Copyright 1999 Times Publishing Company
St.
Petersburg Times
November 03, 1999, Wednesday, 0 South
Pinellas Edition
SECTION: EDITORIAL; EDITORIALS; Pg.
18A
LENGTH: 660 words
HEADLINE: A matter of privacy
BODY:
While the Clinton administration's
proposed rules for protecting medical records move us in the right direction,
it's up to Congress to finish the job.
When a recent Wall Street Journal
poll asked Americans what they feared most in the coming century, the loss of
personal privacy topped the list. It even outpaced terrorism on the public's
fear barometer.
It's no wonder people are spooked. In an information
age, where personal data is a valuable commodity and powerful computers make
storing, referencing and selling that data a matter of a few keystrokes, we know
our privacy is slipping away. To help arrest that slide, the Clinton
administration has announced a set of rules to guard the
privacy of some of our most sensitive personal
information: our medical records. The proposed rules are a
needed first step in providing dependable protections for the privacy of medical
records, but they don't go far enough. It's up to Congress to go the rest of the
way.
People may presume that what happens in a doctor's office is a
private matter. After all, doctor-patient confidentiality is a medical ethic.
Yet few legal protections give patients redress when that confidentiality is
breached. A patchwork of state rules protects the privacy of some records
sometimes, but there is no comprehensive federal protection. In most places,
identifiable medical records can legally be shared with employers,
telemarketers, researchers and others without telling patients or getting their
consent.
The Clinton administration is partly to blame for this medical
privacy crisis. The president supported the administrative simplification
provisions in the 1996 Health Insurance Portability and Accountability Act,
which dictated to medical providers and health insurers that records be
computerized, using a standard format. The point was to make health records
easily and instantly accessible to doctors, hospitals, insurers and pharmacies.
But with that accessibility comes a lack of security.
To assuage the
fears of privacy advocates, the law gave Congress until late August 1999 to
protect the privacy of medical records. When Congress failed to act within that
time, the president was charged with rulemaking.
Clinton's proposed
rules would prohibit health insurers, hospitals and doctors from disclosing
identifiable medical records without patient consent, for reasons other than
patient treatment, payment for health services or health care operations. In
addition, patients would have a right to review their own medical files and be
informed of who accessed their records and for what purpose. Lapses in security
and improper disclosures could lead to criminal and civil penalties.
While these regulations move us in the right direction, they
don't go far enough. The medical establishment, including the American Medical
Association and American Psychiatric Association, expressed disappointment that
the rules didn't rein in some of the invasive practices of HMOs, such as
reviewing medical records to find cheaper forms of treatment. Civil liberties
groups note that the rules fail to limit law enforcement's access to medical
records. Police don't need a warrant to get medical records, despite the
significant privacy interests at stake. And nothing in the rules protects
patients from disclosure by employers, public health agencies and life insurance
companies. The president's rules can be strengthened in some areas, but it's
really up to Congress to enact broad privacy protections in these other areas.
As we deregulate the banking sector to allow health insurers to merge
with banks and credit card companies, it would be comforting to know that
federal rules will prevent your banker from seeing the results of your latest
physical. While more needs to be done, the administration's regulations at least
provide enough of a legal shield so that doctor-patient confidentiality won't
become a quaint 20th century relic.
LOAD-DATE:
November 3, 1999 
