There is no Patient Privacy

Dr. Deborah Peel is probably the nation’s foremost advocate for patient privacy. The Texas psychiatrist has worked tirelessly to include privacy protections in all of the health reform ideas of the past twenty years.

She recently gave a presentation at TEDx where she informed the geek community of how extensive medical data breaches have become. Not just extensive but perfectly legal and even encouraged by our government. Bottom line ― there is no medical privacy anywhere in American health care.


Dr. Peel’s mission is to inform people about what is happening, but her remedies are pretty thin. We need to keep in mind the old adage — he who pays the piper picks the tune. Patients will control their data only when they control the money. We have to move away from third party payment, whether that third party is your employer, private insurance, or a government agency. As long as someone else pays our bills they will know what services we consume, whom we buy those services from, and what condition those services were supposed to treat.

We will not have privacy until we control the money. After all, every penny spent on health care comes from us ― there is no other source. It may come from us in the form of insurance premiums, taxes, or lost wages on the job. It is all our money, and it is supposed to be spent for our benefit.

We have allowed these other parties to manage our money because we thought they would do a better job than we could. But they haven’t done a better job. They have done a lousy job. They have given us a health care system that is bureaucratic, inconvenient, unaccountable, of questionable quality, and far too expensive. And now, as Dr. Peel notes, we are not even allowed confidentiality for our most intimate transactions.

We need to take our money back and control our own spending. We need to reward providers that treat us right and shun the ones that don’t. That is the only way we will ever achieve a health care system that values the patient.

Comments (15)

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  1. Devon Herrick says:

    The thought that most worries me is that beneficial collaboration of patient data is difficult in many cases. For instance, a doctor cannot grab a colleague in the hallway and ask a question about my condition. On the other hand, illegal and unauthorized breaches or losses of my privacy occur all the time — often to my detriment.

    • Perry says:

      This is typical of government overintervention and unintended consequences. Millions of dollars are being spent to “comply” with HIPAA through healthcare facilities, yet someone can hack your medical records and get not only your medical info, but SS# and date of birth.

  2. Jimbino says:

    I go to Mexico and elsewhere for medical treatment and dentistry. They respect my privacy.

    • Erik says:

      So you think.

      • Jimbino says:

        I just had cataract surgery in Brazil for half what it would cost me in the USSA. What leads you to question my assertion that Obama will NOT get access to my patient records in Brazil?

        Yeah,yeah, I know: Obama is listening into Dilma’s phone calls and reading her e-mail.

        • John Fembup says:

          “What leads you to question my assertion that Obama will NOT get access to my patient records in Brazil?”

          If your medical records are not secure I’d say the least of your problems is Obama accessing them, whether in the US or Brazil.

          And besides, the more pertinent question for you is “why do you think your medical records in Brazil are secure from Brazilian snoopers, hackers, and fraudsters?”

  3. DOF says:

    Not surprised honestly. Seems like every single time, someone ‘reveals’ all our secrets well, weren’t secrets at all.

    I’m not surprised things are the way they are. There is not enough transparency in the way these processes work, and like you say in your post, too many ‘entities’ between buyer and supplier. These ‘entities’ are able to gather information they really should not possess.

  4. Big Truck Joe says:

    I’m confuzzled. Does the good Dr want me to authorize any “movement” of my data between physicians, hospitals, pharmacies and other covered entities engaged in the treatment payment and healthcare operations. This would slow to a crawl healthcare as we know it. I’m not sure I get the problem she’s espousing nor her argument for a solution.

  5. frank says:

    Not to mention the fact that people are unwilling to go to a doctor for fear that their personal information is at risk of being exposed.

    • John R. Graham says:

      I had heard that patients who see psychiatrists are very sensitive about this. I had not realized cancer patients and others are also.

      • Buster says:

        No kidding! Just about every elderly relative I know seems more than happy to share the details of every malady they have with me — both real and imagined.

        • John R. Graham says:

          I think the concern of Dr. Peel and others is that there should be a way to disclose your medical data to parties whom you trust, without inserting them into a marketplace where any party defined by the government as a HIPAA-covered entity can trade it.

          I wonder of the Blue Button movement would satisfy her concerns?

  6. Bill B. says:

    “Bottom line ― there is no medical privacy anywhere in American health care.”

    You could take out the word “medical” and the sentence would still be just as valid.

  7. Val says:

    Division B, Title IV of HR1 of 2009 (the Stimulus bill) established a national medical dossier on each of us. $19.1 billion to start it. Every insurance company must submit your data.

    • John R. Graham says:

      We’ve covered the meaningful-use payments pretty frequently at this blog. Where in that section of the ARRA do you see a “national medical dossier” and the direction that “every insurer must submit your data”? Actually, that part of the bill does not mention health insurers at all. It is about payments to hospitals and other providers to invest in EHRs.