Most Americans assume that the facts they tell their doctor are confidential and protected. In fact, medical records enjoy less legal protection than video rentals. And Congress has not acted to safeguard the confidential communications between doctors and patients. Instead, it has already laid the groundwork for the national database that would make our medical histories accessible to millions of unidentified users without our knowledge or consent.
The popular Kennedy-Kassebaum Health Insurance Portability and Accountability Act (HIPAA) added an eleventh hour provision that every American be assigned a national “health identification number.” This alarming measure received no public debate, no hearings and little scrutiny. This section of the law is a ticking time bomb.
Our patient’s medical records deposited in a national database without our consent nor our patient’s consent would make it available to anyone with access. Although just a few hundred thousand initially, the secondary access is well into the millions. Suppose you have discussed mental illness, impotence, incontinence, cancer or even genetic testing, you may never obtain insurance again or even get a job.
In fact, a University of Illinois study of Fortune 500 companies disclosed that one-half already admitted to using medical records in employment decisions. A Maryland banker who had access to the state health commission computer, pulled up a list of every person who had cancer in his area and checked it against the names of customers at his bank. He then called in the mortgages of all the cancer patients. He was not even punished. A women with a genetic predisposition to breast cancer was denied insurance coverage for treatment because it was labeled a “pre-existing condition.”
Our profession must resist every effort at making our patients’ records an open book. While we should facilitate their use for medical treatment decisions, they should not be used for financial, employment or political gain.