No Rx for Privacy

Congress had an opportunity this year to set a national standard that would protect the privacy of medical records from snooping commercial eyes. Perversely, it is doing just the opposite. Like a midnight prowler, Rep. Greg Ganske (R-Iowa) tacked onto unrelated banking reform legislation an amendment that would allow health insurers to sell medical records to other insurers without the consent or even knowledge of the patients. Using this data, a car insurer, for example, could deny coverage or jack up premiums for any individual with high blood pressure.

That amendment, which shamefully remained intact through the House Rules Committee, chaired by Rep. David Dreier (R-San Dimas), should be soundly defeated when it reaches the House floor today .

The need to set a federal policy for safeguarding medical data was recognized by Congress in 1996 when it passed the Health Insurance Portability and Accountability Act. The law required Secretary of Health and Human Resources Donna E. Shalala to draw up privacy regulations if the Congress itself didn’t enact privacy laws by August. Shalala drafted well-thought guidelines for regulations that would allow the sharing of patients’ medical files by treating physicians and for medical research. It would guard against abuses by requiring that patients’ names be concealed.

Under the the Ganske bill, not a shred of those protections are left. Individuals would be allowed to ask for nondisclosure of their medical files to others--employers, banks or direct marketers--but medical insurers could deny coverage to anyone objecting to disclosure. Moreover, the law may well preempt stronger state medical privacy measures, such as those in California that protect the confidentiality of HIV test results.

It is bad enough that the medical privacy policy would be set by a rider to another, unrelated legislation without hearings or public debate of any kind. But the impact of such legislation is even worse. Health insurers could peddle patients’ privacy with little or no restraint, insurance policies could be denied based on incomplete or inaccurate medical records. The states may be preempted from enacting or enforcing their own medical privacy laws.

A large number of adults in California have admitted lying to their doctors or withholding information about their health for fear of being denied jobs or insurance coverage. With laws like Ganske’s amendment, that number is certain to rise. As a result, medical records will be less complete or simply wrong.

Ganske’s measure has raised a chorus of protest from physicians, psychiatrists and therapists, as well as the American Civil Liberties Union.

The House should not only defeat the amendment, but also refuse to consider making the confidentiality of medical records a mere adjunct to unrelated legislation. This issue deserves full deliberation at public hearings.

Legislators usually become angry and defensive when ulterior motives are ascribed to legislation. But if voters are to believe that this measure is unrelated to the fact that the insurance industry was the single largest soft-money donor to Republicans in 1997-98, then let Dreier and Ganske explain how this anti-consumer amendment benefits those voters.