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Clinton unveils new medical privacy rules
Saturday, October 30, 1999 By Ann McFeatters, Post-Gazette National Bureau
WASHINGTON -- President Clinton yesterday announced his new proposal to protect the privacy of medical records, intended to make your health data as secret as your video rentals.
But even as he did, privacy advocates asserted that the new regulations didn't go far enough and health insurers complained that they went too far.
With polls showing that one of Americans' top concerns is loss of privacy, especially in the area of personal health information, Clinton said yesterday, "Every American has a right to know his or her medical records are protected at all times from falling into the wrong hands."
He added: "The American people are concerned, and rightfully so. Americans should never have to worry that their employers are looking at the medicines they take or the ailments they've had."
One of the problems that consumers complain about is that they don't always know when their medical data are disclosed to employers, financial institutions or pharmaceutical companies -- learning of it only later, when they've been denied a job or a mortgage, been embarrassed or suffered in other ways. There are no federal protections now; various states have widely varying laws.
Basically, the proposed rules were required by a 1996 law but are limited in scope by that same law. They would permit consumers to see their medical records and correct any errors and decide who could see the records. They also would require new forms, called "administrative subpoenas," for law enforcement personnel to fill out in an effort to make them think twice about whether reviewing medical records in a specific case is really necessary.
They would bar banks and credit-card companies from getting specific information on diagnoses and treatment of their customers. At present, a bad medical report can be used by a bank as the rationale for refusing to grant a mortgage.
The new regulations Clinton proposed won't be final until Feb. 21, however, and won't take effect for two years after that. They also don't apply to paper records, only those that are electronic or computerized. And they don't require a judge to sign off on what medical records the police may see.
Potentially even more significant, the regulations do not prohibit third parties, such as lawyers or consultants who routinely see medical information, from passing it on.
Also, minors would not have a special federal right to privacy. A minor's rights would be dictated by the laws of the state where he or she lives.
Ronald Weich, a lawyer with the American Civil Liberties Union, said the group had been critical overall of Clinton's record on civil liberties but that on this issue it "applauds" the president on "this dramatic development." But Weich said, "We hope to strengthen regulations to make sure police don't have access to our most personal information without review by a judge."
Donna Shalala, secretary of the Department of Health and Human Services, told reporters the regulations couldn't be tougher because of the strictures of the law. She said the best solution was for Congress to pass a law strengthening controls on medical data.
Janlori Goldman, director of the health privacy project at Georgetown University, said the issue would become even more critical. Because of the passage of a new law by Congress a few days ago that breaks down the firewall between the insurance and banking industries, "your medical records can be anywhere and you have no control over them," she said.
The health insurance industry is upset with the new regulations because its companies would have a new burden to inform patients about use of their medical data. The industry argues that the regulations will cost billions of dollars (a Blue Cross and Blue Shield Assn. estimate is $43 billion over five years) and could stymie new scientific research.
Shalala shot back that the best government estimate was that the regulations would cost $3.8 billion over five years, or one-tenth of 1 percent of the nation's total health care bill. She said that if the industry says it would cost more, it is essentially admitting that it hasn't been doing much to protect patient privacy.
Holding up her Blockbuster video rental card and noting that it has more privacy protection than her health card, Shalala said the problem was that Congress failed for two years to pass a law as it directed itself to do in 1996.
"We've worked very hard to do what common sense and common decency say should have been done a long time ago; that is, to come up with reasonable rules for protecting the privacy," she said. Later she added, "We continue to believe the best solution is comprehensive legislation passed by Congress."
Clinton also urged Congress to act. "There are still protections, some of them, we can give our families only if there's an act of Congress passed.
"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," the president said.
He specifically noted that the new regulations, should they go into effect as planned in 2002, would create new criminal penalties as well as fines for improper use or disclosure of medical information.
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