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That’s a key claim in President Obama’s health care plan — actually, it was a key claim of John McCain’s plan as well. It doesn’t take any acute powers of observation as a patient to notice the places where data has to be re-entered by a new doctor or hospital, or where important data isn’t available and the patient is asked to report it instead. (I was once asked about the results of a cardiac stress test I had had three years before, of which I had only the vaguest memory.) It’s reasonable to hope that computerized medical records could do for delivery of medical care what, say, computerized parcel records have done for parcel delivery.

But it’s also easy to dream of a perfect world that is unlikely to be reached or to look like the dream once we get there. And that is the bottom line on a good Wall Street Journal column by noted physicians Jerome Groopman and Pamela Hartzband, Obama’s $80 Billion Exaggeration. The $80 billion number, they report, comes from a four-year-old RAND Corporation study with a lot of wishful thinking and not a lot of data. The doctors raise a privacy concern, too — not that the data will be mishandled and leaked, but that the entire enterprise is in part designed as a monitoring program by the federal government.

Some have speculated that the patient data collected by the Obama administration in national electronic health records will be mined for research purposes to assess the cost effectiveness of different treatments. This analysis will then be used to dictate which drugs and devices doctors can provide to their patients in federally funded programs like Medicare. Private insurers often follow the lead of the government in such payments. If this is part of the administration’s agenda, then it needs to be frankly stated as such. And Americans should decide whether they want to participate in such a national experiment only after learning about the nature of the analysis of their records and who will apply the results to their health care.

The suggestion that the government will want to chew on the data to try to figure out what works is unsurprising. But it surely hasn’t been highlighted, and it raises some fundamental questions. What is the data in my medical record going to be used for, how long will the data be kept, and can I be sure it won’t be repurposed?

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