Proposal to privatize health IT advisory body spurs debate

Labor and consumer advocacy groups say proposed spin-off would lack accountability and transparency.

A debate is stirring over a proposal by the Health and Human Services Department to privatize the government's existing advisory body on health information technology.

The American Health Information Community, chartered in 2005, currently counsels HHS on hastening the adoption of health IT. Now HHS is forming a successor entity, as required under the charter. The agency's proposition calls for an independent and sustainable public-private partnership.

HHS is accepting public comments through Sept. 10.

Several labor and consumer advocacy groups and the seniors' group AARP have submitted comments opposing privatization over concerns that the proposed spin-off would lack accountability and transparency.

"While we believe AHIC needs the active and committed participation of private-sector health industry representatives, the federal government needs to retain an active role in governance and oversight to ensure that priorities and policy recommendations reflect the national interest," stated a letter sent by the AFL-CIO, Consumers Union, the National Consumers League, National Partnership for Women and Families, and Service Employees International Union.

Sen. Sheldon Whitehouse, D-R.I., proposed legislation in May that would establish a private, nonprofit corporation to develop a secure health IT system. The entity would operate similar to organizations like the financial provider Fannie Mae.

Whitehouse said in a statement on Tuesday that he supports HHS' notion that advancing national health IT requires a body that can draw on private-sector resources and expertise. But he added that the organization must be subject to public oversight, incorporate consumer input, prioritize privacy and security, and have a stable revenue source.

Whitehouse's bill, a somewhat different approach, would address all four issues. "I hope [HHS] will widen its thinking on the privatization of AHIC to include alternate policy solutions like the one I've proposed, and to ensure that Congress and the public have a substantive role in this process," he said.

But AARP disagrees, positing that AHIC's current structure should be maintained and strengthened to address privacy and security in a clear and public process.

Deven McGraw, the chief operating officer of the National Partnership for Women and Families, said she is unclear on the motivation for a private entity to concentrate on privacy and security. "The need to maintain business operations might trump public interest," she said.

If safeguards for security and privacy were in place, along with protections for consumer input, her organization would be more comfortable with a private entity, McGraw added.

Douglas Henley, executive vice president of the American Academy of Family Physicians and an AHIC member, said he wants to see a public-private partnership with a stable funding source and a direct tie to HHS, the HHS secretary and the Centers for Medicare and Medicaid Services. "It does need to be a public-private entity, not just a private entity," he said.

The analogy he uses is the National Quality Forum, a public-private nonprofit chartered to implement a strategy for healthcare quality measurement and reporting. The forum's members include consumers, public and private purchasers, employers, healthcare professionals, provider associations, insurers, accrediting bodies, labor unions and supporting organizations. Membership dues are its key source of funding.