md
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response 1 of 11:
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Apr 16 16:42 UTC 2002 |
I agree that your medical records shouldn't be shared without your
consent, except maybe in certain emergencies. But there's a lot of
nonsense in #0.
The author implies that paying for treatment out of pocket somehow
guarantees that your records aren't shared with anyone. I assume that
would be because if you pay your doctor out of pocket he won't have to
send any information to an insurance company. But so what?
In the first place, even if treatment records *are* sent to an
insurance company for claim purposes, it ends there. They won't send
copies to, for example, your employer. In most cases, they won't do it
even if you tell them to. They won't even send *you* copies. They
might share your records with another insurance company if you
authorize it for some purpose they deem acceptable (an application for
insurance, or a claim), but that's about all. They had to pay your
doctor a lot of money for those records, and now you want them to spend
even more money on the employee-hours and system use needed to make
copies for someone else? It doesn't work that way.
In the second place, whether you pay the bill yourself or submit an
insurance claim, the fact is that as long as the information is there
in your doctor's file, it can be shared. For example, if you sign an
authorization form in connection with an application for life
insurance, the life insurance company can request copies of medical
records from every health care provider and facility you name on your
application. Your doctor will send them copies of his entire file,
including the treatment you paid for out of pocket because you "didn't
want anyone to find out about it." So much for privacy. You can
always get around this, of course, by not disclosing the "problem
doctor's" name on you application. Then all you have to do is hope
that your problem doctor's name doesn't appear in the records of any
doctor or facility you do name on your application, like, for example,
anyone you might have mentioned his name to, anyone he referred you to,
or anyone who referred you to him. Assuming you get past that one,
which you won't, you also have to stop seeing the problem doctor
forever, and you have to remember never ever to mention his name again
to anyone. There is a remote chance you can get away with something
like this -- I've actually seen it done once or twice -- but don't
count on it. And here's the great part: if the insurance company
catches you withholding material information from them (i.e., something
serious that would've changed their decision to issue a policy to you
if they'd known about it), they can sue you for fraud. They'll get
your policy back, they'll never have to honor any claim of yours, and
that's after they drag you through the courts for three years.
The author asks, "Who will get genetic testing if the results are used
to cancel life insurance policies, and who will take medications that
later disqualify them from attending law school, flight school or
entering the military?" Isn't the hidden assumption here that people
are able to conceal important medical histories from law schools,
flight schools and the military, and that people in fact routinely do
so? Admittedly, a law school probably doesn't need to know that a
student is taking medication for a heart condition, and probably
couldn't legally refuse to admit the student even if it did know. But
*pilot* school? The military?? You've got to be kidding. There are
good reasons for demanding privacy and the individual's right to
consent, but not being able to get a pilot's license because the FAA
might find out about your bum ticker isn't one of them.
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flem
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response 2 of 11:
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Apr 16 16:49 UTC 2002 |
Boy, *that's* a little over the top.
The patient privacy requirements in HIPAA are quite strict. Much more
so than any previous legislation that I'm aware of, and, if the piles
of healthcare business magazines lying in our office bathrooms aren't
lying, rather stricter than the current non-legislated policies most
hospitals have now. Weakening HIPAA's requirements by allowing an
exception for regulatory permission to release patient records is
not exactly going to send us tumbling into some kind of Big Brother
corporate police state.
This is not to say that I support the change alluded to, just that from
my only modestly informed viewpoint, #0 is way, way overstating the case.
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