chapter  5
27 Pages

What’s wrong with health privacy?

In 2000, President Clinton introduced the landmark Standards for Privacy

of Individually Identifiable Health Information2 (federal standards) with the words ‘‘[n]othing is more private than someone’s medical or psychiatric

records.’’3 It is well known that the Health Insurance Portability and

Accountability Act of 1996 (HIPAA)4 committed the federal government to

a process of ‘‘Administrative Simplification’’ to reduce healthcare costs, but

Congress wanted to limit how far the healthcare industry could externalize

attendant privacy risks to patients.5 Yet, in the aftermath, what should

have been a final victory for patient autonomy and informational privacy

has turned into another divisive debate about professionalism and healthcare regulation. State and federal privacy law may be omnipresent, the

pages of medical journals and law reviews may be filled with exhortations

of confidentiality, and the media, often disingenuously, may be quick to

pounce on system failures, but health information privacy is surprisingly

fragile.