1. Since information can be easily accessed and transferred in electronic format, request that your medical record not be computerized, all sensitive health care transactions be done on paper, and no smart card be required. If computerized records are preferred for convenience, get a written assurance of the privacy and security policy.

2. Request a medical record number and insurance card number that is not the social security number of you or your spouse.

3. Do not automatically sign any patient consent form. Decide whether or not your insurer, other doctors, or researchers should automatically have access to your record. Read carefully, limit the time frame of access by adding an expiration date, and cross out intrusive sections. Sign and date all changes. Resist the pressure to sign the form without reading it. Get a copy of your signed consent form.

4. Do not automatically complete clinic or mail surveys and detailed questionnaires which can become part of the permanent medical record of you or your child--or which can be used by the government or HMOs to create patient profiles.

5. Get a high deductible insurance policy, negotiate prices to limit costs, pay cash, save your receipts, and only deal with the insurance company if you reach beyond your deductible.

6. Remember that a 1995 Minnesota law gave state government officials full access to your medical record -- and federal officials want Congress to give them full access.

7. Remember that employees of employer health services or "confidential" employer assistance programs may be obligated to report to your employer.

8. Find out if your child has been placed in a state government immunization registry for which you have not given consent, or has answered psychological questions in state school assessments.

9. Since you are under no constitutional obligation to be a research subject, give access to your medical records only if, and for as long as, you wish. Remember, by not responding to letters from Minnesota research institutions requesting patient consent you are giving your "implied" consent.

10. Talk with your doctor about confidentiality concerns, request omissions of sensitive information from your record, and consider use of pseudonyms when confidentiality concerns are high.

To contact CCHC


HISTORICAL QUOTES

"Since the layman is unfamiliar with the road to recovery, he cannot sift the circumstances of his life and habits to determine what is information pertinent to his health. As a consequence, he must disclose all information...even that which is disgraceful or incriminating. To promote full disclosure, the medical profession extends the promise of secrecy...The candor which this promise elicits is necessary to the effective pursuit of health; there can be no reticence, no reservations, no reluctance..."
        Hammonds V. Aetna Casualty & Surety Co., 243 F. Supp. 793 (N.D. Ohio 1965) as written by Robert Ellis Smith in "Our Vanishing Privacy."

"The time may come when no one can be sure whether his words are being recorded for use at some future time; when everyone will fear that his most secret thoughts are no longer his own, but belong to the Government; when the most confidential and intimate conversations are always open to eager, prying ears. When that time comes, privacy and with it liberty, will be gone. If a man's privacy can be invaded at will, who can say he is free? If his every word is taken down and evaluated, or if he is afraid every word may be, who can say he enjoys freedom of speech?"
        Justice William O. Douglas, Osborn v. United States, 385 U.S. 323 (1966)

"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized."
        The Fourth Amendment of the U.S. Constitution

"Information in 56 percent of government databanks is examined regularly by private corporations and educational institutions, with few questions asked, according to the GAO [General Accounting Office]. In almost all cases, the government doesn't even bother asking what the data is being used for."
        Jeffrey Rothfeder, PRIVACY FOR SALE, 1992 (as written in Cloning of the American Mind, B.K. Eakman)


THE MINNESOTA LAW

"The commissioner may require health care providers and health plan companies to collect and provide patient health records and claim files, and cooperate in other ways with the data collection process...Patient consent shall not be required...[T]he commissioner may obtain a court order requiring the provider or group purchaser to produce documents and allowing the commissioner to inspect the records...The commissioner shall require health care providers to collect and provide both patient specific information and descriptive and financial aggregate data..."
        Minnesota's state health care reform law (MS 62J.321, 62J.41, & 62J.45)

Quotes of Consequence MN Law Gives Goverment Access to Medical Records National Patient Record Linking System Underway