Obamacare Is Not a Secret Sex Directory

Confidentiality remains protected by law. Doctors will not become covert government agents. But the Affordable Care Act may get more physicians talking with patients about preventing sexually transmitted infections.
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"'Are you sexually active? If so, with one partner, multiple partners, or  [sic] same-sex partners?' Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law."

So begins a screed in the New York Post, which also ran on FoxNews.com, earlier this week. This and more shocking things about Obamacare are brought to us by Betsy McCaughey—the one-time inventor of the "death panels" rumor.

I know, a person with an extreme agenda says an absurd thing, what's new. This sort of thing matters right now, though, because still only around a quarter of Americans say they understand the Affordable Care Act well, and it remains a point of contention. People want and need clear information for productive discussion. It is important to sift through some of the more volatile nonsense.

I also see it as an engaging way to learn something about the health law. McCaughey seems to be drawing an egregious conclusion from a clause that's worth being aware of.

So, McCaughey holds a Ph.D. from Columbia University and is a constitutional historian and self-described "patient advocate." She was lieutenant governor of New York from 1995 to 1998. She is the author of a book called Beating ObamaCare. Jon Stewart has called her dangerous, and James Fallows once gave her an award for "Most Destructive Effect On Public Discourse By A Single Person" with regard to Clinton-era health reform. This is one of those figurative, joke awards, though.

In this week's article, McCaughey tells us that Obamacare is not a plan to make healthcare more accessible to every American; the real “aim [is] to turn doctors into government agents.” How? By “pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.”

This stuff is not true, though, fortunately. Doctors are trained to take a sexual history, as part of a thorough evaluation, even when you're just complaining of foot pain. Few disease processes happen in isolation in the body. It's all part of the strange, late-stage Jenga tower that is human health, but when a doctor asks if you're sexually active, take it as a sign that you're being thoroughly cared for.

Obamacare does say that insurance must now pay physicians for preventive services, including things like STI counseling. This is meant to help patients not contract sexually-transmitted diseases, and save the whole system money down the line. It's cheaper and easier for everyone to just not get gonorrhea than to end up with a baby blinded by gonorrhea, or to require antibiotics and contribute to the advent of super gonorrhea.

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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