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Remarks on Medical Records Privacy and an Exchange With Reporters

October 29, 1999

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 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 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.

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 least take the request seriously because, I think, if she gets a 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 whole. But I think they have to be in a position to protect 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 which concerned me, we ought to make sure that we have deployed the 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 really—I 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.

NOTE: The President spoke at 9:28 a.m. in the Oval Office at the White House. In his remarks, he referred to former Senator Carol Moseley-Braun, nominee for Ambassador to New Zealand; Gov. George W. Bush of Texas, Republican candidate for President; and former Senator Bill Bradley, Democratic candidate for President. The transcript released by the Office of the Press Secretary also included the remarks of Health and Human Services Secretary Donna Shalala.

William J. Clinton, Remarks on Medical Records Privacy and an Exchange With Reporters Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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