PATIENT PRIVACY

November 1, 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 discussion follows this background report. The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.

A Health Spotlight Report: Patients' Bill of Rights Nov. 1, 1999: A discussion on the president's privacy proposal. Oct. 27, 1999: The House votes against assisted suicide. Oct. 7, 1999: Patients can now sue their HMO's. Oct. 6, 1999: Congress debates HMO reform legislation. Sept. 30, 1999: Patients vs. HMO's July 16, 1999: A Republican bill passes July 15, 1999: Senate votes against HMO suits. July 14, 1999: A partisan debate. July 13, 1999: Should patient's be able to sue HMO's? July 1998: Forum: Should the government manage care? July 9, 1998: Debating managed care The NewsHour's Health Spotlight. Browse the NewsHour's coverage of Health   Health Privacy Project Health Insurance Association of America American Psychiatric Association American Psychoanalytic Association Blue Cross and Blue Shield White House	JIM LEHRER: Susan Dentzer of our health unit begins our look at the new medical privacy regulations. The unit is a partnership with the Henry J. Kaiser Family Foundation. DOCTOR: 1128/78. Excellent. SUSAN DENTZER: Whether it's information about your latest doctor's visit... the drug you just picked up at the pharmacy... or anything at all that might appear on a medical bill, millions of pieces of medical information about you are on record somewhere. In the past, that data has mainly been available on paper. Now it's increasingly likely to be recorded on computer disks, or even floating in cyberspace. And as a result, some experts think an individual's ability to keep that information private is in greater peril than ever. HEALTH CARE WORKER: Does the other knee bother you at all? SUSAN DENTZER: Medical information is routinely shared among a number of parties, including health care providers, insurance companies, and employers. Sometimes that's for benign reasons, such as comparing records among hundreds of patients to make sure they're all getting the best care. But patient advocates worry that some uses of medical information are too invasive of individual privacy, and President Clinton agrees. PRESIDENT CLINTON: Today, with the click of a mouse, personal health information can easily and now legally be passed around without patients' consent to people who aren't doctors, for reasons that have nothing to do with health care.
	Employers use medical information
	SUSAN DENTZER: In fact, one recent survey showed that more than a third of all Fortune 500 companies check someone's medical records before a hiring or promotion. And privacy experts worry that in the future, information about individuals' genetic makeup and likelihood of incurring major diseases could hurt their ability to get jobs or insurance. Congress failed to meet a self-imposed deadline last summer to pass federal legislation to protect individual medical privacy. So last week President Clinton proposed new regulations designed to provide consumers with some important new protections. Patients would for the first time have a federally guaranteed right to view and obtain copies of their medical records. They could also ask that mistakes be corrected. Health care providers and health plans would have to tell consumers how their information was being used, and to whom it was being disclosed. And in general, President Clinton said, health information could be used only for health care purposes. That means employers couldn't screen individuals' health information to avoid hiring people who'd been sick, or for snooping on them later. PRESIDENT CLINTON: Americans should never have to worry that their employers are looking at the medications they take or the ailments they've had. SUSAN DENTZER: But under the new regulations, providers and payers would still have broad leeway to use medical records in their operations without patients' consent. That worries some privacy advocates, who fear that patients would lose some more stringent protections they've already won through state laws and various court decisions. They say these could total $40 billion over five years, or ten times what the administration predicts. Even President Clinton last week seemed painfully aware of the proposal's limits. Because of a quirk in federal law, it would only apply to records that are on or printed out from a computer, not to records that are maintained on paper. PRESIDENT CLINTON: 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. SUSAN DENTZER: The Department of Health and Human Services will now receive public comment now for two months before final regulations are to be issued next February. They are scheduled to take effect in 2002.