Privacy Is Everybody's Business

Posted: September 18, 1997

So who do you think knows about that embarrassing little medical problem you may have had recently?

Your doctor, of course. And the nurse.

The receptionist who faxed your health insurance claim form knows.

So, too, the health insurance worker who typed the information into the company's giant computer banks.

Depending on your little medical problem, local and state health departments probably know.

And if the federal government is paying for treatment through Medicare, Medicaid, Social Security disability or Workers' Compensation, the bureaucrats know, too.

Other insurance companies could know if your file is sent to the Medical Information Bureau, a central database containing the medical records of 15 million residents of the United States and Canada. More than 750 insurance firms use the bureau to check on an applicant's health and welfare before selling a policy.

And let's not forget those friendly folks in your workplace's human resources department. Many companies are insisting on access to medical records to help keep their insurance costs down.

Heck, at this rate you might as well put what ails you on a T-shirt.

Personal medical records are supposed to be exactly that: personal. But over the years, with increased computerization and data collection, people's privacy rights have been dying on the operating table.

Currently, there are only ill-enforced and -defined state laws protecting the confidentiality of medical records, which have been used by drug companies and others to sell products or provide entertainment.

Under Pennsylvania law, for example, only the confidentiality of someone's HIV status is strictly protected.

That's why Health and Human Services Secretary Donna Shalala is right on target in calling for new federal laws to protect the privacy of medical records.

Shalala wants organizations that provide or pay for health care to be held responsible for keeping records under tight control - or face federal sanctions.

She wants hospitals, clinics and insurance companies to tell patients in writing how their personal medical records will be used and protected and under what circumstances they may be disclosed.

She also wants patients to have the right to examine and copy their medical records and correct errors.

The American Civil Liberties Union believes that Shalala's recommendations don't go far enough. Civil libertarians want patients to have the right to block their medical records from being entered into computerized databanks. That may be going too far, especially since computer technology has made it easier to track communicable diseases.

Indeed, by collecting and sharing medical information, public health agencies are able to track outbreaks of E. coli infections and such diseases as meningitis.

And there are moments when the people's need to know is greater than someone's need to keep certain things private. How should one weigh, for instance, the medical privacy rights of someone running for president?

But it's one thing to share your medical information for the good of the community, another when it's used to give someone a lead for a prescription drug sale or to discriminate illegally in hiring, firing or housing.

It's hardly a secret that it's time for the president and Congress to step in with strong laws to safeguard Americans' privacy.

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