THE SENATE is now considering a measure called the Medical Records Confidentiality Act of 1995, which, its sponsors declare, is meant to "establish strong and effective mechanisms to protect the privacy of persons with respect to personally identifiable health-care information."
For people concerned about their medical records flying hither and thither, this may appear welcome.But watch out.
It is hazardous to judge a piece of legislation by its title.
The bill's real purpose is to set a uniform federal standard for handling medical records in order to aid the computer- ization of these files and the flow of information across state lines, all in the name of more efficient care.
To accomplish this, the bill pre-empts many state statutes that protect medical confidentiality as well as important common-law remedies for disclosing information without a patient's consent.
Although the bill details procedures for obtaining consent, it also establishes a formidable list of exceptions to this requirement.
The bill also fails to effectively address the growing problem of insider access to personal medical information, especially in a health-care network or HMO.
Patients are at a growing disadvantage. Insurers and corporate health-care providers seek to cut costs. Doctors are driven to seek efficiency. Employers, schools, marketing companies, government agencies and statisticians seek access to what used to be confidential files.
Enter the information-processing industry, saying it will cut costs, improve efficiency and speed the flow of information.
There is scant evidence for such assertions. Henry Aaron of the Brookings Institution has argued convincingly that computerized medical data bases will drive up health-care costs.
In any case, it is not for lack of information that our health-care system is failing millions of Americans - the uninsured, the underinsured, the undertreated and the overtreated.
Democrats promised us health-care reform and failed. Republicans promised us freedom from intrusion into our personal lives but are now sponsoring legislation that will open up our personal health records.
The Medical Records Confidentiality Act is fundamentally flawed. We need legislation - but legislation written to protect patients. Doctors should act in defense of ethical standards they have committed themselves to uphold.
Let patients and physicians act together to protect our rights.