Healthcare

Proposed expansion of the Prescription Monitoring Program violates patients’ rights

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I am gravely concerned about provisions in LD 2117 which would mandate that all prescriptions dispensed for all Maine citizens be recorded in an electronic government database, the Prescription Monitoring Program (PMP). The PMP already exists to track controlled substance prescriptions, such as opiates (Oxycontin, Morphine, etc.), tranquilizers (Valium, Xanax), and stimulants (Ritalin, Adderall) to prevent drug abuse and ‘doctor shopping.’

This bill would dramatically expand the program far beyond its intended scope. On its face, this appears to be a governmental intrusion against the privacy rights of its citizens, which is Orwellian in nature. 

While the authors of the bill tell us that anyone who desires can ‘opt out’ of their new database, no one should feel reassured. Too often, we have seen a controversial government policy which was originally sold as optional become mandatory over time.

If this becomes the case, then without a warrant, and without the consent of either the patient or their physician, the government would be collecting intimate personal and private healthcare information on its citizens. Whatever theoretical public benefit this legislation might offer is outweighed by its potential consequences, be they intentional or unintentional.

This proposal represents a threat to the civil liberties of Mainers and should not go unchallenged for several reasons:

  • If patients cannot trust that their treatment information is not kept solely between them and their health care provider, they may delay or completely avoid seeking necessary medical care.
  • We cannot assume that any electronic database, including those with ‘bank level’ encryption is invulnerable to hackers both within this country and abroad.  It has been reported that Virginia’s Prescription Monitoring Program has already been hacked, so why would we think Maine’s wouldn’t?
  • Because pharmacies have financial relationships with health insurance companies (i.e. CVS owns Aetna), there is potential that insurance companies will have a back door through which they can get around the Health Insurance Portability and Accountability Act (HIPAA) and access prescription information on patients, even when they choose not to use their insurance to pay for medications so as to keep this information confidential.
  • If every physician, pharmacist, nurse practitioner, and physician assistant has access to all the prescription information of every person in the state, there is the possibility that one of these providers could go rogue and leak a public figure’s information for personal gain or for partisan reasons.
  • There would be temptation for elements within the government to use the newly expanded PMP as a tool to target its citizens via Red Flag Laws to restrict their second amendment rights.
  • It is a key tenant of the Hippocratic Oath that a physician should protect a patient’s privacy.  There are certainly instances where the public good demands that exceptions be made, such as for the prevention of the spread of communicable disease, or when a patient may harm him or herself or others, but in this case the potential greater good does not outweigh the rights of the individual to privacy.
  • Such an intrusion into the private affairs of its citizens by the government appears to be a violation of the Fourth Amendment of the U.S. Constitution.

For all these reasons, I encourage the committee members to be on record as being guardians of the civil liberties of their fellow Mainers and stand in opposition of this bill.

Note: LD 2117 has not been reported out of committee. All committee work has been suspended due to the coronavirus and the Maine Legislature is set to adjourn sine die Tuesday. There is no word yet on when and if the Maine Legislature will reconvene in 2020.

About Michael Ciampi

Michael A. Ciampi, M.D. is a family physician practicing in South Portland. Being frustrated with the dysfunctional state of insurance and government-directed health care, he became a pioneer in the Direct Primary Care movement, opening one of the first DPC practices in New England in 2014. Since then, dozens of physicians have followed his example and now work directly for their patients rather than insurance company middlemen. He is an active advocate for free-market healthcare reforms. Dr. Ciampi is a cofounder of the national Direct Primary Care Alliance, president-elect of the New England DPC Alliance, and a healthcare policy advisor for the Heartland Institute.

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