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President Clinton's remarks on medical privacy
October 29, 1999

SECRETARY SHALALA: Mr. President, I am pleased to welcome everyone here today. We have worked very hard to do what common sense and common decency says should have been done a long time ago. That is, to come up with reasonable rules for protecting the privacy of our health care records.

The President understands that the citizens of this country deserve health care that is real, that is affordable, that offers choices and that is there when we need it and he understands that this issue is important to every American. That's why today's announcement builds on what he has already done to protect the health of American families. He has fought for the Patients' Bill of Rights, for Medicare reform, for children's health insurance, for a prescription drug benefit, to expand biomedical research and, today, his announcement on health care privacy is historic.

I am very proud to introduce the President. Thank you, Mr. President.

THE PRESIDENT: Thank you, Secretary Shalala. I would like to thank you for all the work that you and so many people in your department have done on this issue. I thank the representatives of the various groups who are here with me today for their concern for, and commitment to, the issue of medical records privacy.

These health care and consumer advocates support what we are trying to do to protect the sanctity of medical records. I believe the American people will support us as well.

Every American has a right to know that his or her medical records are protected at all times from falling into the wrong hands. And, yet, more and more of our medical records are stored electronically and as they have been stored electronically the threats to our privacy have substantially increased. So has the sense of vulnerability that so many millions of Americans feel.

To be sure, storing and transmitting medical records electronically is a remarkable application of information technology. Electronic records are not only cost effective; they can save lives by helping doctors to make quicker and better-informed decisions, by helping to prevent dangerous drug interactions, by giving patients in rural areas the benefit of specialist care hundreds of miles away. So, on balance, this has been a blessing.

But as Secretary Shalala just said, our electronic medical records are not protected under federal law. The American people are concerned and rightfully so. Two-thirds of adults say they don't trust that their medical records will be kept safe. They have good reason. Today, with the click of a mouse, personal health information can easily and now legally be passed around without patients' consent to people who aren't doctors for reasons that have nothing to do with health care.

A recent survey showed that more than a third of all Fortune 500 companies check medical records before they hire or promote. One large employer in Pennsylvania had no trouble obtaining detailed information on the prescription drugs taken by its workers, easily discovering that one employee was HIV positive. This is wrong. Americans should never have to worry that their employers are looking at the medications they take or the ailments they've had.

In 1999 Americans should never have to worry about nightmare scenarios depicted in George Orwell's 1984. I am determined to put an end to such violations of privacy. That's why I'm honoring the pledge I made in the State of Union Address and using the full authority of this office to create the first comprehensive national standards for protection of medical records.

The new standards I propose would apply to all electronic medical records and to all health plans. They would greatly limit the release of private health information without consent. They would require health plans to inform patients about how medical information is used, and to whom it is disclosed. They would give patients the right to see their own health files and to request corrections. They would require health plans and providers to strengthen internal safeguards. They would create new criminal and civil penalties for improper use or disclosure of the information.

These standards represent an unprecedented step toward putting Americans back in control of their own medical records. These standards were developed by Secretary Shalala and the Department of Health and Human Services. Over the next 60 days the Secretary and her department will take comment from the public before we finalize the standards.

Again, on behalf of all the families in this country, I thank you Madam Secretary for this work.

Now let me say something that I think is now well known. I am taking this action today because Congress has failed to act, and because a few years ago Congress explicitly gave me the authority to step in if they were unable to deal with this issue. I believe Congress should act. Members of Congress gave themselves three years to pass meaningful privacy protections, and then gave us the authority to act if they didn't. Two months ago their deadline expired. After three full years there wasn't a bill passed in either chamber.

Even as we put forward our plan today, I think it is important to point out there are still protections, some of them, we can give our families only if there is an act of Congress passed. For example, only through legislation can we cover all paper records and all employers.

So today again I ask Congressional leaders, please help protect America's families from new abuses of their privacy. You owe the American people a comprehensive medical privacy law. As we have found out in working through this order, the issues are complex, difficult decisions have to be made. But we will work with you in a bipartisan fashion. We can do this together and we owe it to our families to protect their privacy in the most comprehensive way possible.

Thank you very much.