CFC’s Zack Kaldveer on NPR regarding proposed new prescription Database

KQED’S (NPR) California Report recently covered Jerry Brown’s plan
to create an online prescription drug database to catch would be drug abusers and fraudsters. The database would be available
to doctors, pharmacists, and law enforcement.

Representing the consumer and privacy rights position was Zack Kaldveer of the Consumer Federation of California. Just listen to the California Report’s June 5th edition. The segment begins just over half way into the 10 minute program.

Or just click here:Listen (RealMedia stream)
Download (MP3)

Since I talked about the issue for at least 10 minutes with KQED, I’d like to share some of the complete comments I made, rather than just the one sentence soundbite.

Generally speaking, the database raises a whole slew of privacy concerns.

First of all, the new database, to be funded
by private interests (insurance industry in particular)
, and in fact, it was Kaiser itself that funded the
feasibility study for the program, would "allow doctors and pharmacists to immediately
a database of more than 86 million drug prescriptions. All
prescriptions filled for schedule II, III and IV drugs ‘ including powerful
painkillers like morphine, hydro-codone and codeine ‘ would be instantly

Its being sold as a way of cracking down on drug abusers,
meaning law enforcement will also have access to your records…but they haven’t
said how this access would be approved or denied.

Before I comment more, here’s some clips from the San Diego Union Tribune:

…his office plans to place the state’s prescription-tracking database on a
secure Web site that health-care providers can log onto to obtain the
information instantly
. The move is intended to make it tougher for
patients to go from doctor to doctor and fill multiple

Brown’s proposal, the Troy and Alana Pack Foundation would fund
the database’s
implementation costs, with the state Department of Justice absorbing maintenance

Jerry Flanagan of
the Foundation for Taxpayer and Consumer Rights, a consumer advocacy group based
in Santa Monica, warned that in establishing such a database efforts would need
to be made to ensure patient information isn’t released to identity
or unwanted marketers. ‘Nationally, the push to put records
online has evolved faster than the concern to make them private,’ said Flanagan.

The San Jose Mercury News
sheds some more light on the issue:

It will cost
about $3 million to develop and operate the program for three years, according
to a 2007 feasibility study paid for in part by Kaiser Permanente. Funds have not
yet been identified, but supporters are hopeful health care providers and
insurers will foot the bill. Nationally, prescription drug fraud costs insurers
as much as $72 billion a year, according to a 2007 study by the Coalition
Against Insurance Fraud.

Kathy Ellis of the
Department of Justice said details about law enforcement access to
California’s system have yet to be worked out
. Access likely will be
granted on a case-by-case basis to prevent "fishing" in the system, she said.
"They’d have to identify what their need is. I don’t see a patrol officer having
a direct need for that information."

It is important
that enforcers not rely on numbers
when looking at suspected abuse
cases, said Sherry Green, executive director of the National Alliance for Model
State Drug Laws.

"Even if something looks outside the
traditional range,
that doesn’t in and of itself mean that something’s wrong," said
Green. "Prescription monitoring officials can’t make those kinds of health
determinations ‘ all they can do is make a recommendation that something needs
to be scrutinized more."

In Maine, civil libertarians
fought the development of drug-monitoring
. An online system, launched
in 2006 in response to the state’s OxyContin epidemic, has "an arm’s-reach relationship
with law enforcement," said program director Daniel Eccher. Investigators can’t
access records without a subpoena.

I guess the obvious point is that
if such a program is to be implemented we must ask ourselves whether the
possible pitfalls
of allowing our private prescription records to be so
easily accessed outweighs the claimed benefits of "stopping drug

By the least, any such database must include the
strongest of safeguards
to ensure a patient’s private information is protected from
identity thieves, overzealous law enforcement, or unwanted

Some suggestions might include: Legislation
that puts into law, a stringent, ironclad privacy policy for this database and
its maintenance.

For instance, there should be an electronic
audit trail examined regularly
ANYONE who has accessed your file and
consumer’s should have access to these (as in their) medical records and to that
electronic audit trail so they knew who’s been snooping around.

also am skeptical anytime the "war on drugs" is used
to rationalize the
increasing deterioration of our right to privacy. Since this
whole program was pushed by the insurance industry (and who
paid for the feasibility study), and is going to be funded by private sources,
we should wonder whether industry profits and government power is the real end
goal here?

Imagine the money the insurance industry stands to both save and perhaps increase through the potential – even if illegal – intrusion into patients’ medical records (so they can market to new potential customers). Or what about the health workers simply using their access to the system to snoop around peoples’ records for personal reasons (many instances of this)?

Similarly, if we really wanted to reduce drug
we should focus on fully funding our schools,
offering first class drug counseling and rehabilitation services, and stopping
the advertising of prescription drugs on television every night (among many other tactics).

It goes
without saying too, that government could also abuse this
. We’re opening a Pandora’s Box to say the least…and since this
kind of data sharing and storage is a likely fact of life in our future, then we
better be vigilant in protecting our privacy from those who might seek to
benefit from it at our expense.