Multinational Monitor

MAY 2001
VOL 22 No. 5


Rollback: The Corporate Regulatory Feeding Frenzy
Foreward by
Monitor Staff

Bush's Corporate Cabinet
by Charlie Cray

The Repetitive Motion Un-Rule
by Deborah Weinstock

Arsenic and Old Regs
by Lynn Thorp

The Roadless Tramelled
by Ned Daly

Bankrupt Policies
by Jake Lewis

Bush’s Hot Air
by Phil Radford

Mining Their Own Business
by Charlie Cray

Defending Contractor Irresponsibility
by Robert Weissman

A Regulatory Accident in the Making
by Charlie Cray

Cheney and Halliburton: Go Where the Oil Is
by Kenny Bruno
and Jim Vallette


The Politics and Law of Worker Rights
an interview with
William Gould


Behind the Lines

Challenging the Oiligarchy

The Front
Medical Privacy, For Now

The Lawrence Summers Memorial Award

Names In the News


The Front

Medical Privacy, For Now

Medical privacy regulations issued in December by the U.S. Department of Health and Human Services (HHS) and greeted as a milestone by health privacy advocates may soon be reworked by the Bush administration.

The Health Insurance Portability and Accountability Act (HIPAA), passed by a Republican Congress in 1996, set in motion the process that led to the new privacy protections.

HIPAA gave Congress three years to pass comprehensive medical privacy regulations. After Congress failed to meet the deadline, HHS stepped in as required by HIPAA to fill the void.

HHS’s final regulations, which took effect in mid-April, are the first and only federal rules to protect the privacy of medical information kept by private health care providers and HMOs. The regulations would give patients increased control over the use and disclosure of their personal health information and give them important new rights such as the right to see, copy and amend their medical records.

Despite an aggressive campaign by some in the health care industry to delay the effective date of the regulations, HHS allowed the regulations to go into effect on April 14, 2001. Key players in the delay campaign included the American Hospital Association, Blue Cross and Blue Shield Association and the Healthcare Leadership Council, a coalition of chief executives of leading hospitals, health plans, medical device manufacturers, drug companies and pharmaceutical chains.
Now that the regulations have taken effect, industry groups are urging they be revised and the timetable for compliance be extended.

These regulations “will set back protections for patients and consumers,” says Mary Grealy, Healthcare Leadership Council president, and will “have a significant real world impact in the doctor’s office, in the hospital ward and at the pharmacy counter.”
Industry opponents complain about multiple elements of the final rule, including the requirement that health care providers obtain a patient’s written consent before using and disclosing protected health information, the requirement that plans and providers only use or disclose the minimum amount of information that is necessary to accomplish the purpose of the use or disclosure (Grealy says such provisions are “unworkable, unnecessary and, in a hospital setting, potentially harmful to patients”), and the circumstances under which providers and plans are allowed to disclose information to third-party “business associates” (e.g. claims processors) acting on behalf of the plan or provider.

Supporters say most of the industry complaints about the regulations are based on distortions and exaggerations. For example, Blue Cross/Blue Shield representatives have asserted that the regulations will “jeopardize the quality and timeliness of patient care.” Supporters of the rules say that it is the current lack of privacy that drives a wedge between patients and their providers and impedes the provision of quality health care, as privacy concerns lead patients to withhold information, avoid asking certain questions or fail to seek care altogether. Privacy advocates say people withdraw from full participation in their own health care because they are afraid sensitive health records will fall into the wrong hands, leading to discrimination, lost benefits, stigma and unwanted exposure.

Not all health-related entities share the goal of weakening the regulations. Many on-the-ground health care managers and professionals support the regulation and the timeline for implementing it. A recent survey of health care managers, chief information officers and systems analysts, conducted by Phoenix Health Systems, suggests that the vigorous opposition of some Washington, D.C.-based industry groups does not accurately reflect the views of the people actually charged with implementing the privacy regulations.

Time will tell if the Bush administration satisfies corporate and other interests seeking to weaken the regulations, or defers to the strong public support fro privacy protections.

— Joanne L. Hustead is senior counsel for the
Georgetown University Health Privacy Project.


The May 2001 Lawrence Summers Memorial Award* goes to the Georgia Highway Contractors Association.

“Environmentalists are telling us how to live our lives, preventing us from driving cars, forcing us to live downtown. In America, these are still personal choices. Tyranny didn't win in South Korea. Don't let it get a foothold here.” -- A Korean war veteran appearing in a TV commercial for the Georgia Highway Contractors Association, in an ad to counter anti-sprawl initiatives.

Source: “All Things Considered,” National Public Radio, April 16, 2001. 25, 2001.

*In a 1991 internal memorandum, then-World Bank economist Lawrence Summers argued for the transfer of waste and dirty industries from industrialized to developing countries. "Just between you and me, shouldn't the World Bank be encouraging more migration of the dirty industries to the LDCs (lesser developed countries)?" wrote Summers, who went on to serve as Treasury Secretary during the Clinton administration. "I think the economic logic behind dumping a load of toxic waste in the lowest wage country is impeccable and we should face up to that. ... I've always thought that underpopulated countries in Africa are vastly under polluted; their air quality is vastly inefficiently low [sic] compared to Los Angeles or Mexico City." Summers later said the memo was meant to be ironic.



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