October 29, 1999
President Clinton proposed new regulations for patient privacy last
week that would guarantee patients access to their medical records and
health care providers would have to tell patients when and why their
information was being used. A transcript of his Oval Office remarks
SECRETARY SHALALA: Mr. President, I am pleased to welcome everyone
here today. We have worked very hard to do what common sense and common
decency says should have been done a long time ago. That is, to come
up with reasonable rules for protecting the privacy of our
The President understands that the citizens of this country deserve
health care that is real, that is affordable, that offers choices and
that is there when we need it and he understands that this issue is
important to every American. That's why today's announcement builds
on what he has
I am very proud to introduce the President. Thank you, Mr. President.
THE PRESIDENT: Thank you, Secretary Shalala. I would like to thank
you for all the work that you and so many people in your department
have done on this issue. I thank the representatives of the various
groups who are here with me today for their concern for, and commitment
These health care and consumer advocates support what we are trying to do to protect the sanctity of medical records. I believe the American people will support us as well.
Every American has a right to know that his or her medical records
are protected at all times from falling into the wrong hands. And, yet,
more and more of our medical records are stored electronically and as
they have been stored electronically the threats to our privacy have
To be sure, storing and transmitting medical records electronically
is a remarkable application of information technology. Electronic records
are not only cost effective; they can save lives by helping doctors
to make quicker and better-informed decisions, by helping to prevent
But as Secretary Shalala just said, our electronic medical records
are not protected under federal law. The American people are concerned
and rightfully so. Two-thirds of adults say they don't trust that their
medical records will be kept safe. They have good reason. Today, with
the click of
A recent survey showed that more than a third of all Fortune 500 companies check medical records before they hire or promote. One large employer in Pennsylvania had no trouble obtaining detailed information on the prescription drugs taken by its workers, easily discovering that one employee was HIV positive. This is wrong. Americans should never have to worry that their employers are looking at the medications they take or the ailments they've had.
In 1999 Americans should never have to worry about nightmare scenarios depicted in George Orwell's 1984. I am determined to put an end to such violations of privacy. That's why I'm honoring the pledge I made in the State of Union Address and using the full authority of this office to create the first comprehensive national standards for protection of medical records.
The new standards I propose would apply to all electronic medical
records and to all health plans. They would greatly limit the release
of private health information without consent. They would require health
plans to inform patients about how medical information is used, and
to whom it is
These standards represent an unprecedented step toward putting Americans back in control of their own medical records. These standards were developed by Secretary Shalala and the Department of Health and Human Services. Over the next 60 days the Secretary and her department will take comment from the public before we finalize the standards.
Again, on behalf of all the families in this country, I thank you Madam Secretary for this work.
Now let me say something that I think is now well known. I am taking this action today because Congress has failed to act, and because a few years ago Congress explicitly gave me the authority to step in if they were unable to deal with this issue. I believe Congress should act. Members of Congress gave themselves three years to pass meaningful privacy protections, and then gave us the authority to act if they didn't. Two months ago their deadline expired. After three full years there wasn't a bill passed in either chamber.
Even as we put forward our plan today, I think it is important to point out there are still protections, some of them, we can give our families only if there is an act of Congress passed. For example, only through legislation can we cover all paper records and all employers.
So today again I ask Congressional leaders, please help protect America's families from new abuses of their privacy. You owe the American people a comprehensive medical privacy law. As we have found out in working through this order, the issues are complex, difficult decisions have to be made. But we will work with you in a bipartisan fashion. We can do this together and we owe it to our families to protect their privacy in the most omprehensive way possible.
Thank you very much.
Q Mr. President, Senator Helms has offered to schedule a hearing on Carol Moseley-Braun's nomination next week if you will ensure that the IRS, the White House and the Justice Department produce a bunch of documents by Monday. Do you see that as a serious offer or do you think he is just toying with your nominee?
THE PRESIDENT: I don't know. First of all, I have asked our White
House staff to review the request for information and evaluate it in
terms of what would be proper to forward to the committee and whether
there are some things that wouldn't be. I think we should at least take
So I hope we can work it out and I am going to -- like I said, I have asked the White House staff to evaluate Senator Helms' request and to see whether it's possible for us to do.
Q Mr. President, in Kosovo this week, an attack on Serb civilians has led some military officials to conclude that the peacekeeping force may need to be expanded. Do you agree with that, Sir?
THE PRESIDENT: Well, I think they have been doing a good job on the
whole. But I think they have to be in a position to protect the civilians
and to act appropriately when people come under fire. We actually have
been in the process of reviewing not only that but also the progress
I am not sure that more forces will solve the problem. What we see -- let me just say that what we see in Kosovo -- and this is not surprising -- is that there are a lot of communities that are doing quite well. And so they don't rise to the level of news coverage most days. You know, they are just good, old-fashioned people in small towns doing their business.
The peacekeepers have found that there are several communities where the local officials themselves are clearly in control, clearly have the support of the local population and are clearly committed to minimizing civilian violence or the exposure of civilians to violence, whatever their ethnic group. Then there are some places that need more people.
So the first thing I would say in response to your question is, as
regards to all these kinds of incidents, but particularly that one which
concerned me, we ought to make sure that we have deployed the resources
that we have there in the best possible way before we make any decision
that more are needed. Of course, we have a representative on the ground
there, a leader that represents the United Nations, and he can give
us some guidance about whether they need more
Q Did you watch the Republican debates last night and what do you think about the fact that George W. Bush was not there?
THE PRESIDENT: They all have to make their own decisions and I didn't watch it. I kind of -- I look at them wistfully. I really -- I did, you know, a slew of them. I don't think I missed a single one in '92 and I enjoyed them all. (Laughter.)
I do think they're useful. And even though, very often, they are not news events because you see that the similarities to the candidates are greater than their differences and that's why, you know, Senator Bradley and Vice President Gore are Democrats and the other five are Republicans.
But I think it is useful to participate in them because you get a feel for what the issues are in specific states and also how people react and they are, I think, a good thing. I think they strengthen democracy, they get people interested and they make people more interested in voting.
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