[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.