Tuesday, May 8, 2012

PDMPs and Privacy

According to a report this morning, Missouri remains only one of two states (New Hampshire is the other) that will go into 2013 without a prescription drug monitoring program (PDMP).

Senate Bill 710 (Engler, R-Farmington), which would have created a prescription drug-monitoring database for Missouri, ended its chances yesterday, the victim of an eight-hour filibuster by opponents of the proposed legislation.

Sen. Rob Schaaf, R-St. Joseph, a family physician, led opponents of the proposal.

Engler told WorkCompCentral on Monday that Shaaf has opposed similar legislation in past legislative sessions. He said the prescription database initiative is dead for this session, but he expects another attempt  to be made in 2013.

John Eadie, executive director of the PMP Center of Excellence, in Rensselaer, N.Y., which tracks prescription drug-monitoring programs, told WorkCompCentral on Monday that 48 states have approved PDMPs and 40 programs are operational. Only New Hampshire and Missouri have not yet approved drug-monitoring programs.

Schaaf issued a column on Friday to constituents in which he said that “the people don't want the government tracking what medications they are taking -- that is private information that should stay between a patient and a doctor,” and during the filibuster, he attacked the legislation as a violation of individual privacy, calling it “outrageous that bureaucrats would be able to track our medications that we legally obtain.”

Schaaf said the legislation “intends to prevent doctor-shopping … (by people going) from physician to physician obtaining prescriptions to either fuel their addiction, or to sell the drugs illegally. However, just because these individuals are breaking the law and making poor choices, why should everyone else have to give up their liberty and privacy?"

So just because someone is breaking the law and making poor choices by racing down the freeway at 85 miles per hour we should not be subjected to radar enforcement of the speed limit because that invades my liberty and privacy?

The reason we have to implement laws that seem invasive of rights to law abiding citizens is because of those few individuals that "are breaking the law and making poor choices".

Most of us, I presume, don't give a hoot about whether someone else knows that I'm taking Oxycontin, or Lipitor for that matter. If that is in some public database (which a PDMP is not - it is accessible only by licensed physicians and pharmacists) then whoop-de-doo. I just don't have a problem with that.

Heck, Rush Limbaugh seemed to overcome the public disclosure of his Oxycontin habit just fine. Plenty of other public figures go through the initial embarrassment of public disclosure of their drug habits and recover their careers without much of a hiccup.

Privacy advocates argue the slippery slope theme and perhaps they're right. Perhaps a PDMP does represent an erosion of privacy, and erosion of individual's ability to hide and keep to themselves.

My guess is that most people don't worry about that sort of thing because most people don't have anything to hide.

And frankly, in the age of the Internet, there isn't a whole lot of privacy anyhow. In particular with social networking, most people volunteer unbelievable information about themselves that is made wholly public in a completely unwitting manner. If people really understood how information consolidators can take disparate pieces of data and make surprisingly accurate composites for marketing purposes they might be squeamish about posting in public forums.

But they are not - because most people just don't have a lot to hide. And the benefit of being accurately marketed with either goods or services is a benefit to most people - it saves time and money for most everyone.

My guess is that the opposition to PDMPs really has very little to do with privacy and has more to do with something of a monetary nature.

In the grand scheme of society, individuals give up certain privileges for the benefit of the whole as a means of furthering the species.

Eadie said that a 2011 study by the Massachusetts Department of Public Health found doctors frequently were not aware that their patients were seeing multiple doctors and obtaining prescriptions from them. According to the study, only 8% said they were aware, and only 9% said they believed there was a medical basis for the patients’ actions.

To me, that is much more alarming than if Pfiser knew that I was a prime marketing candidate for the next generation of satins.

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