If I do not use the universal healthcare system in my province, my personal medical data is not disclosed to the public health insurance system. There actually are various ways of doing this. Health care can generally be purchased privately here; it simply cannot be insured privately.Obviously if you take actions to hide your health care from your government, such as opting out of the government health care system by purchasing private health care, your government cannot keep track of your health information.
I suspect that most people in Canada, however, get public health care and, consequently, the government has records of their health issues.
http://www.thirdworldtraveler.com/Health/PrivateCare_Canada.html"At the 1995 CMA meeting, one speaker noted that "the majority of people could not afford private care, and they are the vast majority requiring the most care." Members of the Prime Minister's National Forum on Health concur with that view."As I explained, what is disclosed to the health insurance plan is a billing code. If I consult my doctor for 15 minutes, the insurance plan has no idea what I consulted about. If I get a mammogram, the plan knows that the service provided by the x-ray lab was a mammogram. If I see an ENT about an ear infection, the plan may know what service the ENT provided (I assume that when I had my ear vaccuumed, ew, there was a special code for that), or may not.I don't know precisely how the
Canadian insurance system works, but my wife has worked in medical insurance billing here in the US and I assure you there are codes for everything. I've got a copy of the "2006 Professional ICD-9-CM" text here in my hands and I won't bother typing examples, but trust me, there's a code in here for everything including "Carter's little pills" and I'm not joking. It's probably true that the insurance company has no idea what you talked about with the doctor during a consultation, which will simply be billed as "consultation", but you can be certain that there is enough billable information in code to paint a pretty good picture of your health care issues.
The bottom line is, you have a government agency that has your health information, and it's probably extraordinarily detailed if it's anything like American insurance companies.
In my case, it is the agency that pays for the service I choose to obtain for my healthcare purposes, and the agency is told only the billing code for that service, which may or may not identify the specific service provided.I'm about 99% positive that the billing codes for your services fairly accurately reflect the services rendered, which paint a pretty good picture of your health issues. Undoubtedly, your insurance agency contains far, far more health information than our NICS system contains, which is basically two things: 1) have you ever been adjudicated mentally incompetent and 2) have you ever been involuntarily committed to a mental institution.
Compare and contrast:
In your case, it is an agency that is totally unrelated to anything having to do with the health or healthcare of the individuals in question, and the information is disclosed without the consent of the patient.Like I said, it's basically the same situation. If you use government health care in Canada, as I expect most people have no choice but to do, you have a government agency that has your health information, whether you consent or not, and so do we. The only difference is your firearm-approval people can't access the information to see if there are disqualifying medical reasons for owning a firearm. The fact that our agency doesn't have anything to do with health care doesn't materially matter. It's still a government agency maintaining a government health care database about its citizens.
I use the provincial health insurance plan to pay for healthcare that I voluntarily seek out, and so the health insurance plan is informed of the general nature of the services it is paying for, with my knowledge and very obvious implied consent. By presenting my OHIP card to the provider, I plainly consent to the provider submitting a billing code to the insurer, and disclosing whatever info is necessary in order to obtain payment for the service. The insurance plan does *not* have access to individuals' medical records unless an audit of the physician is undertaken, for example, and there are stringent procedures for that.I'm quite certain that your insurance agency has more detailed medical information about you than our NICS system ever will.
Also, most people don't voluntarily seek out health care. Under your system, if you want health care, unless you are rich enough to afford private health care you really don't have any choice but to consent to the billing information being sent to the insurer - your government.
So again - you have a government agency that holds health care data about your citizens with some level of granularity, while we have a government agency that also holds health care data with a lower level of granularity (probably much, much lower).
Specifically, our agency only contains data about people who have been adjudicated mentaly defective or involuntarily committed to a mental institution or found incompetent to handle own affairs.
It is highly likely that your government agency contains far more health care information about citizens than ours does.
Compare and contrast:
An individual is involuntarily committed for medical care, and that information is reported to an agency with which s/he has no dealings, which is totally unrelated to his/her health care, and to which s/he has never consented to having his/her medical info disclosed.
And you are still claiming to think these are not apples and oranges.Again, most medical care is involuntary. The fact that you have dealings or not with the agency doesn't materially affect the situation. Your data is still being sent to a government agency without your consent. The fact that the agency isn't related to your health care also doesn't materially affect the situation. You still have a government agency with your health care information.
And at the end of the day, that's all that really matters here. You've got a government agency maintaining a database of the citizens' health care information. Now the only question is do you allow the people who are in charge of screening people for firearm ownership access to the data or not. In Canada, the answer is no. In the USA, the answer is yes.
I don't know of any such "medical database". As I said, in the near future it will be possible for physicians to consult a patient's medical history electronically (both here and in the US). There will be a database accessible BY HEALTH CARE PROFESSIONALS who require access in order to treat a patient.I think we've pretty well established that your national insurance agency has a pretty good medical database of the citizens who can't afford or otherwise don't use private health care, which is probably nearly everyone. While the billing codes may be somewhat ambiguous for some things, I'd be willing to bet money that those codes reveal far, far more information about your health than is sent to our NICS system.
In any case it's great that there will be an electronically accessible database for health care professionals to use.
It would be silly not to use such a database to screen out people who should not own firearms. Don't you want to keep crazy people from owning firearms? Why rely on interviews which might only hint at mental problems if you're lucky when you can have the real data?
If it were a condition of applying for a firearms licence that I authorize disclosure of medical info -- say, by obtaining a report from a physician that s/he has consulted my medical history file and found no disqualifying events -- then no information would be "made public". It would be provided to the licence-issuing agency AT MY REQUEST, by the physician, and with my consent, for a purpose that I myself decided.
Oh, and - the report would state only that there were no disqualifying events (or that there were disqualifying events, I suppose, if I authorized the physician to submit such a report, which I likely wouldn't, if I were such a person -- in which case I wouldn't get a firearms licence because my application would be incomplete).So basically, you don't have any problem with a government health care database being interrogated and the results made known on your behalf when you go to buy a firearm.
Sounds just like our NICS system, just with a different agency maintaining the database.
I am very certain that, here at least, no arrangement would ever be made to permit the licence-issuing authority to have direct access to anyone's medical records. The access would come through a physician's report, just as in the case of physicals required by employers and schools, workers' compensation boards, disability insurers, etc.That's fine, and I'll point out that our NICS system doesn't have direct access to anyone's medical records, either. In any case, it fundamentally makes no difference who the gatekeeper is. Effectively, you've got a government database of health care information, and it will be interrogated, with your consent, when you attempt to buy a firearm.
If you want NICS to go through a physician to access the data, that's fine, I'm sure they can be put on the staff, though doctors make expensive secretaries.
It's not at all a bad idea, and the advent of electronic medical records will make it possible. No one could doctor-shop and avoid having his/her medical history discovered. Maybe I'll suggest it to my political party ... that the firearms officer must be provided with a physician's certificate saying that the individual has no history of x, y or z. Good idea.Like I said, I guess in the grand scheme of government expenditures it's no big deal if NICS hires physicians to go access applicants' medical database histories, but it's nothing a minimum wage secretary, or hell even a computer couldn't do. I mean if the proper flags are set in your medical history database, no person is required to make an analysis at all.
And I will point out, if I haven't already, that your ongoing pretense here -- that the disclosure I am talking about occurs at the point of the NICS check -- has grown old, tired, boring and beyond the point where I will believe that you actually do not grasp the real issue.Well originally you seemed upset that there was a public disclosure of your medical and criminal history when you attempted to buy a firearm. Obviously the guy you are trying to buy the gun from is going to find out you have a mental or criminal disqualification. So I'm glad we agree that I have put that objection to bed. There will be no public disclosure of any information that an applicant is not already aware of, and if they don't want it publicly disclosed they simply need not attempt to obtain a firearm.
The situation, if rights were being respected, would be that no one's medical history would be disclosed to the NICS database if s/he never attempted to purchase a firearm.As I have said, it seems to me our NICS database contains far less information about people that your national insurance agency possesses. Both agencies acquire your medical history without your consent, except for the few people who can afford private health care and thus stay off the government's radar.
Now if you want to have a
different government agency be in charge of the health care database, and have NICS go through physicians to interrogate and filter the results, that's fine by me, though it is a completely unnecessary expense. If the health care database is properly constructed there need only be a a few relevant fields such as "Adjudicated mentally incompetent (Y/N)?" and "Involuntarily committed to mental institution (Y/N)?" and NICS, or whatever authorizing agency would only be authorized to query those few fields of your health records to render a decision about your fitness to own a firearm. No physician, or even a person, is needed to do that.