MEDICAL PRIVACY: Some Say House Measure Releases Too Much
Health privacy advocates are furious over a provision included in the financial services modernization package, approved 343-86 by the House Friday, that could allow health insurers to disclose patient medical data to "credit card companies and other financial institutions," the Los Angeles Times reports. "Under this legislation, a health insurer can send a patient's diagnosis to a credit agency. They can say, in effect, 'By the way, Joan Smith has a brain tumor; don't lend her any money,'" said Tim Westmoreland of the Georgetown University Law Center. The clause was touted by sponsor Rep. Greg Ganske (R-IA) as a "medical confidentiality" measure -- Ganske argued it would allow the disclosure of patient data "only for billing and other health care operations." But privacy experts countered that the clause constituted a "'publicity' provision that, because of the way it is worded, would allow broad disclosures of private medical information without a patient's permission." Specifically, they complained that the bill allows for the wholesale release of patient information -- whether billing records or treatment and diagnosis information -- and that it contains "no restriction on what the credit card companies could do with the information." The Senate has already approved the financial services bill, but without the medical privacy provision, so the fate of the measure will be determined in a House-Senate conference committee (Rubin, Los Angeles Times, 7/2).
A Baton Rouge Advocate editorial argues that medical records privacy "is a complicated issue, and we believe it should be debated not as part of the big financial services bill, but separately in comprehensive privacy legislation now before Congress." The paper concludes, "We hope that a Senate and House conference committee can agree to put aside the Ganske language so that it can receive the detailed attention it needs" (Advocate, 7/5).
Wind City Reax
A Chicago Tribune editorial argues that Ganske's amendment "opens up medical files to so many eyes that its privacy protections are effectively meaningless," and that the conference committee should scrap the measure. The paper also takes Sen. James Jeffords (R-VT) to task for authoring a bill "with so many loopholes it would effectively water down privacy rights rather than protect them. One of its most egregious provisions would allow medical insurers to require patients to sign away their privacy rights as a condition for getting insurance." The paper concludes, "Congress shouldn't surrender ... responsibility to federal bureaucrats by default, nor should it effectively undermine these rights by enacting half-baked legislation" (Chicago Tribune, 7/4).
Margie Scarf writes in this week's New Republic that although nobody knows what medical records privacy policies HHS Secretary Donna Shalala will implement if Congress misses its August 21 deadline to create a framework as mandated by the 1996 Health Insurance Portability and Accountability Act, "a look back at a tentative, 90-page proposal she submitted to Congress in September, 1997, provides a less-than-comforting impression." Shalala's draft provides for "allow law enforcement officials, or, under certain circumstances, 'official(s) of the U.S. Intelligence Community' easier access to individual records," along with "next of kin," researchers and insurance company clerks, who need the data for "health care and payment purposes." Scarf writes, "In other words, Shalala's guidelines would allow for all sorts of access to these confidential records by all sorts of people -- and unless Congress or the administration intervenes, those guidelines will likely shape the final privacy regulations." Noting that huge "profits can be realized by easing legal access to our health data," and that there "is a long gravy-train forming around our medical records," Scarf concludes that corporations "stand to reap millions -- while the rest of us stand to lose not only insurance, our jobs and our money, but our privacy and our personal dignity as well" (7/12 issue).