Re: Section 112 Account - response to reponse

[James Love <love@tap.org>]

On Wed, 8 Nov 1995, Deirdre Mulligan wrote:
> JAMIE'S Q:  My doctor has my records, and they give them to 
> >my insurance company.  
> 
> RESPONSE:  only if you have authorized this disclosure.  Maybe you want to
> pay out of pocket and then you wouldn't have to authorize any information
> to flow to your insurance company because it would Not be needed for
> payment.

    I guess if I received a rather large raise this would be an option 
for me.  Right now, this is a meaningless option, because of my income.


   [snip, snip, snip...]

> JAMIE'S Q:  hundreds of health care trustees may have had access to my
> medical records.  Do I have to ask each one for my sec.112 info?  If I
> don't know who to ask, do I have to ask everyone? 
> 
> RESPONSE:  You have a relationship with your doctor and your insurance
> company -- they should have records of every disclosure you have authorized
> and every agent with whom they have contracted to complete activities for
> which you authorized them to use information.  The object of the record
> keeping and access rights provisions of the bill is so that the individual
> can oversee the use of their information by making sure it is only flowing
> when they have authorized the flow.  

   Except for those 2 million government employees and researchers who 
will have access without consent.

> The bill creates a paper trail.  

     paper trail?  Will these records be on paper?


> The
> way the bill is written you can go to anyone who has handled your
> information and get access to your record and record of disclosures.  But,
> practically if you start from your provider you should be able to trace the
> information's path.  Especially if you have only authorized the use of your
> information for treatment and payment purposes.  

    So, if a health researcher, health oversight agency, or public health 
person gets my record from a third party, without my consent and with 
giving me any notice, than I have to decide to search out all the 
trustees who may have done this, from the Sec. 112 "paper trail".


   Has it occurred to you that this makes it pretty hard to find out 
what's going on?  Why don't those records show up in my doctor's office, 
so I have a better way of finding out?  Does this massive computer 
technology only make it possible to put me under surviellance, or could 
it (should it) be used to put the investigators under surveillance?


   In discovery in a legal proceeding, one way to hide information is to 
dump records on oponent, and hope that amide all the stuff, they will 
never find what they are looking for.  I beleive the Sec. 112 accounting 
will be a poor substitute for notice.  Why not just have notice.  Why do 
we have to spend weeks or even years to track down all our trusteess to 
find this stuff?  


  [snip, snip, snip ....]

> JAMIE'S Q:  Won't this be very difficult if not impossible to track?
> 
> RESPONSE:  Most people today have no ability to track, let alone CONTROL,
> how their sensitive information is used and disclosed.  The Bennett-Leahy
> bill puts control over information flow back into individual's hands by
> requiring consent for the information to flow with a limited number of
> exceptions (which we have discussed, and agree that we would like to see a
> number of them tightened).  It facilitates tracking so individuals and
> others responsible for enforcing the bill can ensure compliance and
> identify abuses, by requiring that those who handle information maintain a
> record of how the information flows.  Right now no one is under a legal
> obligation to keep track of where your health information is sent and you
> have very little actual or legal control.  

    
   I guess by your standards of anything is better than nothing this 
representings a huge improvement.  It seems to be that it is pretty 
inadquate.

> Deirdre
> 
> ****  Please note:  I request that all recipients obtain my prior 
> ****  consent before electronically forwarding or otherwise disseminating
> ****  this message.  Thank you for protecting my privacy.


   Deirdre, your note was posted to an open internet discussion list, 
which was created for a public debate about S. 1360.  If you don't want 
messages sent to this list made public, don't send them here.
jamie


----------------------------------------------------------------------
James Love, love@tap.org
P.O. Box 19367, Washington, DC 20036; v. 202/387-8030; f. 202/234-5176
Consumer Project on Technology; http://www.essential.org/cpt/cpt.html
Taxpayer Assets Project; http://www.essential.org/tap/tap.html