Medical privacy rule changes: Public comments due April 26.

The Bush Administration has proposed significant changes in the Clinton Administration's rules on medical privacy. The proposed rule is open for public comment for a short period of 30 days.

The Washington Post summarized the changes as follows: "The proposal would alter the requirement, put in place by the Clinton administration, that patients give their written permission before their medical records may be disclosed to doctors, hospitals, pharmacies and insurance companies. In the new requirements, those who use their records must at some point notify patients of their privacy rights." ("Medical Privacy Changes Proposed; Bush Plan Would Lessen Patients' Say on Records," by Amy Goldstein, Washington Post, March 22, 2002). The long version of the proposed changes -- 40 pages of small print in the Federal Register -- is available through the link below.

A government's site, favoring the changes, is: http://www.hhs.gov/ocr/hipaa/

Arguments pro and con can be found in the Washington Post reference above, and in The New York Times, "Bush Acts to Drop Core Privacy Rule on Medical Data," also March 22, 2002.

Comment

We have not had time to fully analyze the changes and do not intend to submit comments. But we want our readers to know about the option.

We have mixed feelings about opposing the changes, because we fear that in practice, the right to give consent before one's medical records are used will be theoretical, not real. We fear that in reality, patients will just have more paperwork thrust at them to read and sign before they can get treatment at all, from any facility. Since most people who have sought medical care do not have a good option to just walk out and abandon the quest, this is not a real choice.

The basic concern motivating opposition to the Bush Administration proposal -- how can personal sovereignty be maintained in a world of huge institutions that seldom respect people -- is one of the central issues of our time. But creating formal rights that are not practical to use could discredit this quest and do more harm than good. We need to find other ways to proceed.