Health-Care Debate Stirs Privacy Fears Clinton's Plan Would Use Computer Links

Article excerpt

NYDIA VELAZQUEZ knows firsthand about the pain of unauthorized disclosure of medical records.

Someone leaked her personal medical file, showing that she had attempted suicide in 1991, to the New York news media during Velazquez's successful run for Congress last year.

Velazquez, D-Brooklyn, still doesn't know how the records were obtained, and the case remains under investigation.

While privacy cases involving politicians can raise other issues - including the public's right to know about a potentially debilitating illness of a national leader - the unauthorized disclosure of medical records of ordinary citizens also has been a growing concern.

"People often don't even know that their privacy is being violated," said Janlori Goldman, director of the American Civil Liberties Union's privacy and technology project.

It is not uncommon for insurers and employers to share health data on workers without their knowledge, Goldman said, although there is little information on how often such unauthorized disclosure occurs. Patients should be able to tell their doctors deeply personal information about their physical or mental well being, experts say, without fear that the details will be made available to employers, insurers or others.

Some disclosures are allowed - as when emergency room doctors alert police about gunshot wounds or public agencies about possible cases of child abuse. Researchers doing medical studies also may get access to patients' files after the records have been "blinded" to remove names and other identifying data.

But a growing uneasiness about the privacy of medical records has become part of the national debate over health care. The health plan proposed by President Bill CLinton would rely on extensive use of electronic data banks to simplify medical record keeping and make it easier to monitor the performance of doctors and other health-care providers. The plan also calls for a "health security card" that all Americans would carry to verify eligibility for benefits. …