October 7, 2011; Source: New York Times | You have to hand it to Senator Charles Grassley (R-IA). Whatever you think of his Republican politics, when it comes to standing up for ethics and transparency—not only in the nonprofit sector but in government also—Grassley is usually vocal and aggressive, issuing “love letters” calling for immediate action. Yes, we know, many nonprofits viewed the Senate Finance Committee hearings under Grassley in 2004 and 2005 as a witch-hunt, but they weren’t. This guy believes in taking aim at entities that conceal information he believes the public should know.
In this case, Public Citizen, the Association of Health Care Journalists, and a number of other nonprofits had complained that the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services had removed the National Practitioner Data Bank from its website. Small potatoes? The Data Bank is a public record for hospitals, medical boards, and insurers to share information about bad doctors. The idea was to make sure that bad doctors were identifiable to employers, and not able to escape one scandal and slip into jobs elsewhere. A Public Use File was created for use by researchers and journalists, but numbers replaced the doctors’ identities.
Despite the confidentiality of the names, intrepid journalists were able to figure out the identities of some of the doctors, and some of the doctors were less than happy. Reporters said that the Public Use File doesn’t help them identify doctors unless they already know who they are looking for based on other interviews, court records, and disciplinary decisions by state governments. Nonetheless, based on the doctors’ complaints, the HRSA threatened to sue a reporter for the Kansas City Star who had named a doctor, and the agency pulled the Public Use File off its website.
It’s not smart to remove government accountability information under Chuck Grassley’s nose. He wrote a scathing letter to the agency on October 7th, protesting the decision and supporting the nonprofits’ own letter to HHS Secretary Kathleen Sebelius in late September. “It seems disturbing and bizarre that H.R.S.A. would attempt to chill a reporter’s First Amendment activity with threats of fines for merely ‘republishing’ public information from one source and connecting it with public information from another,” Grassley wrote. Grassley’s complaint was supported not only by Public Citizen and the journalists groups but also by Robert E. Oshel, who actually devised the Public Use File in the mid-1990s and said that HHS had misinterpreted the law.
According to the Times, 23 academic researchers wrote another letter suggesting that the HRSA/HHS decision to pull the Public Use File “took a large step in the direction of the ‘bad old days’ when secrecy prevailed and providers’ interests took precedence over patients’ safety and well-being.” Grassley’s letter also got to the point of the importance of transparency and disclosure:
“A journalist’s shoe-leather reporting is no justification for…threats (of litigation) or for HRSA to shut down public access to information that Congress intended to be public. Shutting down public access to the data bank undermines the critical mission of identifying inefficiencies within our health care system—particularly at the expense of Medicare and Medicaid beneficiaries. More transparency serves the public interest. Generally speaking, except in cases of national security, the public’s business ought to be public. Providers receive billions of dollars in state and federal tax dollars to serve Medicare and Medicaid beneficiaries. Accountability requires tracking how the money is spent.”
We couldn’t have said it better ourselves.—Rick Cohen