Today marks the first day for three months that you can choose to opt out of a My Health Record. In this post, having just done so myself, I hope to convince you to do so as well.

My expertise in in public health, and so I am perfectly qualified to explain both sides of this in a fair and balanced way.

The first thing you should know is why the Federal Government pushed ahead with this plan. The reason is simple – cost. This is a huge cost-saving measure, it is estimated (conservatively) to save at least $30,000,000 per year. But think about that for just a second – that’s only $1.20 per citizen per year… is it really worth the privacy and security risk to save just $1.20 per year? If I had to pay $5 per year to opt out I would be happy to do so – in fact I can envision myself paying even more than that if asked to; to me the value of my privacy and security is well beyond $1.20 – and I’m not even an at-risk healthcare customer!

What are the risks/negatives?

Well let’s start with domestic violence. We know it’s extremely prevalent, and I personally have zero respect for offenders. Now I know that it can be complicated, and that offenders were often victimised themselves – but this is extremely serious criminal conduct we’re talking about. I don’t know how you get to the point that you can beat your spouse and/or children and sleep at night without having the goddamned common responsibility to hand yourself over to police. But this is the world we live in. People like this exist. Employed in every area of society – including in health services. The My Health Record will allow anyone with access to it to to instantly find out your latest healthcare activities – where you went to the doctor, where you went to the pharmacy to have your script filled. That information alone will, I confidently predict, lead to people who have escaped from domestic violence being traced and found by their abusers.

That’s far from the only problem. When you go to the chemist to have your script filled – the Pharmacist doesn’t need to know your full medical history, and any questions they have for you they can ask. That’s why Pharmacy is a profession. But with a My Health Record the pharmacist will now have your full medical history visible to them when you fill a script. If you’re filling a script for a course of antibiotics, does the Pharmacist really need to know that 20 years ago you had a surgical abortion? What kind of stigmas might people face when their sometimes uglier medical history is laid out in full?

The My Health Record only helps to improve the data sharing between surgeries. How often do you change doctors? How often do you visit a different hospital? The Record will not be of any benefit to your ordinary visits to the doctor, the only areas of improvement are to reduce human error and the time it takes to transfer records between surgeries. And also it will reduce duplication of services, since services rendered will be saved permanently in your record. For example if you have an x-ray it will be permanently stored, and in some situations that would mean you wouldn’t need to have another one 10 years later.

We do not have data security. Repeat after me: We do not have data security. And again: We do not have data security. Until recently, and I mean literally very recently, many doctors kept their patients records purely in a physical file never digitised to a computer. To transfer it to another doctor’s surgery would involve sending it by fax. The AMA President Dr. Tony Bartone literally called this “prehistoric”! Jesus Christ, there’s nothing “prehistoric” about that, records are more secure in physical form than they are on a digital database. If a digital database was shown to be provably secure he may have a point – but they aren’t. This is exactly the same reason that most locksmiths I know prefer the mechanical locks to digital ones – they are more provably secure. Any digital lock, as they have said to me, could easily have a built in back-door by the manufacturer that no one knows about. But I’m not saying the government is putting in a back-door, what I’m saying here is that the front door is not secure. The government is not even giving any guarantees that your My Health Record will be 100% secure – in fact they’ve already planned for failure by legislating huge fines for improper access!

Wow, that sounds pretty bad – what about the benefits?

As already mentioned the main benefit is to reduce the cost of healthcare administration. Here is the so-called “prehistoric” system:

So yeah there are multiple points of opportunity for human-error in there. There’s no doubt about that. But let’s remember theses are medical doctors that we’re talking about, that kind of human-error is already minimal. There is no denying that keeping Government-controlled centralised records is beneficial to stakeholders – it will be cheaper to taxpayers, and it will provide a nice easy honey-pot for law enforcement and intelligence agencies to gather information from. Here is the simplified process:

As mentioned above it will reduce duplication of services, and there is no doubt about that.

Finally, it will provide the most up-to date information to medical staff in emergency situations, and in some situations that will save lives. For example if you happen to have a life-threatening allergy to common medications like penicillin or morphine, or there are other emergency situations where immediate access to your medical record could be the difference between you living or dying. In this situation you should have a My Health Record as the benefits clearly outweigh the risks.

What should You do?

For most people I would strongly suggest opting out. Of course the choice is up to you and I hope you make an informed choice; but keep in mind this is an automatic opt-in system and you need to take action if you wish to opt-out.

I am not criticising the government on the opt-out nature of this system. Yes opt-out systems often leave a very sour taste in my mouth, but let’s face it it’s not their fault that every other Tom Dick and Harry fucked it up already. Also, I am not arguing that the Record is an attempt by the government to spy on you. That said, I do think they have been woefully inadequate in communicating this new system. It’s almost as if it’s gone by without anyone noticing. The cost-saving isn’t really that much, it’s actually pretty pathetic and appears to assume that doctors aren’t going to pay their own receptionists to transfer health records! I guess the assumption is made on the basis that the receptionist can be made redundant with enough technology (!) but seriously, creating such a clinical impersonal environment is only going to hurt the trust with healthcare clients.

How to opt-out

If you wish, you can opt-out here. To complete the process online you will need your Medicare card and (!) driver’s license. If you don’t have both of those you can call the number instead.