June 18, 2001
Medical Privacy Threatened by Federal Health Bureaucrats
The vast majority of Americans want and expect their medical records to be kept strictly confidential. Recent polls show that Americans overwhelmingly oppose giving government the power to create a national health database or issue health ID numbers. People instinctively understand that federal databases and ID numbers only serve to destroy personal privacy by making it easier for both government and the private sector to access their private medical history. Yet federal bureaucrats at the department of Health and Human Services, with the help of Congress, have succeeded in implementing regulations which place every American's medical records in the hands of the government. Worst of all, they have done so while claiming to protect our privacy! Only in Washington can so-called "medical privacy" regulations actually authorize such blatant invasions of privacy by the government.
The most dangerous aspect of the new regulations is the implementation of a national medical record database. All health care providers, including private physicians, insurance companies, and HMOs, will be forced to use a standard data format for patient records. Once standardized information is entered into a networked government database, it will be virtually impossible to prevent widespread dissemination of that information. If the federal government really seeks to protect medical privacy, why it is so eager to have its citizens' medical records easily available in one centralized database? The truth is that a centralized database will make it far easier for both government agencies and private companies to access your health records.
HHS officials have sought to reassure the public that the new rules require patient consent before physicians may release medical information. Unfortunately, however, the consent protection has very limited effect. First, your physician likely will refuse to treat you if you decline consent to share your records. This is almost certain to happen, because heavy fines (and even jail sentences!) will be imposed on physicians who don't exactly follow the new regulations. Furthermore, there are very broad exceptions to the consent rule for ill-defined categories such as "oversight of the health care system," "public health," "law enforcement activities," "judicial and administrative proceedings," and "national defense and security." These exceptions give the government almost unlimited justifications to access your private records not only without your consent, but also without your knowledge. The law enforcement exception is particularly troubling, because the 4th Amendment clearly prohibits warrantless searches of medical records by government officials. So while on the surface the new rules may seem to give patients some control, the reality is that the consent protection is largely meaningless.
We should remember that private physicians have maintained patient privacy for centuries without government involvement, relying instead on personal conviction, the Hippocratic Oath, and professional standards. Patients once knew without question that anything they told their doctor would remain confidential. However, the physician/patient relationship is certain to change for the worse when control over patient records is transferred from medical professionals to government agencies. When patients know that their sensitive medical information will be turned over to government agencies or placed in a national database, they inevitably will be less open and honest when seeking medical care. Patients with drug and alcohol problems, mental illnesses, sexually transmitted diseases, HIV, or other stigmatized health concerns will be especially reluctant to seek treatment. The inevitable result will be a decline in the standard of care delivered by doctors and an increase in health care costs.
As a physician, I have vigorously opposed the new HHS rules since they first were proposed by the Clinton administration. I introduced legislation earlier this year to prevent their implementation, but unfortunately the deadline for Congress to act on my bill expired last week. However, the fight is not lost, as the rules do not become legally enforceable until 2003. Congress still has time to pass new legislation which prohibits the federal government from gathering your private medical information. I urge every American concerned with medical privacy and quality health care to join me in the fight to keep government out of our medical records.