Medical Records, The Need To Avoid Misuse
By Paul M. Weyrich (06/29/07)
One of the great concerns among the medical community today is the lack of a comprehensive national database of medical records that would allow health insurance companies and physicians access to the medical histories of consumers and patients. There is particular concern about people who change healthcare plans or physicians frequently because their records are not available automatically to their new insurers and healthcare providers. The same apprehension applies to emergency-room physicians, who often do not have access to the medical histories of those they treat.
I have heard people in the medical profession contrast their business with the financial industry, in which most records are electronic and easily accessible. This is a false analogy. Individual financial institutions certainly retain electronic files that contain their customers’ information and can be accessed at any branch across the country. The difference is this—these are private financial institutions that maintain only their own records, not those of other financial institutions. There is no national database that contains all of our financial information. Nor are the records of all financial institutions across the country linked. If the government wishes to gain access to a person’s financial records, it must obtain either the person’s permission or, in the case of criminal misconduct, a judicial search warrant.
Vocal supporters of a national medical database have made progress on the issue in Congress recently. On May 23, Senator Sheldon Whitehouse (D-RI) introduced Senate Bill 1455, the National Health Information Technology and Privacy Advancement Act of 2007. The bill would create a private non-profit corporation, subject to federal regulation, to develop and administer a national health information system. It would require the Secretary of Health and Human Services to review both the development and operation of the system and to supervise the relationship between the non-profit and state, local or private entities.
The problem is that it would allow the United States Government to enter into a contract with the non-profit to use the information on the system. It also would allow “non-identifiable” healthcare data to be used for “public health and research purposes.” It is true that the system would have to adhere to current federal privacy laws. The bill would also create a “chief privacy officer” to ensure the technology used would sustain, not erode, the confidentiality and security of patient medical records and to evaluate legislative proposals involving the collection and use of this personal information by the Federal Government.
In spite of these precautions, I remain skeptical for three reasons. First, the language of the bill is too ambiguous to adequately protect such important information. Second, the Government has a poor track record on this issue. In the past several years, numerous computers and files containing veterans’ medical information have been lost or stolen from the Department of Veterans Affairs and other government agencies have had similar problems. On May 16, THE WASHINGTON POST addressed a new report by the Government Accountability Office that noted how the Department of Homeland Security is breaking federal privacy laws by failing to inform the public of the ways it uses personal information to target passengers, including United States citizens, who are flying into or out of the United States. European officials, who are re-negotiating an agreement with the Federal Government to share air passenger data, have expressed concern that the U.S. Government has not adequately protected such information, which includes the name, address, travel history and credit card numbers of passengers. It has been difficult to determine whether or not travelers have been harmed by the screening program because government officials refuse to acknowledge the exact uses and data sources of the program.
Finally, I firmly believe that it is not in the best interests of our liberty to surrender this private information to the government so casually. There is no compelling reason why the Federal Government, or any other government for that matter, should have easy access to a comprehensive medical database. Medical information, like financial information, is highly personal, and in the wrong hands it could be used to manipulate and limit individuals and our freedoms. It could also be used, in a worst-case scenario, to blackmail or punish people. This was not the intent of the original powers of the Federal Government. Nor was such a database within the scope of those powers.
The principle of our Constitution and Bill of Rights was to limit the power of the government, which has a tendency to over-reach and involve itself in the daily minutiae of citizens’ lives, particularly in a highly developed bureaucratic state. While it remains to be seen whether strictly private companies could establish limited medical databases to facilitate patient coverage for physicians, much as insurers currently keep their own records, I believe it is wiser to err on the side of caution in this case than to willingly turn over our private medical histories to the government for safe-keeping. To willingly give the government access to our vital records flies in the face of our experience with and inherited knowledge of government and power.
Paul M. Weyrich
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