    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (1999, Book II)]
    [October 29, 1999]
    [Pages 1915-1917]
    [From the U.S. Government Publishing Office www.gpo.gov]

    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

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    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

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    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.

    Kosovo

        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.