Editorial: Privacy bewilders lawmakers

When Congress left for its August recess it failed to meet its self-imposed deadline of Aug. 21 to pass legislation to ensure that a patient's medical records are kept confidential. A 1996 federal law set the deadline and mandated that if Congress failed to act it would be up to the U.S. Department of Health and Human Services to write privacy regulations instead. The problem with allowing federal regulators to do this, though, is that by law they are only allowed to write rules governing electronic records -- they cannot address the privacy of paper files. Although it missed the deadline, Congress has a chance to redeem itself and create privacy legislation when it reconvenes in September since the regulations aren't expected to be ready until February.

A Washington Post story on Monday illuminated the need for Congress to tackle the issue and cited some privacy abuses, such as patients unknowingly having their medical information shared with others. For instance, Ronnie Tompkins, a long-distance driver for a trucking firm in Atlanta, was fired in December 1997 even though he had a clean driving record. So what did Tompkins do? He checked in briefly at a drug treatment clinic, saying he felt depressed and was drinking too much when he was not working. While the insurance company refused to pay for his treatment, it went ahead and notified his employer, who believed it was unsafe to let him drive. Most patients believe that when they enter a doctor's office what is divulged to the physician won't leave the room. But as Tompkins found out, in today's world of managed care, insurers too often compromise any shred that is left of physician-patient confidentiality.

A survey of 1,000 Americans conducted earlier this year for the California HealthCare Foundation, a philanthropic group, found that 60 percent trust their health care provider to keep their personal information confidential. But there was a strong distrust of health insurers to do the same, with only 35 percent saying they trusted health plans to keep their records confidential. In addition, 15 percent of Americans say they have taken extraordinary steps to ensure that their medical information stays private. Some even have jeopardized the care they receive, going to the extreme of giving their doctors wrong information about their medical history out of fear that somehow the information would get into the wrong hands.

Considering how much sensitive information is now easily accessed through computers, it is essential that Congress take action to preserve the privacy of medical records. As advocates of privacy protection legislation note, more protections exist for video rentals than for medical records. Congress has a lot on its plate when it returns in September -- a patient's bill of rights, campaign finance reform, tax cuts and the federal budget -- but it shouldn't overlook this important issue. Congress should guarantee that medical records aren't shared outside a physician's office unless the patient gives his permission.

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