[Med-privacy] Phil Inquirer: Editorial | Medical Records Safe from prying eyes? March 21, 2005
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Wed, 30 Mar 2005 01:05:08 EST
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Philadelphia Inquirer
Posted on Mon, Mar. 21, 2005 =20
Editorial | Medical Records Safe from prying eyes?
How can any regulation be called a "privacy rule" when it permits sharing=20
Americans' most personal medical information with 800,000 or so health,=20
business and government entities?
Even a hospital gown offers more privacy, and this widespread access to=20
medical records should leave patients with a different sort of chill runnin=
g up=20
the spine. How can they be open about their medical needs if traditional=20
doctor-patient confidentiality has been eroded?=20
Medical privacy rules put in place in 2003 under HIPPA - the Health=20
Insurance Portability and Accountability Act of 1996 - can make it harder t=
o send=20
someone flowers in the hospital, or check on their condition, than limit ac=
cess=20
to patient records.=20
That's because the Bush administration rule change two years ago did an=20
about-face on a Clinton-era policy that had required patients' consent befo=
re=20
their medical data could be shared.=20
The subsequent court battle to restore those protections suffered a setback=
=20
last year. But in an appeal heard March 9 before three federal judges in=20
Philadelphia, the challenge may have reached a turning point in patients' f=
avor.=20
If their probing questions were any guide, the U.S. Court of Appeals for th=
e=20
Third Circuit judges brought a healthy skepticism to government claims that=
=20
Americans' medical records are safe from prying eyes.=20
Judges Marjorie O. Rendell, Theodore A. McKee and Richard L. Nygaard were=20
presented with a compelling case by patient groups, physicians and privacy=20
advocates that key HIPPA protections are an illusion.=20
In brief, the so-called privacy rule says that data can be shared without=20
patients' consent to carry out treatment, payment or - here's the catch-all=
-=20
"health care operations." It's designed to cut red tape, what a Justice=20
Department lawyer described as "a tough balancing between efficiency and pr=
ivacy."=20
Trouble is, the rule tips the balance against patients' reasonable=20
expectation that private information won't be shared too widely.=20
For instance, the "health care operations" wording would permit the use of=20
pharmacy mailing lists for certain direct marketing to consumers. Employers=
=20
and even prospective buyers of a managed-care insurer could gain access to=20
health data, too. Not much private about that.=20
While HIPPA lets patients examine their medical records, it grants them few=
=20
ways to track how their information is shared.=20
A Massachusetts congressman, Democratic Rep. Edward J. Markey, offers a=20
sound proposal (H.R. 1709) to restore patient consent in a way that would n=
ot=20
interfere with health-care providers doing their jobs.=20
Were the right to consent restored, that would force health-care providers,=
=20
insurers and others to reveal how medical information would be used in=20
exchange for getting patients' consent.=20
At a time when some employers are sniffing for tobacco on job candidates'=20
clothing, citizens need to be more concerned - and empowered - about who ge=
ts=20
to flip through their medical files. Medical data should be used to treat a=
nd=20
track illness, not screen applicants.=20
There's even more reason for concern about safeguarding health information,=
=20
given the recent lapses with computerized databases. Just ask the 145,000=20
citizens whose financial and personal data was leaked by databank ChoicePoi=
nt=20
Inc. to scam artists.=20
Either the Third Circuit or Congress can restore a better balance on patien=
t=20
privacy. The judges are in the best position to act quickly to do so.
=20
____________________________________
=A9 2005 Philadelphia Inquirer and wire service sources. All Rights Reserve=
d.
http://www.philly.com=20
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<TD vAlign=3Dtop bgColor=3D#ffffff rowSpan=3D2><STRONG><FONT size=3D4>Ph=
iladelphia=20
Inquirer</FONT></STRONG><BR>
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5></TD>
<TD>Posted on Mon, Mar. 21, 2005</TD>
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src=3D"http://www.philly.com/images/common/spacer.gif" width=3D1=
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<TD colSpan=3D2>
<DIV class=3Dbody-head><STRONG></STRONG><BR><SPAN=20
class=3Dheadline>Editorial | Medical Records Safe from prying=20
eyes?</SPAN><BR><B><SPAN class=3Ddeck></SPAN></B><BR><B><SPAN=20
class=3Dbyline></SPAN></B><BR>How can any regulation be called a=
=20
"privacy rule" when it permits sharing Americans' most personal=20
medical information with 800,000 or so health, business and=20
government entities?</DIV>
<P>Even a hospital gown offers more privacy, and this widespread=
=20
access to medical records should leave patients with a different=
=20
sort of chill running up the spine. How can they be open about t=
heir=20
medical needs if traditional doctor-patient confidentiality has=20=
been=20
eroded?</P>
<P>Medical privacy rules put in place in 2003 under HIPPA - the=20
Health Insurance Portability and Accountability Act of 1996 - ca=
n=20
make it harder to send someone flowers in the hospital, or check=
on=20
their condition, than limit access to patient records.</P>
<P>That's because the Bush administration rule change two years=20=
ago=20
did an about-face on a Clinton-era policy that had required=20
patients' consent before their medical data could be shared.</P>
<P>The subsequent court battle to restore those protections suff=
ered=20
a setback last year. But in an appeal heard March 9 before three=
=20
federal judges in Philadelphia, the challenge may have reached a=
=20
turning point in patients' favor.</P>
<P>If their probing questions were any guide, the U.S. Court of=20
Appeals for the Third Circuit judges brought a healthy skepticis=
m to=20
government claims that Americans' medical records are safe from=20
prying eyes.</P>
<P>Judges Marjorie O. Rendell, Theodore A. McKee and Richard L.=20
Nygaard were presented with a compelling case by patient groups,=
=20
physicians and privacy advocates that key HIPPA protections are=20=
an=20
illusion.</P>
<P>In brief, the so-called privacy rule says that data can be sh=
ared=20
without patients' consent to carry out treatment, payment or -=20
here's the catch-all - "health care operations." It's designed t=
o=20
cut red tape, what a Justice Department lawyer described as "a t=
ough=20
balancing between efficiency and privacy."</P>
<P>Trouble is, the rule tips the balance against patients'=20
reasonable expectation that private information won't be shared=20=
too=20
widely.</P>
<P>For instance, the "health care operations" wording would perm=
it=20
the use of pharmacy mailing lists for certain direct marketing t=
o=20
consumers. Employers and even prospective buyers of a managed-ca=
re=20
insurer could gain access to health data, too. Not much private=20
about that.</P>
<P>While HIPPA lets patients examine their medical records, it=20
grants them few ways to track how their information is shared.</=
P>
<P>A Massachusetts congressman, Democratic Rep. Edward J. Markey=
,=20
offers a sound proposal (H.R. 1709) to restore patient consent i=
n a=20
way that would not interfere with health-care providers doing th=
eir=20
jobs.</P>
<P>Were the right to consent restored, that would force health-c=
are=20
providers, insurers and others to reveal how medical information=
=20
would be used in exchange for getting patients' consent.</P>
<P>At a time when some employers are sniffing for tobacco on job=
=20
candidates' clothing, citizens need to be more concerned - and=20
empowered - about who gets to flip through their medical files.=20
Medical data should be used to treat and track illness, not scre=
en=20
applicants.</P>
<P>There's even more reason for concern about safeguarding healt=
h=20
information, given the recent lapses with computerized databases=
.=20
Just ask the 145,000 citizens whose financial and personal data=20=
was=20
leaked by databank ChoicePoint Inc. to scam artists.</P>
<P>Either the Third Circuit or Congress can restore a better bal=
ance=20
on patient privacy. The judges are in the best position to act=20
quickly to do=20
so.</P><!-- end body-content --></TD></TR></TBODY></TABLE><BR><BR></TD=
></TR></TBODY></TABLE><BR>
<HR width=3D"97%" color=3D#cccccc SIZE=3D1>
<CENTER><SPAN class=3Dbyline>=A9 2005 Philadelphia Inquirer and wire service=
=20
sources. All Rights Reserved.<BR>http://www.philly.com=20
</SPAN></CENTER><BR></DIV></FONT></BODY></HTML>
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