October 29, 1999

9:28 A.M. EDT

 

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.

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 who, 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 rise 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 are 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.

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.

-END-

9:40 A.M. EDT