By: Dr. Mark Kestner - Columnist
If you have not been asked by your primary care doctor about whether you keep guns in your home, you soon will be.
The question is usually asked as "Do you keep loaded firearms in your home?" The answer will be recorded in your health record at your doctor's office. As part of the Electronic Health Records (EHR) initiative led by the federal government your response may also be collected by the federal government.
The federal law that launched Obamacare, otherwise known as the Affordable Care Act, includes the question as part of its provisions. However, you are not compelled by law to respond to the question.
There are many that will debate whether it is your doctor's business whether or not you own, use, or have access to guns. Still more will debate whether this information should be readily available to the federal government through your health records.
Other questions that are new include subjects such as domestic abuse. You will likely be asked a question like "Do you have reason to be afraid that your spouse may physically harm you?"
While it may appear that your doctor has suddenly taken a special interest in many more aspects of your life than they did previously, the truth is that the federal government is mandating that your doctor retrieve the information from their patients.
Doctors have been required to shift to electronic health records that are formatted in a certain way to make the information universally accessible. In addition, they are being required to ask personal questions such as those above. Your response is formatted in a way that makes it available to government entities.
The federal Medicare program is structured in such a way that physicians had little choice but to comply with the program. On the one hand, if physicians complied with the program fully by last year they were rewarded with a financial incentive of several thousand dollars. However, if they delayed or failed to agree to provide the data they will be penalized by a certain percentage of Medicare payments going forward.
For example, physicians that have not complied yet not only were not given a reward but also received notice recently that their reimbursement from Medicare will be cut 1 ½ percent. If they don't comply this year their reimbursement will be cut again. Medicare reimbursement is already quite restricted and often doesn't cover the actual costs for the services covered.
In essence, the feds are using their control of Medicare reimbursement to manipulate how your physician handles your personal health information.
As part of that process, the doctors are required to seek the answers to a certain number of personal questions from all their patients, including asking about gun ownership.
Some people see this as a responsible effort on the part of the federal government to reduce the number of accidental and intentional tragedies that involve guns.
Others see it as an overreach into the privacy of patients in an attempt to find a way to work around rights afforded by the 2nd amendment.
Either way, having physicians become involved with the topic of gun ownership and use is a touchy subject.
In some states such as neighboring North Carolina, persons seeking a concealed carry permit must obtain certification from a physician that they are sufficiently healthy mentally and physically to safely keep, carry and operate a handgun.
In spite of this, a recent national survey of physicians found that two thirds of doctors agreed that they are not adequately equipped by their training to determine how well a person is qualified to obtain a permit allowing concealed carry.
Other physicians point out that complying with that type of assessment violates the patients' right to privacy. States that require such medical background reports appear to be requiring the applicant to waive their rights to privacy of their medical records to secure their right to bear arms.
Recently in Florida a new law was enacted that forbids a doctor from talking to their patients about guns. This new state law appears to be in response to the questions that are the topic of this article.
The question remains of whether this is good public health policy or federal intrusion into your personal privacy under the guise of public health.