Monday, November 1, 1999
Volume 35, Issue 43; ISSN: 0511-4187
Remarks on action to preserve privacy of medical records and an exchange with
� Remarks on Action To Preserve Privacy of Medical Records and an
Exchange With Reporters
� October 29, 1999
� The President. Thank you, Secretary Shalala. I would like to thank
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
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
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 3 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
3 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
� So today again I ask congressional leaders, please help protect
America's families from new abuses of their privacy. You owe the
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
� Thank you very much.
� Nomination of Carol Moseley-Braun
� Q. Mr. President, Senator Helms has offered to schedule a hearing
on Carol Moseley-Braun's nomination next week if you will ensure
that the IRS, the White House, and the Justice Department produce a
bunch of documents by Monday. Do you see that as a serious offer, or
do you think he is just toying with your nominee?
� The President. I don't know. First of all, I have asked our White
House staff to review the request for information and evaluate it in
terms of what would be proper to forward to the committee and
whether there are some things that wouldn't be. I think we should at
hearing, she will be confirmed. And I don't think it's right for one
of our strongest allies, New Zealand, to be denied an Ambassador or
for a former Senator-in my judgment, did a good job in the United
States Senate, to be denied the opportunity to serve because of a
previous dispute with the chairman of the committee over the proper
handling of a patent for the Daughters of the Confederacy. I think
that that's, you know, not an appropriate basis on which to
determine whether someone should serve as an Ambassador or not.
� So I hope we can work it out, and I am going to-like I said, I have
asked the White House staff to evaluate Senator Helms' request and
to see whether it's possible for us to do.
� Q. Mr. President, in Kosovo this week, an attack on Serb civilians
has led some military officials to conclude that the peacekeeping
force may need to be expanded. Do you agree with that, sir?
� The President. Well, I think they have been doing a good job on the
civilians and to act appropriately when people come under fire. We
actually have been in the process of reviewing not only that but
also the progress of political developments there.
� I am not sure that more forces will solve the problem. What we
see-let me just say that what we see in Kosovo-and this is not
surprising-is that there are a lot of communities that are doing
quite well. And so they don't arise to the level of news coverage
most days. You know, they are just good, old-fashioned people in
small towns doing their business.
� The peacekeepers have found that there are several communities
where the local officials themselves are clearly in control, clearly
have the support of the local population, and clearly committed to
minimizing civilian violence or the exposure of civilians to
violence, whatever their ethnic group. Then there are some places
that need more people.
� So the first thing I would say in response to your question is, as
regards to all these kinds of incidents but particularly that one
resources that we have there in the best possible way before we make
any decision that more are needed. Of course, we have a
representative on the ground there, a leader that represents the
United Nations, and he can give us some guidance about whether they
need more people.
� Republican Debates
� Q. Did you watch the Republican debates last night and what do you
think about the fact that George W. Bush was not there?
� The President. They all have to make their own decisions, and I
didn't watch it. I kind of-I look at them wistfully. I reallyI did,
you know, a slew of them. I don't think I missed a single one in
'92, and I enjoyed them all. [Laughter]
� I do think they're useful. And even though, very often, they are
not news events because you see that the similarities to the
candidates are greater than their differences, and that's why, you
know, Senator Bradley and Vice President Gore are Democrats and the
other five are Republicans.
� But I think it is useful to participate in them because you get a
feel for what the issues are in specific States and also how people
react, and they are, I think, a good thing. I think they strengthen
democracy; they get people interested; and they make people more
interested in voting.
� Thank you.