Government intrusion

You ASSUME Cheney has something to hide. Others ASSUME the hospitals may have something to hide as well. The only way to tell in either case is to make public the documents themselves.

fishin

That's the first really dumb argument I've seen you make.

That's the best you can come up with?

fishin

Scraping...humbling...

I was just set to lay into you when I realized I had misread what you'd written, and what you were analogizing.

My apologies. I take back what I said about that being the dumbest argument I'd seen you make. That title must, in all fairness, remain above another post you made earlier.

Unfortunately, under HIPPA, this is true. Most Americans don't know it. The bill, supposedly protecting patient's confidentially actually simply made more paper work for patients and doctors, made it difficult for families to work with doctors of their ill family members and opened everyone's medical records to insurance companies, the federal government and any number of other government agencies like the police, etc. This is classic Bush/Repub/fundamentalist/neocon strategy.

The problem here is that the effectiveness of medical care is in jeopardy. If patients don't have confidence that their records will remain confidential, not just about abortion, but about all medical care, including psychotherapy, they will not be honest with doctors about their symptoms or behaviors or will not seek medical help they need. It's an attack on the integrity of the medical profession and reveals a clear failure to understand the concept of civil rights. But we already knew this about this administration and Ashcroft in particular.

another good reason to support your local neighborhood motel abortionist/psychologist/pharmacist (the one with the long black rubber golves) who doesn't report to Ashcroft.

Yes.. I'm sure it was all part of their strategy to get Ted Kennedy to introduce and sponsor the HIPAA legislation, have all the Democrats in the Congress vote in favor of it and to get Bill Clinton to both push and sign it too.

The HIPAA legislation was originally quite different. Bush first agreed to protect the confidentiality of patients when some organizations, the American Psychoanalytic Association among them threatened to sue. In one year, he reversed himself after he was certain he was safe to do so. He's big friends with the insurance companies, you know, fishin.

If you go back and look at section 164.512(f) of the original HIPAA rules put out by the Clinton Administration in December 28th, 2000 you'll find that the exact wording is still there.

But HIPAA doesn't apply in this case anyway. HIPAA covers "individually identifiable health information" and in this case the request is specifically for information where anything individually identifiable is removed.

hang on fishin, I'll get you some information

Hospitals and the doctors who perform abortions should not have to release records unless there is substantial evidence that they have broken the law.

As far as partial birth abortion is concerned, it is an awful situation to be in and an agonizing decision to have to make. It must have an exceedingly low rate of occurance compared with first trimester abortions. The Repubs are kicking and screaming simply because they want to make this unfortunate operation illegal.

This is an intimate life decision, not some corporate bigwig planning on how to keep his stock options without falling under the unbrella of conflict of interest. There can be no comparison between the two in terms of whether or not to release records.

Further, there already exists information on abortion rates provided by the Centers For Disease Control; as you will see, approx. 88% are performed before 13 weeks and 1.5% are performed after 20 weeks--see the link and the excerpt below:

www.cdc.gov/mmwr/preview/mmwrhtml/ss5109a1.

Results: A total of 861,789 legal induced abortions were reported to CDC for 1999, representing a 2.5% decrease from the 884,273 legal induced abortions reported by the same 48 reporting areas for 1998. The abortion ratio, defined as the number of abortions per 1,000 live births, was 256 in 1999, compared with 264 reported for 1998; the abortion rate for these 48 reporting areas was 17 per 1,000 women aged 15--44 years for 1999, the same as in 1997 and 1998.

The highest percentages of abortions were reported for women aged <25 years, women who were white, and unmarried women; slightly more than half were obtaining an abortion for the first time. Fifty-eight percent of all abortions for which gestational age was reported were performed at <8 weeks of gestation, and 88% were performed before 13 weeks. From 1992 (when these data were first collected) through 1999, increases have occurred in the percentage of abortions performed at <6 weeks of gestation. Few abortions were provided after 15 weeks of gestation; 4.3% were obtained at 16--20 weeks and 1.5% were obtained at >21 weeks. A total of 27 reporting areas submitted data stating that they performed medical (nonsurgical) procedures (two of these areas categorized medical abortions with "other" procedures), making up <1.0% of all procedures reported from all reporting areas.

fishin, you own firearms? I do. A main argument against government intrusion regarding personal ownership of guns is "open the door a crack when it seems reasonable and the door gets flung wide open to the un-reasonable"
btw the Nun (and most liberals) totally disagrees with me on this point.

I'm with the nun on this one. I don't buy it either. (And I do own several firearms)

I keep a decorative razor sharp samurai sword near the door for this purpose. Contrary to popular belief; you don't have to know how to use it. :wink:

Here you go, fishin.........more coming........hold on please.

http://pn.psychiatryonline.org/cgi/content/full/39/2/2

Actually, a bipartisan assault on privacy led to massive privacy breaches in the Original HIPAA Privacy Rule. The privacy defects in the Original Rule were the result of both the Clinton and Bush Administrations.

Ashcroft's subpoenas were based on the exceptions to the right of medical privacy in the Original Rule.The abortion/subpoena stories in the media make no mention of the fact that HIPAA (in the Original Rule, not changed by the amendments) Section 164.512 actually sets the nation up for lots more judicial and law enforcement fishing trips in the nation's medical records for whatever purported moral or punitive missions the AG or law enforcement may wish to pursue.

It gives judicial, administrative, and law enforcement the right to access and use medical records without consent. Yep, unbelievable but true.

In all, in the Original HIPAA Section 164.512, there are 12 categories of totally unrestricted access (no right of consent) to the nation's medical records. Besides law enforcement and judicial and administrative access, the other categories are uses "required by law", for "public health activities", for domestic violence and child abuse, for "health oversight activities", about "decedents", for "organ and tissue donation", for "research purposes", to avert serious threats to health or safety, for "specialized govt. functions", and for worker's comp. These are huge loopholes which do not serve this nation well.

Section 164.512 was one many other civil rights groups very strongly opposed in their comments on the proposed Original Rule, to no avail. Nobody thought law enforcement should have unfettered access to medical records without a judge or court at least giving assent and
oversight. But DOJ and the police prevailed.

The lawsuit seeks primarily to restore every American's right of consent, by eliminating the amendments to HIPAA. The amendments gave over 600,000 covered entities federal regulatory permission to use and disclose PHI for routine purposes (treatment, payment, and health care operations).

During the oral arguments on Dec 10th, the government's attorney admitted that the intent of the government was to eliminate the right of Americans to control all routine uses of their PHI (personal health information). The problem is that virtually any conceivable use of PHI can be justified as one of those 3 categories, so effectively all Americans have completely lost control of their medical records (except of course President Bush who has been able to restrict the release of his medical records during National Guard service 30 years ago).

The lawsuit was structured to focus on what was thought possible and on the issue (right of consent) that affects every single American.

Clearly, the punitive search and seizure stuff Ashcroft is doing, as permitted by the Original Rule, is unconstitutional.

Hopefully, the success of the suit will encourage others to sue to change the other horrible defects in HIPAA.

Hopefully too, the success of this lawsuit will also get Congress to finally look at and fix the other privacy defects in the Original HIPAA Rule.

Those filing the law suit relied on the Original HIPAA Privacy Rule, which has many serious defects but gave every American the right of consent (an incredible strength and the first federal privacy right which covers people's privacy everywhere, as opposed to the Jaffee Redmond decision, which protects privacy only in the federal court system).

The Original HIPAA Rule has much good in it for patients, like the
protection of psychotherapy notes the American Psychoanalytic Association (APsaA) worked to have included and a very pro-privacy Preamble.

HIPAA is a very mixed bag. But it was decided by those filing the suit that the best strategy would be to restore the Original Rule and then
work to change the defects.

fishin wrote:


Both the lawsuit and the abortions records cases involve exactly the same issue: whether the government may eliminate the right to medical privacy of law-abiding citizens who pose no threat to society.

But you're right, fishin, in that the ApsaA and other civil rights groups have been highly critical of the Clinton Administration for its many attempts to destroy medical privacy.

Both political parties have taken actions very harmful to medical privacy. The APsaA has repeatedly spoken out about all who try to destroy this ethical basis of Medicine and Psychoanalysis, meanwhile working with political leaders on both sides of the aisle to save privacy.

However, I have no doubt that HIPAA, in it's original form and the amendments will be used by an AG like Ashcroft, who has no respect for individual rights, if it serves his religious and political interests, to violate every right he sees fit to violate. Bush, Ashcroft, the neocons and the fundamentalists have mush less than the average understanding or respect for the civil rights of anyone other than themselves and those they seek to please and/or make richer.

oh dear,

it appears I've run everyone off..........where'd everyone go?........but just in case I haven't here's another op ed piece from today's Philadelphia Inquirer

http://www.philly.com/mld/inquirer/news/editorial/7969012.htm

Posted on Tue, Feb. 17, 2004

Editorial | Medical Record Privacy

The U.S. Injustice Dept.

Was it only April? That's when Bush administration officials were touting their new federal privacy rules as a major advance in safeguarding Americans' personal medical data.

By winter, though, Attorney General John Ashcroft's Justice Department was battling to obtain the medical records of patients in Philadelphia, Chicago, New York and elsewhere who underwent a controversial late-term abortion.

Justice lawyers offered this startling rationale for their records request: Given "modern medical practice" and the involvement of third-party health insurers, they said, "individuals no longer possess a reasonable expectation that their histories will remain completely confidential."

So which is it? Either federal officials are serious about protecting details of patients' medical care, or they're not. Citizens need to know, one way or the other. And no fibbing, please.

For a credible answer, the nation may have to look to a federal judge in Philadelphia.

Patient groups, physicians and privacy advocates have asked U.S. District Judge Mary A. McLaughlin to review the federal medical privacy rules - and then toss them out. McLaughlin has the case under consideration, having heard arguments in mid-December.

Citizens for Health, a patient-privacy advocacy group, made a compelling case that the protections provided for medical records may be an illusion. A key shortcoming in the privacy rule under the Health Insurance Portability and Accountability Act of 1996 is that patients' consent is not required to divulge records in many instances.

U.S. Health and Human Services Secretary Tommy G. Thompson dropped the requirement for patient consent on grounds it would snarl health care. But there are worse threats than red tape.

Look at the legal challenge to the Partial Birth Abortion Ban Act of 2003 that's before courts in Chicago and New York. Justice Department officials defending the ban are seeking patient records under the privacy rule provision that allows them to do so with a judge's approval. Again, that's without patient consent.

Government lawyers say they'll protect the patients' identities. They say they're merely trying to prove these late-term abortions were medically unnecessary.

But that's hardly going to reassure the dozens of women who had these legal abortions prior to the Nov. 5 signing of the ban. Their medical privacy is at risk, and adding to their anguish is terribly unfair.

For every citizen, the Justice Department tactic has to stir similar fears. What's to safeguard their most personal medical details?

Hahnemann University Hospital and several other hospitals are waging a good fight against the demand for patient records. But that's not enough. As the abortion-ban litigation evolves, Congress needs to revisit patient privacy.

A core group of U.S. House members led by Rep. Edward J. Markey (D., Mass.), has offered a bipartisan measure that would restore patient consent to the federal privacy rules.

Label as Exhibit 1 the Bush administration's demand for patient records: It's proof of the need for congressional action that truly will protect Americans' medical privacy.

Ashcroft and Co. seem to have the "If you've done nothing wrong, you've nothing to worry about" approach. The caveat lies in that they are allowed to change the definitions of right and wrong whenever they feel like it.