Jewish World Review Oct. 26, 2001 / 9 Mar-Cheshvan, 5762

Drs. Michael A.Glueck & Robert J. Cihak

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Consumer Reports


Your right to medical privacy --- even in terror time


http://www.jewishworldreview.com -- CIVILIZATION is a tricky affair. It depends on two opposite conditions. One is our ability to live and work together, especially under conditions of common danger and stress. The other is our ability to get some distance from each other. Physical space is good; we all need our personal bubbles. But even more important is a certain kind of legal space known as privacy.

It might seem strange to be preaching privacy nowadays. But our subject here is more restricted. It's medical privacy, i.e., your right to an honest relationship with a physician who's neither obliged nor likely to divulge your secrets. Unless you're totally honest with your physician, he or she can't treat you properly.

But the government is planning to destroy your right to medical privacy, as always under the mantra of It's for Your Own Good and perhaps as part of the accelerating defense against terrorism.

Remember the failed Clinton health plan which would have required everyone in the country to have their own ID number so that medical records could be traced anywhere by computer? It's back from the dead, incorporated in HIPAA, the 1996 Health Insurance Portability and Accountability Act.

If and when the relevant parts of HIPAA are enforced, your private medical records will become federal government property. It could happen tomorrow.

Fortunately, Representative Ron Paul, (R-TX), a physician, has spearheaded laws that prevent funding the snoops. Rep. Paul has twice introduced bills to that effect. He has now introduced H.R.2615 - The Patient Privacy Protection Act - to repeal these odious provisos. If Paul's measure becomes law, bureaucrats can't assign each of us an ID number. Government officials then couldn't track the medications and treatments you take, what lifestyle choices you make, what genetic factors you have inherited, or use this information to your social, political, economic, or medical disadvantage.

If you don't want government agents browsing in your personal medical records, contact your representative. Ask him or her to sign on as a co-sponsor for the bill. Ask your senator to introduce parallel legislation in the Senate.

But what of the "potential benefits" to a national medical ID and data base? These come in two forms -- neither really worth the cost in tax dollars or the perils to privacy.

First, according to a September 21, 2001 "Wall Street Journal" article, some contend "that electronic health records could improve peoples' chances of surviving in emergencies." In an emergency, doctors can indeed treat you better if they're aware of significant "medical conditions or drug allergies." But this relatively small amount of information is probably more reliably available if you carry it on a metal bracelet or in a note on your person. In the near future, you will likely have the option of carrying such information on a credit card sized piece of plastic. If you're knocked out in an accident and this information is also destroyed, emergency physicians are trained to do the best possible with limited information.

Second, there's a curious trend known as "evidence-based medicine" - as though the practice of medicine weren't "evidence-based" before somebody made up this particular politically correct bit of nonsense. In essence, this holds that the more information you have about what's going on medically in the country, the better you can treat people. Obviously, in some ways this is true. But it also leads to a "one-size-fits-all" approach to diagnosis and treatment . . . and to payment for treatment. People are different. What works in one case may not work in another, regardless of what the computer says.

And then there's the matter of computers. In an emergency, especially a mass emergency, there's no guarantee that the thing will be available. Not to mention the problems associated with hackers.

Nor do the American people want such a system. A recent Gallup Poll showed 91 percent of Americans opposed. More ominously, an August 13, 2001 "U.S. News and World Report" physician survey revealed seven out of eight doctors were ALREADY being asked by patients to exclude data from their records. You don't have to be a futurist to realize what would happen to the doctor-patient relationship, were the government to get its ID cards and data bases.

As physicians, this snoop doggy dog of a bill gives us -- and should give 300,000,000 patients -- the chills.



Michael Arnold Glueck, M.D., of Newport Beach, Calif., writes on medical, legal, disability and mental health reform. Robert J. Cihak, M.D., of Aberdeen, Wash., is president of the Association of American Physicians and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists who write numerous commentaries and articles for newspapers, newsletters, magazines and journals nationally and internationally. Comment by clicking here.

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© 2001, Michael A. Glueck & Robert J. Cihak