Jewish World Review July 25, 2003/ 25 Tamuz, 5763

Marianne M. Jennings

Marianne M. Jennings
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Consumer Reports


HIPAA: The federal government strikes health care again


http://www.NewsAndOpinion.com | I stand behind the yellow line at the Fry's pharmacy because Hipaa says so. Hipaa is not a large store greeter or immigrant pharmacist from Uzbekistan. The Feds have been at it again, regulating their little hearts out on medical care, something they will tinker with until we have a quality health care system like our neighbors to the North, one in which we wait six weeks for an appendectomy, the expedited schedule for surgery due to pain.

This time the Feds developed the Health Insurance Portability Accountability Act - Hipaa. Hipaa does many things, including lots of boilerplate notices for us. The boilerplate notices explain privacy rights on medical records and the right to keep the next pharmacy customer from knowing your medications. Hence, the yellow line to put us out of earshot. I wonder if they know I can still read the paperwork from behind the yellow line.

I got a Hipaa notice from the pharmacy, the dentist, the pediatrician, and the mammography folks. When the orthodontist threatened me with Hipaa paper work, I declined.

Hipaa notices read like a second-grade teacher explaining when recess will be allowed. For example, did you know that under Hipaa a doctor can disclose to a relative that you have died? Oh, what times are these that doctors were squealing on you to relatives about your death without you ever knowing. Good thing the Feds are on the job.

Medical care providers now must have a "Privacy Officer" to administer Hipaa rights. I envision a Nurse Ratched type as the Hipaa privacy officer, stamping forms for Hipaa waivers as she glances over her half specs to police the yellow line. My eight-year-old cited Hipaa for refusing to discuss what the dentist told him about cavities and brushing. "I refuse to answer on the grounds of Hipaa. Get a waiver from the privacy officer," he huffed, glancing through his Yu-Gi-Oh cards. Ah, federal empowerment!

Hipaa paperwork, however, is small potatoes compared to its privacy mandates. Medical providers must take precautions so that discussions with patients are not overheard by other patients. An entire industry of sound-masking systems has emerged and enjoys the boon of federal regulation gone amok. For $389.20, you can have a "sound-masking machine" that would make snake oil salesmen blush. This little black box, placed in waiting and treatment rooms, prevents Hipaa information from floating about to the ears of the unauthorized. Hipaa makes me worry that we trust the Feds with airport inspections.

All this cost and effort so that 12 youths can sit together in a giant orthodontia treatment room with everyone pretending they are not aware their common overbites and overlaps. Perhaps the black box zaps their memories of crooked teeth. Hipaa does "Vanilla Sky."

The waiting areas in surgicenters have curtain dividers for Hipaa privacy, but, apparently, no sound-masking. As I waited with my husband prior to his surgery, anesthesiologists spoke to the occupants surrounding us beneath Curtains 1 and 3. It was like sitting through a Dawson's Creek episode. When they asked the woman next to us if she was pregnant, a simple yes or no would have done it. "I am not sexually active," was her indignant response. My husband commented, 'I've seen her. No Hipaa revelation there."

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I waited with my son for his x-rays in a common room with everyone barefoot and in backless gowns. Hipaa does not cover nudity, as it were. As we waited, one woman grabbed her cell phone to chat with her paramour. Here was the scoop: She had gone down a slide a bit too quickly in Hershey, Pennsylvania. The plane ride back was agonizing because she was fairly certain she broke her tail bone. Her paramour was worried that they might have to postpone their planned trip to meet his ex-wife, scheduled so that the ex-wife could grant approval for their marriage. She assured her paramour, "I'll be just like 'Stepmom.'" The movie, I imagine she was speaking about the movie. Hipaa warnings staved off my temptation to ask.

Hipaa is what happens when the federal government gets its tentacles into a problem cited by a few people. The impetus for all this cost and futile nonsense was one incident in which someone's medical records were accidentally revealed. The incident ends up repeated with outrage twelve times in the Congressional record. Now we all stand behind yellow lines in a flurry of Hipaa paperwork.

The problem with Hipaa is the problem with most federal intervention. Regulate away, but you can't change the nature of things. If you're sitting in a proctologist's office, there is but a handful, ahem, of reasons for your visit. The waiting room at the psychiatrist's office is not filled with people seeking treatment for bunions, unless they're consumed with having them.

There can never be absolute privacy in medical offices. The sign-in sheets alone have names, insurance, and all manner of Hipaa-protected information. We have access to a list of names from which we can draw conclusions about health, problems and why they probably won't meet with the ex-wife's approval. The stepmom-to-be met a painful fate in Hershey, PA and, Hipaa or not, no mother wants her children with a woman who gets wild on a slide.

I know all of that without crossing the yellow line and despite the black box.

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JWR contributor Marianne M. Jennings is a professor of legal and ethical studies at Arizona State University. Send your comments by clicking here.

Up

07/18/03: Boy scouts win Supreme Court case and still cave!
07/11/03: Hepburn couldn't hold a candle next to Mom
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06/30/99: That intellectually embarrassing Second Amendment
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06/17/99: True courage is more than just admitting troubles

© 2002, Marianne M. Jennings