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Monday, September 26, 2011

Medical Privacy: Screwing the Patient

Laws like this make everyone's life better... right?
Medical privacy...  Something everyone thinks that they want and need.  Yet few understand just how problematic real medical privacy, for example as created by the HIPAA laws, can be.

The first problem most people will encounter is the magic of a "missing person" - and no, not the kind you find in your typical Hollywood drama.  My mom, a senior living in a 55 and over apartment sees this frequently.

Someone you're friends with falls ill and the ambulance takes them away to the hospital.  Before HIPAA you simply called up the hospital, and when friend was better or could talk or accept visitors, you were told to call or stop by.

Today no one is allowed this information. 

Often a person taken away from her apartment complex is simply never heard from again - unless a family member happens to stop by the apartment complex to collect their things. 


Because HIPAA makes it a crime to disclose all medical information - including information about whether or not you are even in a hospital.  Did so and so die?  Are they in the hospital?  (Often seniors are sent to nursing homes to recover from things like surgery - something also covered by HIPAA.)  So even if you physically go to the hospital yourself you cannot find people or what happened to them.

(You needn't worry about your DNA, however.  Law enforcement can still collect that because somehow its miraculously immune from HIPAA laws - even though its your personal medical data.  In fact, I wonder if law enforcement is required to follow HIPAA laws with DNA evidence???  I bet not...)

So rather than being able to call ill friends, to visit them, to do anything with them that might help their recovery friends are left wondering if you are still even alive.

If this were the worst of it, it might not be so bad, but it doesn't end here...

A little Googling and you will find articles like this describing ludicrous situations where people's "medical identity" is stolen for things like surgeries.  Cases where the hospital bills people for amputations which obviously have not been done.

But the insidious nature of HIPAA is not revealed until people try and correct these types of medical frauds.

First off, unlike the Fair Credit Reporting Act (FCRA) there is no equivalent Fair Medical Information Act.  The FCRA gives you the right to dispute any issues you may find on your credit report: inconsistencies, bad reports that are not your fault, and so on.  Not so for medical records.

For example, Joe Ryan (see the article link above), who had his medical identity stolen found that because his true signature did not match the phony one the medical information thief used to steal his identity he could not correct his medical data.


The first sign of something truly stupid, in this case a law, is that prevents it you, the person the law is trying to protect, from accessing or correcting your own information. 

The problem here is that HIPAA is not about you at all - its about big pharma and its access to you and your information.

Basically HIPAA is a set of "ground rules" that says "as long as you play by these rules you can do whatever you like."  No matter how asinine that might be.

The second sign of something truly stupid is that it makes everyone a criminal.

As you can see from this article "even talking in the elevator" about someone's protected medical data can be a crime.  So now nurse Suzy, who needs a quick "up or down" on whether some test result came in for you will have to wait around for a day or two until a formal, secret meeting can occur so that this information can be disclosed.  God knows Suzy doesn't want to go to jail so instead of quickly making a determination on what to do to treat you or your sick child she'll just wait a few extra days to do it the "right way."

Of course, in the mean time, you or your kid might just die.

Don't you want the medical professionals to talk about your case?  Maybe they could figure you what's wrong with you if they did...  But HIPAA discourages that by making even casual conversation a crime.

Even leaving a paper on a desk can break HIPAA laws - like opening your case file when you go to the window in the doctors office and the janitor happens by...

The third sign of something stupid is that it tries to replace common sense.

Common sense says that if you're a doctor and you treat little Johnny for VD (there's a term you don't hear much of anymore) you shouldn't go running around shouting to the roof tops that that's what little Johnny has.  Make's sense right?

Just like the body man who fixes Mrs. Smith's car once a month because she keeps having fender benders.  If he publicly ridicules Mrs. Smith for being a careless driver he'll lose her business.

Common sense says that privacy, a privilege to be enjoyed by everyone, should be preserved.  Common sense, however, also says that storing everything about your medical data in Fort Knox is going to make using it and accessing and fixing it expense, tedious, and slow.

I wonder how all this will be paid for?

When little Suzy comments on the elevator to Dr. Joe about Mrs. Smith's "case" and they both end up in jail because Mrs. Smith's husband's lawyer is on the same elevator -  who will pay?

Did you guess it will be you?

Soon medical malpractice will have to include clauses (if they don't already) for "disclosing HIPAA information."  And this will flow to auto insurance companies, pharmacies, hair dressers, and God knows who else...

Cha Ching!

And since nurse, aids, receptionists, janitors, etc. can all inadvertently touch this data under the guise of a "doctor's care" they'll all have to be covered...

Cha Ching!

An because, unlike, say, a botched boob job, where the consequences are at least documentable, how will anyone be able to guess the financial value of someone inadvertently disclosing that Mrs. Smith's boob job was botched in the first place.  More lawyers, more experts, more witnesses, etc.

Cha Ching!

Which leads us to the final sign of stupid: A law that creates negative consequences that far outweigh the initial value of the law in the first place.  In this case across the board cost increases for the benefit of lawyers, insurance companies, and so on that will do nothing for you but raise the cost of medical care without adding any real value beyond what common sense would have done in the first place.

In the olden days "theft" was "theft" - whatever you stole.  Today there is "medical identity theft."

But, as the name says, its still "theft."

Are we so stupid we need a law to distinguish between dog theft and cat theft?  Bird theft and boat theft?

Apparently so.

And apparently we also like to pay double or triple for the privilege...

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