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September 2001
Volume 65 |
Number 9
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VENTILATIONS
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| I’m Changing
My Name to ‘Cash’ |
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Mark J. Lema, M.D., Ph.D. Editor
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Maybe something in men’s brains change after age 50 that
makes them question seemingly innocuous social policies —
little issues such as being given a traffic citation for “speeding”
at 38 m.p.h. in a 30 m.p.h. limit zone or filling out redundant
paperwork. Certainly there are more serious life issues to tackle.
One particular peeve I have had for several years has been a
source of amusement for my wife and children — bonus cards.
Now, is there anything more innocent than signing up for a bonus
card to save money on purchases? One simply provides basic personal
information such as name, address, age, telephone number, Social
Security number, driver’s license, sometimes credit card
numbers, income, e-mail address, educational degrees and hobbies
or interests. As a result, considerable savings can be realized.
Few people give serious thought as to how this information can
be used by the company offering these savings. Most often, they
track one’s usage of items to offer promotional sales or
coupons. Sometimes, they sell lists to pharmaceutical, beverage
and food companies who then offer savings through directed mass
mailing. It is often assumed that this information is kept secure
and confidential by these corporations. After all, it is not the
type of vital statistics freely offered by an individual —
or is it? Have you ever completed a limited warranty registration
after purchasing an electronic product? Why is it important for
a company to know one’s hobbies, the magazines read, if one’s
spouse is pregnant or if one intends to buy a new home? The reason
is obvious when you read the small print, which gives you the
option of not receiving special deals periodically from their
associates.
This issue, like bioterrorism, actually affects you. Consider
that a pharmaceutical company accidentally sent its Prozac users’
names and addresses to all customers using that product, or that
3,000 pages of confidential student information were easily accessible
on the Internet due to an error made by university personnel in
one southern state. I also know of a patient who received coupons
from a pharmaceutical company for menopause hormones, and she
never gave the pharmacy detailed information, except her address
for the drug label. The pharmacy sold the list to the pharmaceutical
company believing that EVERYBODY wants to save a few bucks —
even at the expense of violating one’s anonymity.
Let us briefly return to the bonus card issue. If I pay cash
or even established credit payment (e.g., Visa) to buy groceries,
why should I not receive the discounts on sale items without providing
vital information? I may not wish to have my purchasing history
linked to my name, especially if I also use their attached pharmacy.
Would O.J. Simpson, Congressman Gary Condit, President Bush or
the Pope want the public to know what they purchase in pharmacies,
grocery stores and liquor stores? Consider that these stores can
track one’s purchases on beer, liquor, viagra, birth control
pills, condoms, diaphragms, adult diapers, cigarettes, hair dye
and hemorrhoidal cream, to name a few personal products. One simply
should not need to worry that their common yet confidential purchases
are being traded among corporate America.
This tirade may now make you have a different perspective on
the new HIPAA 1 regulations designed to protect
your patients, your family and you from bias, prejudice, blackmail
and embarrassment should illnesses be discovered by unauthorized
individuals. With the new “expanded” boundaries on investigative
reporting, the free-flowing exchange of knowledge via the Internet
and the public’s need-to-know-everything mentality, even
the mightiest politician will succumb to this exposé. While
being exposed as having a bladder problem through the discovered
use of adult diapers may be embarrassing, it would pale to being
exposed as an ex-addict, alcoholic or hepatitis C carrier through
unauthorized access of one’s medical files.
— M.J.L.
1. Health Insurance Portability and Accountability
Act of 1996 (HIPAA). For further information, link to: < www.hhs.gov/ocr/hipaa/
>.
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