Privacy a thing of Past

Pasta-damn! I'd sue the bastards too.

Spread of Records Stirs Patient Fears Of Privacy Erosion - WSJ.com After her fiancé died suddenly, Patricia Galvin left New York for San Francisco in 1996 and took a job as a tax lawyer for a large law firm. A few years later, she began confiding to a psychologist at Stanford Hospital & Clinics about her relationships with family, friends and co-workers.

Then, in 2001, she was rear-ended at a red light. When she later sought disability benefits for chronic back pain, her insurer turned her down, citing information contained in her psychologist's notes. The notes, her insurer maintained, showed she wasn't too injured to work.

Ms. Galvin, 51 years old, was appalled. It wasn't just that she believed her insurer misinterpreted the notes. Her therapist, she says, had assured her the records from her sessions would remain confidential.

As the health-care industry embraces electronic record-keeping, millions of pages of old documents are being scanned into computers across the country. The goal is to make patient records more complete and readily available for diagnosis, treatment and claims-payment purposes. But the move has kindled patient concern about who might gain access to sensitive medical files -- data that now can be transmitted with the click of a computer mouse.

I guess the solution is to avoid the U.S. healthcare industry, including therapists. Or don't be honest and open about anything with any medical personnel.

Patients tend to be especially sensitive about medical information they believe could stigmatize them in the workplace or among acquaintances, such as records about AIDS, substance abuse and abortion. “What's sensitive to one person may not be to another,” says Deborah Peel, an Austin, Texas, psychiatrist and head of Patient Privacy Rights, a medical-privacy advocacy group. “How many women want somebody to know whether they are or are not on birth control?”

Mental-health records are generally viewed as worthy of the most stringent safeguards. In recent years, courts and state legislatures have afforded psychotherapy records special protections. All 50 states recognize some form of psychotherapist-patient privilege to limit disclosures in legal proceedings, and a similar federal privilege was established in a landmark 1996 Supreme Court ruling.

Because Ms. Galvin learned of the disclosure and filed a lawsuit, unusual in such cases, her experience offers a look at how increasingly complex confidentiality issues are affecting patients and their insurance coverage.

and of course, the lure of selling information for a profit wins out over any old fashioned ideas about confidentiality:

HIPAA's principal goal was to ensure that people could change jobs without losing insurance coverage for pre-existing medical conditions. When employers and insurers complained about the added cost, the federal government pledged to make it easier for medical providers, insurers and others to swap medical information electronically, potentially saving as much as $30 billion over a decade.

To assuage concerns of privacy advocates, Congress authorized the Department of Health and Human Services to draft privacy regulations. The final rules allow health insurers and medical providers -- including doctors, pharmacies and hospitals -- to disclose medical information for “treatment, payment and health-care operations,” among other situations, without specific patient permission. But they aren't supposed to send any more records than necessary for nontreatment purposes.

Dawn Ross, a 37-year-old Los Angeles hairstylist, says she was startled to discover how much a bill collector knew about her. Federal rules permit the release of medical records in connection with “payment.” Soon after Ms. Ross returned home from an uninsured hospital stay, the hospital's collection agency began dunning her for $8,600. When she disputed the bill, she learned that the agency had detailed records about her miscarriage and the treatment she received for it.

The rules also do not require patient permission for the release of records for “health-care operations,” a broadly defined category that includes some marketing, data warehouses and fund-raisers. John Metz, chairman of JustHealth, a consumer health-care advocacy group in California, says he has encountered patients who were diagnosed with borderline diabetes -- then inundated with marketing materials for diabetes services and supplies from their medical providers.

Tags: health, /privacy