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11 responses total.

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.

  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. 
  

#1 slipped in. 

This response has been erased.

It is an interesting area, if only because medical records seem to be one of
few areas, if not the only one, in which it seems really clear to most 
people that privacy is important and should be protected by law.  

Posting inaccurate information can be useful if it prompts
other people to post accurate information.

If medical records can be released, it's only a matter of time until
commercial interests figure out how to deluge you with offers for that
expensive new medication your doctor just prescribed for you.

Heh.  I think it's pretty much consensus that what is posted in most of #0
is rather absurd.  I don't want privacy compromised, either, but it's
embarassing reading the kind of slippery-slope alarmism that is so common in
that kind of opinion.  A lot of the potential worst-case scenarios listed are
already banned by other laws, so it wouldn't be a problem.

Re #8:  Don't be assured by those privacy laws.  State privacy
laws *and* previous Federal privacy laws are all overridden by
new Federal law.  Even state constitutions are overridden.

I wasn't talking about privacy laws.

Re #9:  Not always.  It depends on what the law says.  Some HIPAA-related
        regulations explictly leave more restrictive state laws in place.

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