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Health Freedom Watch
August 2005


Federal Government Proposes Linking Nursing-Home Payments to Vaccinations
Submit Public Comments by August 30!

The August 15 Federal Register announced the federal government's proposed regulation to withhold Medicare payments from long-term care facilities that do not provide (offer and recommend) flu and pneumonia vaccines to nursing-home residents.

According to the U.S. Department of Health and Human Services (HHS), approximately 2 million people reside in nursing homes (long-term care facilities). An estimated 74 percent are vaccinated against flu. HHS's goal is 90 percent.

The proposed rule, however, states, "The resident or the resident's legal representative must be provided the opportunity to refuse immunization. If the resident or the resident's legal representative refuses immunization, the facility must ensure the resident or the resident's legal representative receives appropriate education and consultation regarding the benefits of influenza immunization." (Emphasis added.)

HHS continues, "[W]e believe it vital that facilities secure the consent of their residents or legal representative for vaccination and provide their residents with vaccinations." However, a clear, concise right respecting written informed consent is not delineated in the proposed rule. HHS should clarify its support for written informed consent. No senior (or other citizen) should be coercively vaccinated or treated. Seniors should be informed of their right to refuse vaccination, and the written consent form should specify not only the purported benefits, but also the risks of any treatment.

Coercion conflicts with freedom, whether it's direct or indirect (the latter including not being fully informed about one's right to refuse vaccination). Consent is a precious ethic that must always be upheld in the United States and worldwide.

Concerned citizens should submit their public comments to HHS by 5 p.m. Tuesday, August 30, 2005. Submit comments:

Electronically: (attachments should be in Microsoft Word, WordPerfect, or Excel; Microsoft Word is preferred)

Regular mail: Send one original and two copies to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-3198-P, P.O. Box 8010, Baltimore, MD 21244-8010. HHS says to allow sufficient time for mailed comments to be received before the close of the comment period.

Express or overnight mail: Send one original and two copies to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-3198-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

For further information contact: Anita Panicker (410) 786-5646, Jeannie Miller (410) 786-3164 or Rachael Weinstein (410) 786-6775.


HHS Press release, "CMS Proposal Would Require Nursing Homes to Vaccinate Residents Against the Flu," August 11, 2005: (

"Medicare and Medicaid Programs; Condition of Participation: Immunization Standard for Long Term Care Facilities," Federal Register, August 15, 2005 (Volume 70, Number 156), pages 47759-47771: (

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Growth in Federal Health Programs Results in Massive Collection of Personal Information

Even though public-opinion polls show that Americans care deeply about medical privacy and strongly support the requirement of informed consent before personal health information is shared, federal officials are moving forward on the National Health Information Network of Electronic Medical Records (EMRs) without true health-privacy rights in place. (Health privacy is defined as the freedom to maintain a confidential relationship.) The Institute for Health Freedom (IHF) has reported for some time on the federal government's plan. 


To understand how such health-policy reform is occurring without the consent of the governed, one need only look at the enormous growth in government to see how it is leading to less and less privacy.  The following excerpts are from the Centers for Medicare & Medicaid Services' (CMS) recent Request for Information from the health-care industry regarding electronic medical records. They provide valuable facts for understanding the essentially monopolistic power of Medicare.    


       "CMS is the largest purchaser of health care in the United States, and as such has a significant interest in the health and well being of its Medicare beneficiaries"  (emphasis added).


       "CMS has one of the largest stores of health data in the country, with robust claims history for all of its Medicare beneficiaries" (emphasis added).


       "CMS collects a wide variety of data on our Medicare beneficiaries.  For example, 100% of Medicare fee-for-service claims information is collected and stored" (emphasis added). 


       "CMS will also be collecting 100% of claims paid for drugs under the new Medicare Part D benefit" (emphasis added).


       "With the addition of the prescription drug benefit in 2006, CMS will have claims information on virtually all types of services that Medicare beneficiaries receive" (emphasis added).


       "CMS maintains clinical and functional assessment data for patients in nursing homes and inpatient rehabilitation facilities, as well as for those served by home health agencies." 


The bottom line is that if the federal government (the largest payer of health care in the United States!) is paying doctor and hospital bills, it is going to want to review, study, and analyze health-insurance claims. 


Perhaps it is time to reform our nation's health-care system so that citizens receive cash directly from insurers (private insurers, Medicare, etc.) and pay their own bills (rather than having payments sent to providers).  The United States relied on such a system for many years until Medicare was created in 1965, and life expectancy improved significantly under free-market health care.


The statistics above show clearly that if Americans cherish their longstanding rights to govern themselves and maintain privacy, they are going to have to limit the role of government in their lives.  It's time to consider empowering citizens with the responsibility to pay their own health-care bills, choose their own medical treatments, and maintain confidential relationships with the providers of their choice.




CMS's Request for Information on Centers for Medicare & Medicaid Services' Role in Personal Health Records:

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2005 Institute for Health Freedom.