-Caveat Lector- <A HREF="http://www.ctrl.org/"> </A> -Cui Bono?- http://www.insightmag.com/archive/200001217.shtml Public Comment on Medical Records By Kelly Patricia O’Meara HHS has formulated new regulations allowing agencies to snoop on your private medical records, but it is avoiding a massive reaction by making public comment too difficult. Privacy is so much a part of the American character that in its name the Supreme Court has even authorized mothers to take the lives of their unborn children. But not only records of abortions but other medical events and conditions -- sometimes including embarrassing details that are discussed during medical examinations that traditionally have been left between patient and doctor -- no longer may be protected from falling into the wrong hands, and even may be available for public scrutiny. That’s right. In the name of medical research and “administrative efficiency,” that irritating and recurring thingamabob on your whatchamacallit that long has been a personal matter between you and your doctor now will become part of a massive government database. Naysayers who think of their relationship with their physician in the same vein as that of attorney/client and priest/parishioner complain that these proposed regulations are not only unconstitutional but also more than slightly hypocritical. For instance, they wonder how President Clinton can be so eager to adopt measures that will give him access to all personal medical information when he has refused to release his own medical records. And, despite government reassurances that information regarding individual medical records would be completely confidential, such assurances are a difficult pill to swallow given the history of the Clinton/Gore use of FBI and other confidential files. Those who fear their medical records could somehow be used against them make the point that the FBI still has been unable to ascertain how 408 FBI files on leading Republicans, all containing IRS documents, found their way seven blocks down Pennsylvania Avenue and into computers the White House apparently shared with the Democratic National Committee. Nevertheless, the new regulations to allow federal snooping on the private medical records of every citizen have been written and, short of a thundering public outcry, they will become law. In accordance with official procedure, an avenue first must be made available for public comment. This nominally has been provided by the Department of Health and Human Services, or HHS, at http://aspe.hhs.gov/admnsimp/ . But the unusually complicated and lengthy procedure for comment on this matter suggests to some old hands familiar with bureaucratic obfuscation that a major effort has been afoot to slip this one through without general public notice. The Rubic’s cube kind of frustration begins with just logging onto the Website. First, a citizen wishing to comment must register as a new user. While not difficult, it is interesting that no name or address is required, suggesting that registration is only to complicate the process. And, after registration, the maze becomes more punishing. There are 65 separate sections upon which to comment, each of which involves reading proposed regulatory language that sometimes consumes many pages with detail. Responding to all these questions takes even experienced legislative analysts the better part of a weekend. For those who don’t have two or three days to study the proposal fully and muster appropriate responses to each of the 65 sections, there is a “general” comment section. Those who also may wish to comment to Congress should know that the House Commerce Committee has oversight of HHS regulatory issues and receives comments at www.house.gov/commerce. Of course, comments to congressmen and senators may be considered as well. Insight made repeated calls right up to the highest level of HHS to obtain a status report on the comments received to date. Not one of those calls was returned. Through the office of Rep. Ron Paul, a Texas Republican, this magazine learned that HHS claims to have received fewer than 2,000 responses on the Website, and only slightly more than 5,000 written comments. The agency would not say how many were in opposition to the sweeping new regulatory proposal. HHS Secretary Donna Shalala has the option to make the comments public, noting whether they facilitated changes in the regulations or not. The proposed regulations were made public on Nov. 3, 1999, and the comment period (60 days) has been extended several times, now scheduled to close on Feb. 17. While it may seem that this issue popped up out of nowhere, it has been advanced by the Clinton administration for nearly four years; many consider it a continuation of the failed 1993 Clinton Health Security Act on which first lady Hillary Rodham Clinton took the lead. The proposed regulations to turn your medical privacy over to the government are the result of the passage of the dictionary-length 1996 Health Insurance Portability and Accountability Act, or HIPAA. Although Congress tasked itself with writing legislation by August 1999 to protect medical privacy by codifying what insurance companies and health-care providers may and may not do with your records, it failed to meet its own deadline and by default turned over writing of the regulations to HHS Secretary Shalala. The Clinton administration publicly said the recommendations for national health-information “privacy” legislation “would guarantee patients new rights and protections against the misuse or disclosure of their health records.” Audrey Mullen, government-affairs counsel for Advocacy Inc., a Washington-based organization specializing in health and regulatory issues, tells Insight “the devil is in the details.” The details Mullen is speaking about are the alleged “protections,” including the “unique health identifier,” which is so controversial that regulations to assign every American a number have yet to be proposed. The HHS soon will propose some form of identification that will be provided to each American, following them from cradle to grave and tracking their medical histories. Thanks to Rep. Paul, the Social Security number, which many already see as a national identification scheme, has been taken out of the mix. Insiders say this has left five options, including such futuristic methods as biometric identifiers, directory service, personal immutable properties and public-key/private-key cryptography. Sue Blevins, president of the Institute for Health Freedom, a Washington-based nonprofit educational organization dedicated to defending the right of individuals to choose their health care without government intervention, tells Insight that “the privacy regulations are what is going to guide the unique health identifier.” Blevins explains that Congress already has “passed a one-year moratorium basically telling HHS that it can’t use any funds to set up the unique health identifier. But this is just a stopgap measure -- a jack-in-the-box issue that, when you least expect it, will pop its head up. And in order to stop it completely, Congress has to repeal that section of HIPAA. The regulators are stripping privacy, not protecting it. The way the regulations read, if everyone can collect information about your DNA without your consent, then they don’t need a ‘unique health identifier,’ they already have it.” According to Paul, who is also a physician, “the government manages and pays for medical care to an increasing number of people and Americans are sort of in the middle. One theory is that the consequence of having the government pay for the health care is that at some point they believe ... the American people will have to make a trade-off -- give something up for that benefit.” What the regulators have in mind to be surrendered is the medical privacy of every American. This is why Paul is concerned most about that “unique health identifier” and has introduced legislation, HR 220, which effectively would repeal this portion of the HIPAA legislation. However, according to Paul, “the identifier is already there. The difference now is that the records will be in the control of the government. We consider the repeal of the Social Security number a real victory, but what kind of a victory is it if another kind of identifier is going to be used?” He believes the push for slipping all of this through comes from “big insurance companies who are in bed with the government” and calls it a “fascist system having nothing to do with the quality of medical care. It comes from government rules and laws and it’s the government and insurance companies who will benefit from the information gathered on this massive data bank. These regulations not only strip individuals of any ability to determine for themselves how best to protect their medical privacy, they also create a privileged class of people with a federally guaranteed right to see an individual’s medical records without the individual’s consent.” Copyright © 1999 News World Communications, Inc. . <A HREF="http://www.ctrl.org/">www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are not allowed. Substance—not soap-boxing! These are sordid matters and 'conspiracy theory'—with its many half-truths, misdirections and outright frauds—is used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRL gives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. CTRL gives no credence to Holocaust denial and nazi's need not apply. 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