Big Brother Is Reading Your Test Results

Writing in today’s Washington Post, Philip Longman reports that New York City has begun requiring doctors and laboratories to reveal even more confidential medical information in the name of “public health.”

On Jan. 15, New York City began requiring local clinical laboratories to report to the city health department the results of blood sugar tests performed on citizens. The department plans to use the information to improve surveillance for diabetes, which afflicts an estimated one out of eight New Yorkers and to “target interventions.” Specifically, if you live in New York and have trouble resisting sweets, your doctor may soon receive a call from the health department suggesting that he or she needs to persuade you to change your lifestyle.

What makes this development so extraordinary in the annals of American public health is that diabetes is not a disease you can catch from, or give to, anyone else. U.S. governments have a long history of imposing quarantines and otherwise restricting the liberties of people suspected of carrying contagious disease. Early in the last century, for example, the very same New York City health department famously exiled Mary Mallon (aka “Typhoid Mary”), along with many other infectious patients, to a tiny island “colony” in the East River.

As Longman points out, however, diabetes is not the same as a communicable disease like typhoid or AIDS:

[D]iabetes, though now a fearsome epidemic, is not communicable; nor do the behaviors that lead to the disease (primarily lack of exercise and improper diet) put others at risk of illness. It cannot even be said of diabetics, as is often said of illegal drug users, that their habits foster a life of crime or fund crime syndicates and terrorist networks.

One would think that this would be the end of the debate. No real public health threat, no question that the government has no right to violate medical privacy. Right ? Not according to Longman.

Medical privacy is not free. Lack of free-flowing information in the health care system drives up the cost of health insurance and contributes to the problem of the uninsured. For the population as a whole, it impedes the safe and effective practice of medicine, retards development of medical protocols based on science, and in all these ways and more reduces productivity and life expectancy. Medical privacy is not simply a question of individual right, even for individuals whose medical problems might at first seem purely their own concern.

Nonsense. Pure and utter nonsense. Perhaps it is true that medical treatment would benefit from the free flow of information. This does not mean, however, that the government has the right to know what your blood sugar, cholesterol, or blood pressure test results are. Allowing a law like this to stand would mean, effectively, an end to the entire principle of doctor-patient confidentiality and yet another nail in the coffin of individual liberty.

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  • Michele

    I’ve been thinking about this for the past few days. I too was upset (once again) over the privacy issue when I first learned of this. The reason this charter law was passed, was to attempt to curb city/state health care costs.

    In NY state we have almost the equivalent of socialized medicine where everyone can get health insurance, no matter their source or income level. Diabetes is the illness that is most costly to treat, therefore the thinking was to monitor the lab results of the public health clinics. Believe me, this has not been the only battle regarding reporting of non-infectious conditions. The NYC Board of Health has been doing the same with other health issues.

    Each and every time the prevailing reason was for the good of the public, with the aim to unburden the tax payer’s from the future burden of spiraling health care costs for the indigent.

    As a result, Longman’s conclusion is flawed because much is already known of these groups being affected. In fact, entire studies have been done about the development and progress of diabetes in this socio-economic group that constitutes this indigent class. All of these done with cursory explanations to the patients.

    At present they are getting away with doing this because most of the indigent cases served by these clinics are the poorest of the poor who will easily give away their rights, either from a lack of understanding or from sheer desperation and need of free medical treatment.

    As for the lack of outcry in my state over the erosion of personal liberties that are taking place, I can only surmise it stems from an inherent belief from of the population that all government is good and that is the Government’s responsibility to take care of all our needs… hence the tolerance for socialized medicine and the high debt the City carries to support it.

    Thank you for writing this post!

  • Eric

    Basically, once you accept that the government can provide better for a group than that group, and the market, can, you quickly decide that anything you do in the name of providing for that group is good.