One the eve of the First Ministers Conference in Ottawa, an interesting balloon has been
floated about the creation of a national medical records registry to store medical records
on each and every Canadian.
Thanks but no thanks. Its a bad idea from Big Government and it is an intrusion into the
personal lives of Canadians that is unacceptable.
First and foremost is the security issue. There is absolutely no way this information can
be secured. If I understand the reports correctly, any doctor could retrieve the medical
records on any Canadian through an interlinked online network . If this is what is
proposed, it is totally unacceptable as passwords will eventually make their way around
to banks and insurance companies and anyone else curious about our lives and the state of
our health. This is not like other government databases that can be controlled to a much
greater extent as one assumes it is only government employees themselves that can get
access to such records as tax and auto registrations, but even these records have been
compromised as we all know. As the number of users of a system increases the security
issues just become unmanageable.
It is commonplace for nurses and doctors to access medical files in a hospital and medical
centres such as CLSC's. Many records are already compromised by private investigators
who work for insurance companies, credit bureaus and banks and who are not above
using payments to obtain records through these channels. A super database would be a
feasting ground for those that wish to intrude even further into the lives of Canadians. Of
all records on Canadian citizens, their private medical records are the most private of all.
There are many who do not wish medical or psychological problems and diagnoses
disclosed to any but their own doctor and perhaps a very limited circle of specialists.
It is an intrusion of the first order into private lives and if the government has no right in
our bedrooms they certainly have no right in our medical records. The justifications being
proposed such as better tracking of the health care system and controlling costs speak to
the exact opposite of what is needed to get our health care system operating properly and
efficiently. We need less bigness and a whole lot more of smallness.
While it is true many medical records are kept in file cabinets and much of this
information could be stored in electronic databases which I wholeheartedly support, these
records should be stored in local networks not accessible to the outside. If indeed I wish
my medical records transferred to a doctor elsewhere, I could order the file transferred
So if the government wishes to get involved in this whole area, it can get involved by
writing and issuing a protocol for the storage of medical files electronically. That should
take all of a month and perhaps a team of six consultants and perhaps half a million dollars. But it shouldn't be allowed to
proceed to spend hundreds of millions and build a dedicated network to link databases in
a fashion that compromises our personal information.
We don't need superhospitals either. We need smaller, better managed institutions with a
whole lot less administration and a whole lot more efficiency. This starts with the exact
opposite management approach than is present in the conventional wisdom. Bigger
government does nothing better except to create more bureaucracy and ineffciency and
this is what has plagued and brought down our present medical system. We need to step
back and ask how we can deliver the best health care to Canadians with the least cost and
it starts with a fresh approach...a degree of privatization and competition because this is the only
approach that encourages excellence.
This doesn't mean an abandonment of universal health care. What is does mean is
creating a functioning system that allows consumers to make a choice using a form of
voucher that will reward those that deliver superior and efficient services and penalize
those that operate in a shoddy inefficient fashion.
Canadians must demand changes in the approach to the delivery of all public services.
For too long we have accepted the conventional wisdom that huge bureaucracies can
deliver the goods in health care and education and it just isn't working. Big isn't better
and huge medical databases or huge "super hospitals" do not mean more efficiency. Just
the opposite and we would be well advised as taxpayers and voters to demand better
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