Homestead mailing list

[bobf <bobford79 AT yahoo.com>]

Privacy of medical records will soon be completely gone.  It barely exists 
now, even with the more recent HIPPA laws.  If you have insurance through an 
employer , you always sign permission to the insurance company for access, 
usually human resources at your workplace has access, and this information 
can be betrayed, sold, or traded.

Wityh this new national centralization, privacy will be dead, unless you are 
wealthy enough for complete private pay. This will be terrible and have many 
un-intended consequences. 

>From this am NYT 

-----------------------------------------------------------------------

Privacy Issue Complicates Push to Link Medical Data 

By ROBERT PEAR

Published: January 17, 2009 

WASHINGTON — President-elect Barack Obama’s plan to link up doctors and 
hospitals with new information technology, as part of an ambitious 
job-creation program, is imperiled by a bitter, seemingly intractable dispute 
over how to protect the privacy of electronic medical records. 


Rahm Emanuel, the White House chief of staff-designate, said it was 
“essential” to protect personal health information. 
Lawmakers, caught in a crossfire of lobbying by the health care industry and 
consumer groups, have been unable to agree on privacy safeguards that would 
allow patients to control the use of their medical records.

Congressional leaders plan to provide $20 billion for such technology in an 
economic stimulus bill whose cost could top $825 billion.

In a speech outlining his economic recovery plan, Mr. Obama said, “We will 
make the immediate investments necessary to ensure that within five years all 
of America’s medical records are computerized.” Digital medical records could 
prevent medical errors, save lives and create hundreds of thousands of jobs, 
Mr. Obama has said. 

So far, the only jobs created have been for a small army of lobbyists trying 
to secure money for health information technology. They say doctors, 
hospitals, drugstores and insurance companies would be much more efficient if 
they could exchange data instantaneously through electronic health 
information networks. Consumer groups and some members of Congress insist 
that the new spending must be accompanied by stronger privacy protections in 
an era when digital data can be sent around the world or posted on the Web 
with the click of a mouse. 

Lawmakers leading the campaign for such safeguards include Representatives 
Edward J. Markey of Massachusetts and Pete Stark of California, both 
Democrats; Senator Patrick J. Leahy, Democrat of Vermont; and Senator Olympia 
J. Snowe, Republican of Maine.

Without strong safeguards, Mr. Markey said, the dream of electronic health 
information networks could turn into “a nightmare for consumers.”

In the last few years, personal health information on hundreds of thousands 
of people has been compromised because of security lapses at hospitals, 
insurance companies and government agencies. These breaches occurred despite 
federal privacy rules issued under a 1996 law. Congress is trying to 
strengthen those privacy protections and make sure they apply to computer 
records. Lobbyists for insurers, drug benefit managers and others in the 
health industry are mobilizing a campaign to persuade Congress that overly 
stringent privacy protections would frustrate the potential benefits of 
digital records. 

One of the proposed safeguards would outlaw the sale of any personal health 
information in an electronic medical record, except with the patient’s 
permission. 

Another would allow patients to impose additional controls on certain 
particularly sensitive information, like records of psychotherapy, abortions 
and tests for the virus that causes AIDS. Patients could demand that such 
information be segregated from the rest of their medical records. 

Under other proposals being seriously considered in Congress, health care 
providers and insurers would have to use encryption technology to protect 
personal health information stored in or sent by computers. Patients would 
have a right to an accounting of any disclosures of their electronic data. 
Health care providers and insurers would have to notify patients whenever 
such information was lost, stolen or used for an unauthorized purpose. And 
patients — or state officials acting on their behalf — could recover damages 
from an entity that improperly used or disclosed personal health information. 

Rahm Emanuel, who will be the White House chief of staff for Mr. Obama, 
advocated such safeguards when he was a House member from Illinois. “As we 
move forward on health information technology,” Mr. Emanuel said, “it is 
absolutely essential that an individual’s most personal and vulnerable 
information is protected.”

Advisers to Mr. Obama say he favors strong privacy protections but does not 
want the dispute to slow down the bill.

Mary R. Grealy, president of the Health Care Leadership Council, which 
represents large health care corporations, said the proposed safeguards could 
be an impediment to the widespread adoption of health information technology 
and counteract any economic stimulus effect. 

In a letter to Congressional leaders, Karen M. Ignagni, president of 
America’s Health Insurance Plans, a trade group for insurers, expressed 
“serious concern about privacy provisions being considered for inclusion in 
the economic stimulus bill.”

She criticized, in particular, a proposal that would require health care 
providers to obtain the consent of patients before disclosing personal health 
information for treatment, payment or “health care operations.”

Such a requirement, she said, could cripple efforts to manage chronic 
diseases like diabetes, which often require coordination of care among many 
specialists.

At the moment, senior House Democrats are determined to include privacy 
safeguards in the economic recovery bill. But some insurance lobbyists said 
they hoped Congress would punt on the issue, leaving privacy standards to be 
developed by the Health and Human Services Department, where they believe 
they can make their case more effectively. Microsoft has joined many consumer 
groups in supporting stronger safeguards. The software giant has developed 
products that allow consumers and providers to store and share medical data 
in a secure format. 

“Health information technology will succeed only if privacy is protected,” 
said Frank C. Torres, director of consumer affairs at Microsoft. “For the 
president-elect to achieve his vision, he has to protect privacy.”

Senator Sheldon Whitehouse, Democrat of Rhode Island, and Peter R. Orszag, 
director-designate of the White House Office of Management and Budget, said 
electronic medical records could be more secure than paper records.

“If the files are electronic,” Mr. Whitehouse said, “computers can record 
every time someone has access to your medical information.” But, he said, the 
challenge is political as well as technical.

“Until people are more confident about the security of electronic medical 
records,” Mr. Whitehouse said, “it’s vitally important that we err on the 
side of privacy.”

The data in medical records has great potential commercial value. Several 
companies, for example, buy and sell huge amounts of data on the prescribing 
habits of doctors, and the information has proved invaluable to 
pharmaceutical sales representatives.

“Health I.T. without privacy is an excellent way for companies to establish a 
gold mine of information that can be used to increase profits, promote 
expensive drugs, cherry-pick patients who are cheaper to insure and market 
directly to consumers,” said Dr. Deborah C. Peel, coordinator of the 
Coalition for Patient Privacy, which includes the American Civil Liberties 
Union among its members.