Shalala Responds to Bush’s Proposed Reforms to Federal Medical Privacy Regulations
Pointing to a federal medical privacy regulation change proposed by the Bush administration that would eliminate the requirement that providers, insurers and pharmacies obtain written consent from patients before disclosing their medical records, former HHS Secretary Donna Shalala writes in a New York Times opinion piece that she hopes the administration will "try to craft an alternative that retains the concept of patient consent and still allows providers, under certain conditions, to begin treatment before obtaining consent." The proposed regulation change would not require consent for "routine uses" of patients' medical information such as referrals and processing prescriptions. In such situations, obtaining patients' consent would be optional, Shalala says. On the issue of allowing marketers to access patients' medical records, the Bush administration "got it wrong," Shalala says. The proposed changes are "considerably looser" than the original rules and would essentially allow drug companies to "pay a pharmacy to mail information about a new drug to its customers, without [the customers'] knowledge or consent." In addition, the proposed changes would not provide a way for patients' to "opt out" of such mailing lists. Shalala concludes that "the administration must be careful not to accept changes that could lead to the misuse of patients' personal health information after they entrust it to their doctors or health plans" (Shalala, New York Times, 3/30).
Removing the requirement that patients give their consent in releasing their medical records is a "significant weakening of the rules," according to a San Francisco Chronicle editorial. While the privacy rules originally proposed by the Clinton administration "did need tweaking," the editorial says that complaints by the health care industry that the regulations would delay care "were greatly overblown." The editorial says that patients' medical history -- an "intensely private matter" -- should be respected, and patients should be "actively involved" in who sees such records. The Chronicle concludes: "Consumers should not let the health care industry dictate the ground rules for the sharing of medical records. ... Patients must have a say in what happens with information about the most personal aspects of their lives" (San Francisco Chronicle, 3/31).
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