by Andrew Walden

As part of their effort to place the nation's health care system under Federal control, the Obama administration has released to ProPublica a nationwide database of MDs and the drugs they prescribe.  This follows releases of information about the comparative costs of medical procedures and the safety of hospitals. 

ProPublica has arranged the data into a searchable database correlating each state's individual MDs and the pharmaceuticals they prescribe.

Selectively released information can be a dangerous thing.  For instance, many of the Hawaii doctors prescribing large amounts of narcotic painkillers are surgeons.  They would have a completely legitimate need to deal with post-operative pain.  Will these MDs be intimidated into prescribing fewer pharmaceuticals for their patients?  If so, the Obamacare system will save millions of dollars by denying needed medical care. 

This new-media, information age repressive technique illustrates the danger of making the government your insurer and making private insurers an ex-officio arm of government.  It is a classic top-bottom combination against the middle.  

Here it is from ProPublica: Hawaii MD/Prescription Database

ProPublica: The Prescribers--Inside the Government's Drug Data

Medicare Drug Program Fails to Monitor Prescribers, Putting Seniors and Disabled at Risk

by Tracy Weber, Charles Ornstein and Jennifer LaFleur, ProPublica, May 11, 2013

Ten years ago, a sharply divided Congress [1] decided to pour billions of dollars into subsidizing the purchase of drugs by elderly and disabled Americans.

The initiative, the biggest expansion of Medicare since its creation in 1965, proved wildly popular. It now serves more than 35 million people, delivering critical medicines to patients who might otherwise be unable to afford them. Its price tag is far lower than expected.

But an investigation by ProPublica has found the program, in its drive to get drugs into patients' hands, has failed to properly monitor safety. An analysis of four years of Medicare prescription records shows that some doctors and other health professionals across the country prescribe large quantities of drugs that are potentially harmful, disorienting or addictive. Federal officials have done little to detect or deter these hazardous prescribing patterns.

Searches through hundreds of millions of records turned up physicians such as the Miami psychiatrist who has given hundreds of elderly dementia patients the same antipsychotic, despite the government's most serious "black box" warning that it increases the risk of death. He believes he has no other options.

Some doctors are using drugs in unapproved ways that may be unsafe or ineffective, records showed. An Oklahoma psychiatrist regularly prescribes the Alzheimer's drug Namenda for autism patients as young as 12; he says he thinks it calms them. Autism experts said there is scant scientific support for this practice.

The data analysis showed widespread prescribing of drugs such as carisoprodol, which was pulled from the European market [2] in 2007. In 2010 alone, health-care professionals wrote more than 500,000 prescriptions for the drug to patients 65 and older. The muscle relaxant, also known as Soma, is on the American Geriatrics Society's list of drugs [3] seniors should avoid.

The data, obtained under the Freedom of Information Act, makes public for the first time the prescribing practices and identities of doctors and other health-care providers. The information does not include patient names or the reasons why doctors prescribed particular drugs, so reporters interviewed the physicians to learn their rationales.

Medicare has access to reams of data about its patients, their diagnoses and the medical services they received. It could analyze all of this information to determine whether patients are being prescribed appropriate drugs for their conditions.

But officials at the Centers for Medicare and Medicaid Services say the job of monitoring prescribing falls to the private health plans that administer the program, not the government....

read ... Medicare Drug Program Fails

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New effort by state could cause patients more pain

Star-Advertiser May 11, 2013: The state Hawaii Department of Health recently announced that it will begin to link deaths from prescription drugs to the physicians who prescribed them ("Doctors targeted amid rise in painkiller deaths," Star-Advertiser, May 5)

Legislation has just been passed, sponsored by Gov. Neil Abercrombie through his RICO team and state Sen. Josh Green, empowering the Hawaii Medical Board to suspend the licenses of outlier prescribers of narcotics in an expedited fashion, targeting the worst offenders, also known as pill mills.

The problem is that the majority of medical doctors are already extremely hesitant to prescribe pain medications for fear of legal repercussions. I had an opportunity this week to speak with Dr. Linda Rosen, chief of DOH's Emergency Medical Services and Injury Prevention Branch, who is heading up this intervention. She is now working closely with the medical examiner to obtain a list of patients in Hawaii who died of opiate overdoses and, with the help of the state narcotics division, will link up these cases with the doctors who wrote the prescriptions. Dr. Rosen and I discussed our mutual concerns that this effort could have unintended consequences. With increased surveillance and scrutiny by law enforcement, more physicians might opt out of prescribing opiate medications for pain management.

read ... New effort by state could cause patients more pain

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Cost Transparency Leads to Cost controls

Star-Advertiser Editorial May 11, 2013: Not all the differentials are egregious among the Hawaii hospitals, but to pull up just one example, the official charge for treating a gastrointestinal hemorrhage ran from about $13,000 to nearly $29,000, according to figures the Star-Advertiser published on Thursday.

Industry leaders protest that the charge variation reflects a true differential in the risk pool of each patient population: The ones treating people who are older and sicker have more expenses to cover through their charges.

read ... Medical costs must be known to control them