'Big Brother' wants your medical filesHats off to Jennifer...

LETTERS

July 30, 1996

'Big Brother' wants your medical files

Hats off to Jennifer Katze, chair of the Maryland Psychiatric Society Privacy Committee and the Maryland Health Care Access and Cost Commission Consent Committee. Her clear, factual and well-written opinion Perspective article (July 14, "Who's seeing your files?") should be a wake-up call telling too-trusting Marylanders that ''Big Brother'' is collecting their medical records without their knowledge or consent.

Not only have insurance companies, Medicare and Medicaid been submitting patient data to the state since HCACC began operating in 1994, but we now discover that Maryland's hospitals have been submitting even more comprehensive patient discharge information to another state entity (the Health Service Cost Review Commission) -- also with minimal public awareness -- since 1980. It also turns out that insurance companies are routinely exchanging information that their subscribers had been assured would be kept confidential except as necessary for claims processing.

As a liberty-loving American, I am appalled by the extent to which such practices have already eroded individual privacy and freedom. As a practicing psychologist, I believe that, ethically, I must support the right of patients to control access to their health records -- even when (perhaps, especially when) it is the state that demands them.

There is no issue here of overriding public good that might justify the curtailment of individuals' privacy rights. The state could as easily accomplish its research and cost-containment goals without intruding on privacy, simply by collecting the data in summarized or ''aggregate'' rather than individualized form.

There is just no excuse for subordinating patients' confidentiality rights to state or insurance company agendas.

Patricia Cummings

Gaithersburg

Raising driving age may be wrong answer

The argument of Morris Chafetz, president of the Health Education Foundation, that both the legal driving and drinking age should be 18 is based on assumption, not supportable data.

Mr. Chafetz tells us (July 22, "Adulthood at 18 -- not 16") that the American Journal of Public Health reports that raising the driving age to 18 will reduce the teen-age accident rate by 65 percent. He asserts that, ''Fatality rates dramatically decrease once young drivers reach 18, as maturity and judgment come to the fore.''

How do we know these assumptions as facts? Maybe the accident rates decline at age 18 because of two years of experience behind the wheel. Now, add to the equation the legal access to alcohol. So now you have 18-year-olds with no driving experience at legal drinking age? My assumption is that we will see the accident rate rise, dramatically.

I believe that any society should help its young mature slowly, increasing their responsibility as they learn. Is learning to drive at 16 safe? Probably just as safe as learning at 18. Probably safer than learning at 80. Young people tend to learn quickly and have amazing reaction times.

Is 18 the right age to allow a teen-ager to sign a legal document or open a checking account? For some, it is; for others, not. Of course, there are many people over 18 who have problems with managing money. Is granting a teen-ager the legal right to purchase and consume an addictive drug helping that young adult mature? I think not.

So how do we, as a society, decide ''how old is old enough?'' Why don't we start by looking at some hard numbers on alcohol-related accidents.

Patricia Perry

Owings Mills

Birth rate drives school enrollment

I am responding to Robert Sellers' letter (July 22) blaming school overcrowding on building and development. I have sitting on my desk a copy of Baltimore County's school enrollment figures since 1972.

In 1972, enrollment was 132,016. That number steadily declined to a low of 80,630 in 1986 and has slowly crept up since then to over 90,000 today. School officials do project about 4,000 new students over the next year.

The period of decline in students was during the time of enormous building in Baltimore County, when permits exceeded 10,000 annually in some years. At the same time, the county closed schools due to lack of students.

Demographics and birth rate drive county school enrollment. Check the number of births today and you will be able to predict how many students will be available to enter elementary school in six years.

The decline in birth rate was no one's fault. Were citizens outraged when we lost students and had to close schools?

Birth rate is the only absolute predictor of citizens. People simply live where they want to and will choose schools with the best reputations when they can.

Some schools are over-crowded, others are under capacity. Solutions have to do with the quality of education at all schools and carefully analyzing birth rates in addition to building and housing pattern.

Terry M. Rubenstein

Towson

The writer, a developer, formerly chaired the Baltimore County Chamber of Commerce.

Nutrients don't need prescription

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