Nearly every physician practicing in the United States has sworn to uphold the 2,000-year-old Hippocratic Oath. Among other provisions, a physician taking the oath makes the following pledge:
"I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know."
However, in the last five years, the administration of President George W. Bush systematically undermined the privacy requirements of the Hippocratic Oath, and other legal and customary measures protecting medical privacy.
It wasn’t supposed to be this way. In 1996, Congress enacted what was purported to be an omnibus medical privacy statute, the Health Insurance Portability and Accountability Act (HIPPA).
In 2001, the Department of Health and Human Services (HHS) issued preliminary regulations under HIPPA requiring patient consent for third party use of "protected health information," including its use for such common activities as treatment, billing and "other healthcare operations."
In 2002, however, HHS inexplicably substituted the words "regulatory permission" for "patient consent." This tiny change in the wording of the regulations opened the floodgates for the disclosure of previously confidential health information without a patient’s consent.
As a result, according to the Privacy Rights Foundation, some 800,000 companies, government agencies and other organizations can tap into personal medical information almost at will. And they’re not required to tell you what they do with it.
Today, your medical information can be given to any "covered entity," including business affiliates of health care organizations such as data clearinghouses, accounting firms, law firms, credit bureaus, and banks. What’s more, a federal rule that went into effect in 2006 allows creditors to obtain or use medical information for determining credit-worthiness. Credit-grantors aren’t supposed to use medical data in determining eligibility for a loan or in setting loan terms. However, credit-grantors who have such information can share it with their "affiliates." This magically converts the data into credit information, not medical data.
Another result of this proliferation of medical data is an epidemic in medical identity theft. "An insurance card is like a Visa card with a US$1 million spending limit, says Byron Hollis, national antifraud director of the Blue Cross and Blue Shield Association. Research conducted by the World Privacy Forum suggests that through mid-2006, between 250,000 and 500,000 Americans had already been victims of medical identity theft. The results can also be deadly: One woman found that her blood type had been changed in the hospital record.
What can you do to take back your right to medical privacy? The simplest suggestion is find a physician that has "opted out" of HIPPA’s requirements for electronic transmission of insurance claims.
To qualify for this status, your physician must:
* Not transmit "protected health information" outside the physician’s office.
* Not file via electronic transmittal, or engage a billing service or clearinghouse to file claims on the physician’s behalf—including private and Medicare claims.
* Not volunteered to become a "covered entity" by contract or certification.
If your physician hasn’t opted out of HIPPA—and unfortunately, the overwhelming majority haven’t—there’s another solution. Ask your physician for all copies of your medical records, including the originals. Keep these records in a safe place, and bring them with you when you have an appointment.
There’s a third privacy option as well, but it’s risky: to obtain medical treatment in a fake name, and pay cash only to the treating physician or hospital. It’s risky because if you need a prescription, and are asked for ID (as may be required for some medications, particularly those that are frequently abused), you might not be able to pick it up.
Finally, you can opt for private treatment in another country. Mexico is a popular choice for lower-cost –and private–medical services.
Ridiculous? You bet. But if you value your medical privacy, these options are the only way to keep it, thanks to the Bush administration’s deliberate corruption of the HIPPA rules.
Copyright © 2007 by Mark Nestmann
