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Old August 27, 2012, 09:41 PM   #101
Frank Ettin
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Quote:
Originally Posted by Aguila Blanca
...Laws can be changed. Data once in a system can be VERY difficult to eradicate, and even to control....
And let me add that the time to go to work is when those laws are proposed and there is something concrete to work against.
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Old August 27, 2012, 09:42 PM   #102
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I might as well jump in with this link about access to medical records. In fact I found the link by searching "access to medical records". The results don't jive with my ideas on privacy, for sure!

http://www.lbl.gov/Education/ELSI/privacy-main.html
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Old August 27, 2012, 10:32 PM   #103
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Quote:
Originally Posted by pnac
I might as well jump in with this link about access to medical records. In fact I found the link by searching "access to medical records". The results don't jive with my ideas on privacy, for sure!

http://www.lbl.gov/Education/ELSI/privacy-main.html
I suspect that's very old material. I notice there's nothing there about HIPAA.

This site appears to have much more recent and comprehensive information and was found using the same search criteria on Google.
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Old August 27, 2012, 10:43 PM   #104
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Thanks Frank! This site does look more up to date, still not much privacy though!
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Old August 27, 2012, 10:59 PM   #105
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Originally Posted by pnac View Post
...still not much privacy though!
How so? Under HIPAA who has access to individually identifiable medical information is strictly controlled, what they can do with it is regulated, and to whom it may be disclosed for what purposes is limited. And it's all for providing, paying for, or monitoring the quality of medical care.




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Old August 28, 2012, 12:59 AM   #106
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How has the HIPAA Privacy Rule been enforced so far?

Since the establishment of the Privacy Rule in 2003, OCR has received
almost 45,000 complaints. It has completed full investigations in about 13,000 of
those cases, finding violations in almost 9,000 of them. Of the 32,000 cases where
investigations have not been completed, about 25,000 of them were closed as
being ineligible for enforcement because the complaint was not timely or did not
describe any potential violation.
Link:http://wnylc.com/health/afile/118/105/ It's NY, but I imagine other states are basically the same.

I find this troubling, though I couldn't find what a not "covered entity" was. Maybe it amounts to nothing. Link:http://www.hhs.gov/ocr/privacy/hipaa...poses/506.html

State public records laws, also known as open records or freedom of information laws, all provide for certain public access to government records. How does the HIPAA Privacy Rule relate to these state laws?

Answer:

If a state agency is not a “covered entity”, as that term is defined at 45 CFR 160.103, it is not required to comply with the HIPAA Privacy Rule and, thus, any disclosure of information by the state agency pursuant to its state public records law would not be subject to the Privacy Rule.
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Old August 28, 2012, 09:14 AM   #107
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Just spotted this article: http://www.infowars.com/us-veterans-...ite-detention/

Are there any more questions why I, as a veteran, find this trend to be of concern?
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Old August 28, 2012, 09:50 AM   #108
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Quote:
Originally Posted by the linked article
...defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months” which includes:

• Persistent stubbornness
• Resistance to directions
• Unwillingness to go along with the crowd
• Deliberately annoying others
• Testing limits by ignoring orders
Finally I have a dx! What if ODD is a requirement of one's work?
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Old August 28, 2012, 10:31 AM   #109
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Quote:
Dear Doc,
Perhaps you should be worried about the social disease called crime? Maybe you should concentrate on diseases cause by germs and viruses, and leave the enforcement of law and criminal justice to the experts? I'll listen to you on gun control when you listen to me on heart surgery.
Thank you, see you next check-up day.
Yes, considering that 250K lives are lost each year do to mistakes made by the medical profession, you'd think they'd start saving lives by cleaning up their own back yard.

And a good case could be made for eliminating our inner city entitlement society which breeds all kinds of social problems-- including "gun violence", iliteracy, drugs, and so on.
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Old August 28, 2012, 10:32 AM   #110
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Who believes the following is 'medically-relevant inquiry'?

(1) Do you own firearms?
(2) How many firearms do you own?
(3) How are your firearms stored?

Who believes the following is 'medically-relevant inquiry', when a doctor asks a child these questions in the examining room?

(1) Do your parents own firearms?
(2) How many firearms do your parents own?
(3) How do your parents store their firearms?
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Old August 28, 2012, 10:34 AM   #111
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Apparently, anti-gun doctors.
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Old August 28, 2012, 11:16 AM   #112
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Quote:
Originally Posted by pnac
How has the HIPAA Privacy Rule been enforced so far?

Since the establishment of the Privacy Rule in 2003, OCR has received
almost 45,000 complaints....
[1] Before the HIPAA privacy rules, things might well have happened, but nothing would, or could be done.

[2] You're talking about a 12 year period. How much medical information has been collected, and legitimately used, even just in New York. 45,000 complaints, a great many by your figures, appear to be unfounded, in 12 years has got to be a pretty small percentage.

Quote:
Originally Posted by pnac
...State public records laws, also known as open records or freedom of information laws, all provide for certain public access to government records. How does the HIPAA Privacy Rule relate to these state laws?

Answer:

If a state agency is not a “covered entity”,...
"Covered entities" under HIPAA are basically providers of medical care, and medical insurers and other payors. Third parties that either contracts with in connection with medical care or payment activities are also made subject to the HIPAA rule.

However, state agencies, such as those responsible for providing or paying for medical care, or accrediting or licensing providers are either brought under HIPAA or subject to other confidentiality strictures. And FOIAs generally have exceptions to disclosure requirements that protect certain personal information. In any case, this is a FOIA issue that existed before HIPAA.
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Old August 28, 2012, 04:01 PM   #113
pnac
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[
Quote:
2] You're talking about a 12 year period. How much medical information has been collected, and legitimately used, even just in New York. 45,000 complaints, a great many by your figures, appear to be unfounded, in 12 years has got to be a pretty small percentage.
Not exactly the way I see it. 9,000 violations out of 13.000 investigations is not a very good average!

Quote:
Since the establishment of the Privacy Rule in 2003, OCR has received
almost 45,000 complaints. It has completed full investigations in about 13,000 of
those cases, finding violations in almost 9,000 of them.
Of the 32,000 cases where
investigations have not been completed, about 25,000 of them were closed as
being ineligible for enforcement because the complaint was not timely or did not
describe any potential violation.
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Old August 28, 2012, 04:18 PM   #114
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Quote:
Quote:
Originally Posted by the linked article
...defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months” which includes:

• Persistent stubbornness
• Resistance to directions
• Unwillingness to go along with the crowd
• Deliberately annoying others
• Testing limits by ignoring orders
See if this looks familiar, zuki.
Link: https://en.wikipedia.org/wiki/Sluggi..._schizophrenia

Quote:
Sluggishly progressing schizophrenia or sluggish schizophrenia (Russian: вялотекущая шизофрения, vyalotekushchaya shizofreniya) was a category of schizophrenia diagnosed by psychiatrists in the Soviet Union to justify involuntary treatment of political dissidents. It was defined as a special form of the illness which supposedly affected only the person's social behavior, with no influence on other traits: "most frequently, ideas about a 'struggle for truth and justice' are formed by personalities with a paranoid structure", according to Moscow Serbsky Institute professors.[1] The diagnostic criteria were vague enough to be applied to nearly anyone, as desired. The dissidents were forcibly hospitalized and subjected to treatments which included antipsychotic drugs and electroconvulsive therapy.

Sluggish schizophrenia is not included in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10);[2] however, its Russian version adds sluggish schizophrenia to schizotypal personality disorder in section F21 of chapter V.[3]
ODD appears to be the US equivalent of "Sluggishly progressing schizophrenia".
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Old August 28, 2012, 04:23 PM   #115
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Quote:
Originally Posted by pnac
Not exactly the way I see it. 9,000 violations out of 13.000 investigations is not a very good average!
That's not the point. There were only 45,000 complaints over a 12 year period relating to medical information covering all medical care rendered and/or paid for in the State of New York.

The population of the State of New York in 2007 was about 19,000,000. How many doctors' visits, surgeries, x-rays, other medical or diagnostic services, hospital inpatient days, emergency room visits, physical therapy treatments, prescriptions dispensed, and other medical services were received, and in most cases paid for by third parties, by a population of 19 Million over a period of 12 years? And all of that activity was recorded, often multiple times, in various records of medical care providers and third party payors subject to HIPAA. And what thus must have been an enormous volume of data and records produced only 45,000 complaints, a notable portion of which were determined to be unfounded.
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Old August 28, 2012, 04:49 PM   #116
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But that is the point, Frank. The majority of people don't complain because either,(1)) they don't know their rights have been violated or,(2) they figure it's a waste of time to "fight city hall".

The bulk of other cases weren't investigated because they weren't timely. Most people wouldn't know to complain at all unless they contacted a lawyer, read: they shelled out big $$.

The HIPPA ACT is, I'm sure, a big improvement over pre-HIPPA,however, it's not a cure. It's like putting a "band aid" on a bullet wound! The system is corrupt.
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Old August 28, 2012, 05:08 PM   #117
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Quote:
Originally Posted by pnac
...The HIPPA ACT is, I'm sure, a big improvement over pre-HIPPA,however, it's not a cure....
There is no cure. Our belief in a "cure" for social issues is largely a chimira.

Take privacy. You can keep everything a personal secret. But then you won't be able to get good medical care or have it paid for by insurance. You won't be able to get credit or loans. You won't be able to keep your money in a bank. You won't be able to make investments. Our doctors, bankers, money managers and others need information to be able to do for us what we expect them to do for us.

Everything comes down to a matter of management and trade-off. And every layer of management/protection adds complexity, increases possibility of errors from inadequate information and adds cost. HIPPA cost the health care industry billions of dollars to implement, and those costs translated to increased health care costs and increase medical insurance premiums.

We can learn to understand and deal with things and manage risks and problems, but there's no cure for real life.
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Old August 28, 2012, 05:46 PM   #118
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How did all these businesses operate before the government intrusion into everything, pre-information age? Your answer is probably going be "not very efficiently", but were we better off before all this "efficiency"? We certainly had more privacy, medical costs were affordable and "death by doctor" wasn't any worse than now, probably lower.

I hope you don't take what I say as a personal attack on you, 'cause it's not, but the system stinks.
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Old August 28, 2012, 07:35 PM   #119
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Originally Posted by pnac
How did all these businesses operate before the government intrusion into everything, pre-information age? Your answer is probably going be "not very efficiently", but were we better off before all this "efficiency"?...
No, my answer is probably just as well.

A big push for the HIPAA regulations came from consumer and public interest groups who were concerned about what they thought was a lack of privacy. Fact is that there were many privacy laws at the state level before HIPAA, and medical records were, as a matter of accepted ethics and law, confidential.

HIPAA probably didn't material improve matters, only formalized them at great expense. But people were frightened, and so we got HIPAA.

Quote:
Originally Posted by pnac
...We certainly had more privacy, medical costs were affordable and "death by doctor" wasn't any worse than now, probably lower....
One reason that we perceive that in the good old days we had more privacy and medical costs were lower is that there was less medicine. In the last fifty years,there has been an exponential growth in available treatments, drugs, diagnostic services and medical technology generally. All this technology is expensive, and its use is largely funded by the third party payors which now pay for the vast bulk of medical care.

"Death by doctor" is largely a red herring. Doctors treat sick people. Sick people either get well of die. But it's more popular to blame a bad medical outcome on a mistake by a doctor than on the natural course of the medical problem. Sure, people, including doctors, make mistakes; and there are legal mechanism to deal with those. But a lot of the time the very best any doctor can do won't be good enough.

Quote:
Originally Posted by pnac
...the system stinks.
You're welcome to try to fix it. Perhaps that would be a new career for you.
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Old August 28, 2012, 09:31 PM   #120
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Quote:
Originally Posted by pnac
How did all these businesses operate before the government intrusion into everything, pre-information age?
People paid for goods and services in cash (or gold), for one thing.

How far we have devolved was demonstrated to me just last week. I confess that I went to a Wal-Mart. My purchase was small, and it is always my practice to pay cash at wal-Mart and such stores unless my purchase is moderately large (which is VERY rare). So my turn at the register arrived, I placed my two or three items on the counter and reached for my wallet.

"Credit or debit?" asked the cashier. (No card visible, wallet still in transit from pocket.)

The look on her face when I asked if Wal-Mart still accepts "money" was priceless.
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