Health privacy may be at risk, experts fear Clinton plan seeks use of computers

November 04, 1993|By Knight-Ridder Newspapers

WASHINGTON -- At a crucial point in the hit film "The Fugitive," Harrison Ford slips into a hospital records room and prowls through patients' files, hoping to identify the villain.

Movie-goers cheer Mr. Ford's derring-do, but they might not be happy to know that such breaches of privacy happen in real life, too.

Privacy experts worry that the risks could increase as most Americans' medical records are transferred to computers, a shift that would be compulsory under President Clinton's health care reform plan.

The danger comes less from snoopy outsiders, they say, than from authorized users mining these mountains of personal data for selfish or inappropriate ends.

For example, a few years ago, a Midwestern banker who served on a state health commission, checked the names of his bank's borrowers against the commission's list of cancer patients, looking for bad risks, according to a report from the American Hospital Association to the Department of Health and Human Services.

When medical records are stored on computers, "information about an individual's health status could be linked, without the individual's consent, to financial records, military records or other records," the AHA report said. "The information created could then be used to the individual's harm."

White House officials believe computerization of medical records is essential to control costs, increase efficiency and ensure quality. They also contend that modern computer technology, such as encryption, makes it possible to protect secrets better than when they are scattered in paper files.

The reform bill the president sent Congress would set up a "Health Information System," a vast electronic web zipping hundreds of millions of individual patient records into permanent data banks.

Experts warn that violations of privacy are bound to occur under the proposed system, and that could cause a public revolt against health care reform.

"This is a time bomb waiting to go off," said Professor Alan Westin of Columbia University, a leading authority on privacy issues. "The American public is not in a trusting mood on this issue."

The White House and Congress are trying to respond to the concerns by drafting legislation that would create the first national privacy protection law specifically aimed at the medical records of patients. The law would take effect in 1997.

Few people realize that there now are no federal laws protecting health records.

Among other things, the Clinton bill would forbid employers to use health information collected under the new system to make decisions on hiring or promoting people. Likewise, insurance companies could not use the data to set premium rates.

These practices are common today.

For example, Dr. Donald Lewers, a kidney specialist in Easton, Md., said a patient of his complained last month that her health insurance company raised her premium on the grounds that she was "psychologically unstable." The reason, Dr. Lewers said indignantly, was that the woman had gone through a period of grief after her mother died.

The draft legislation also would require hospitals and druggists to get patients' written consent before they could peddle information about them to commercial marketers -- another frequent practice.

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