More Reasons to Oppose PDMP

Dear Colleague:

Last week, I wrote you a long email to explain my opposition to a dragnet government database tracking the medical information of innocent Missourians. Dragnets are un-American and contrary to the principles of a free society.

After a week in which many of you apparently privately voiced your own opposition, I was surprised to read two newspaper articles attributing your opposition to “fear,” “confusion,” or “misinformation.”

I write today to add a few more points.

Privacy is a Fundamental Human Right, Not a Red Herring

Proponents have called privacy concerns a “red herring.” We know better. A right that the Supreme Court has called the “right most valued by civilized men” should never be called a red herring. Is the First Amendment a red herring? The Second? The Third? The Fourth? The Fifth? If you value limited government, you must be a no on this bill.

There’s a Difference Between Welfare and Private Health Care

I also read that proponents claim this is no different than other databases. For example, proponents told the Post-Dispatch that “more invasive” medical records of Missourians are already stored by Medicaid for welfare recipients and that it is “no different than our electronic medical records.” These statements misinform in two ways.

First, what is “more invasive” is in the eye of the beholder. For many, chronic pain and the prescriptions taken to help them function are more private than other health information.

Second, we’re comparing apples and oranges. A Missourian who signs up for welfare should not get a blank check from taxpayers. Their care should be coordinated to help save taxpayer money. It’s part of the bargain a person makes when they sign up for welfare.

By contrast, Missourians who aren’t on welfare don’t have their health care records in any government database. Proponents also make the big government argument that there’s no difference between your health information being stored by your medical providers / health insurance companies versus it being stored by the government. Just ponder the implications of that argument for a minute. If you share something with a private company or person, it’s the same as sharing it with the government? As powerful as they are, your health insurer is not the government.

Your Constituents Oppose PDMP

Proponents also implicitly argue that most Missourians would be just fine with sharing this medical information with the government. Recent polling indicates the obvious. In November 2014, Pew polled Americans on Internet privacy and found that 81 percent of Americans viewed the “state of [their] health and the medications [they] take” as “very sensitive” or “somewhat sensitive” information. More respondents found this information sensitive than the content of their phone or email messages and every other category of information other than Social Security number.

PDMPs Do Not Work

Despite anecdotal evidence offered by proponents, the most comprehensive comparative study of state PDMPs concluded that they do not make a difference in drug overdose deaths. In “Prescription Drug Monitoring and Drug Overdose Mortality,” a study published in Injury Epidemiology, the authors analyzed the relationship between drug overdose deaths and the implementation of state PDMPs.  “Overall,” the authors find, “implementation of PDMPs was associated with an 11 percent increase in drug overdose mortality.” They concluded, “Implementation of PDMPs did not reduce drug overdose mortality in most states[.]” To be fair, the authors are PDMP proponents, and their proposed solution to a program they found was not working was to increase monitoring, not abandon it. In addition, their data tracked until the year 2008.  

Conclusion: Vote Your Conscience, Vote Your District, Vote Your Principles

As you continue to consider how you will vote, I ask that you keep all of these things in mind. As with any issue, you must look to your conscience, your principles, and your district in making your decision.  Take a look at the facts. Examine them closely and think about their long-term implications. Then take a stand and do so without flinching. When you do that, regardless of how you vote, you deserve respect.


Rep. Jay Barnes