary paperwork filed for any person seeking to renew or obtain a gun license read my page post, today.
