MEDICAL PRIVACY: Balancing Security with Need-to-Know
Today's Los Angeles Times examines the brewing medical privacy debate that pits an individual's privacy concerns against "those who need the information," such as health plans aiming to improve care standards. Although Congress is expected to outline comprehensive medical legislation before August, numerous states have already begun to tackle the difficult issue of how to balance privacy with assurance that providers and health plans can access needed information. "Privacy really is a very deeply held American tenet," said Mark Smith, CEO of California HealthCare Foundation, at a recent medical privacy forum sponsored by the foundation. One "key question" in the development of privacy protections, the Times reports, is whether a federal law would establish a "ceiling" on privacy protections that would impede states' efforts to legislate tougher restrictions. California has considered 17 medical confidentiality bills over the past three years, and already has "a patchwork of protections" for patients undergoing treatment for mental illness, AIDS and substance abuse. "We're concerned about some sort of a federal ceiling that would supersede what's being done in HIV, particularly in California," said AIDS Project Los Angeles' Craig Thompson. Others note that its even unclear what steps are necessary to ensure the privacy of medical records. Latanya Sweeney, an assistant professor of public policy at Carnegie Mellon University, noted that even "when names have been stripped off records that contain birth, sex, race and diagnosis, she can re-identify the individual by cross-referencing with a $20 voter registration list." Sweeney is developing techniques to make re-identification of such data more difficult, and "assure there is no Three Mile Island in computer privacy" (Allen, 2/8).
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