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my last word

  I received a private note about Jamie's questions which I would like to quote:
   1.  Should a patient who goes to a shrink and uses insurance to
      pay for it have the right to prevent medical researchers, public
      health officials, and others from getting access to his records? 
  (My answer:  no.  These people (medical researchers and public health
  officials) do not care about the identity of the patients, b) are under
  severe civil and criminal penalties if they disclosed anything, and c) very
  possibly have _some_ integrity that would prevent them from disclosing
  anything anyway.  What do you 
  mean by "others"?)
      2.  Should patients have the right to keep information from
      genetic testing from insurance companies?
  (My answer:  when you took the Queen's shilling, you forfeited your 
  right to privacy.  If you want someone else to pay for your care, you 
  no longer have the right to keep the knowledge from them.)
  My addendum to these last set of notes is that it is extremely easy for
  those who know nothing (and have demonstrated such) about the providing of
  health care or the management of data to  pontificate about the realtive
  importance of security and confidentiality. The health care professions have
  been attempting to provide care and maintain confidentiality in pace with
  technology since doctors began writing prescriptions in Latin.  
  I would be interested to see any of these letter writers actually try do
  something about any of these problems beyond suggest rules for others to
  attempt to enforce.
  I would be interested to see someone, say Jamie Love, describe and
  demonstrate the "perfect" solution. 
  How sad that this is the best there is - dilettantes waving their hands and
  proclaiming that their own private, noble set of values triumphs over the
  reality of the tough, evil world - full of lurking companies interested in
  breaking computer codes to find out you temperature. 
  Get a grip, people. Get a Life.
  Lewis Lorton, Executive Director
  Healthcare Open Systems and Trials