Patient Privacy May Have Been Lost in Policies of Health-Care Industry -

Article excerpt

WHAT KIND OF privacy can we have in the changing American health care system?

True, there have always been a few gossipy clerks, pharmacists, even the occasional nurse or doctor. But what was once thought of as a professional lapse - breach of confidentiality - is more and more a matter of policy.

Take, for example, the health insurance bill sponsored by Sens. Nancy L. Kassebaum, R-Kan., and Edward M. Kennedy, D-Mass., that Congress just passed. It is intended to help workers keep their insurance when they change jobs and to stop insurance companies from excluding from coverage those with earlier sicknesses - or "pre-existing conditions."

But privacy advocates say it's also a threat to confidentiality. It sets up the first nationwide computer network to store information about patients and to allow the information to be exchanged freely among doctors, hospitals, researchers and insurance companies. The computerized record system will cut down on paperwork, lower costs, give doctors quick information on how to treat the unconscious emergency patient or traveler, let researchers spot early signs of epidemics and track trends in illnesses or their treatment.

Most of the health care industry is required to contribute files, The Washington Post reports. As patients, we don't have to consent to our files going on the network or to researchers using information about us, though we're supposed to have no-name "identifiers," like our Social Security numbers, so the researchers don't know us personally.

Many doctors and some members of Congress are unhappy about that. Several lawmakers have introduced "privacy" legislation. But the reality is that we already have considerably less health privacy than we imagine - and perhaps not much right to it.

Prescriptions, diagnoses and treatment schedules are routinely passed along to many employers these days as part of the effort to control health care costs.

In a Pennsylvania case, for example, a federal court recently ruled that an employee's privacy rights were not violated when his employer found out that he had HIV through checking why he was taking certain medications paid for by his company insurance. The company had a right to know what it was paying for, and the benefits department staff and others w ith a "need to know" only talked about it among themselves, the court said. …