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> Very many things doctors need to be aware of to diagnose conditions have significant social stigma... the risk is too great for any individual Very many thin

> Very many things doctors need to be aware of to diagnose conditions have significant social stigma... the risk is too great for any individual Very many things doctors need to be aware of, because the patients life depends on it, are left out when patients move between specialists and physicians, which happens all of the time. Outbreaks of viral and bacterial illnesses result in thousands of people independently chasing diagnoses and treatment, because the system doesn't share information that could be used to piece together and get ahead of it. Every time my kid gets sick at school, I get to play a game of "What is it? Do we see a Doctor? How much money should we spend?". Lets pretend we know nothing about this and go see a Doctor who hasn't seen anyone else in school, who may provide antibiotics they may or may not need or worse. Effective prevention methods and early detection of bad treatment are discarded because its so difficult to investigate and connect the dots between interventions and outcomes. Patient privacy is important, but the system we have today is nothing less than a tragedy. Real damage in emotional, physical, and economic is happening on a grand scale every day in this country. We shouldn't pretend HIPPA is a good thing, or the current system is doing a good job. Its not. We need to radically transform how we operate, and much more open and connected medical records is certainly a part of that transformation.

JohnFen 3y ago
> We shouldn't pretend HIPPA is a good thing, or the current system is doing a good job. Honestly, my problem with HIPAA is that it's not really adequate. There are too many loopholes in it. I'd like to see it strengthened quite a lot. > much more open and connected medical records is certainly a part of that transformation. As long as the patients those records are about are in full control over their disclosure and use.
EatingWithForks 3y ago
HIPPAA doesn't just cover, say, the spread of tuberculosis. It also bars things like collecting a panel of homosexuals, transgenders, women who are on birth control or have abortions, people seeking treatment for schizophrenia or a personality disorder or addiction, or just fat poor smucks that don't adequately treat their diabetes. Any number of highly stigmatized things or things that Palantir would love to own to sell to a private company. I would start freaking the fuck out if my primary care physician gets to sell my diagnosis for money to Facebook, and I don't give a rat's ass if some 3 year old could've been cured of epilepsy if my doctor was able to do so. HIPPAA prevents my doctor from doing so and I'm glad for it.
- cloverich 3y ago
  What I'm saying is, the protections it provides are overstated, and the damage it does is (greatly) understated. I am not saying lets discard privacy protections all together. I am saying lets not let bad implementations of good intentions convince us to be ok with an extremely expensive system that is not very useful and results in a great deal of physical and economic harm. > I would start freaking the fuck out if my primary care physician gets to sell my diagnosis for money to Facebook, To play Devil's advocate, do you think Facebook doesn't know who is gay and who has diabetes? If Target can figure out when you're pregnant, Google can certainly figure out on which day you plan to go the abortion clinic. This information is already out there and used in ways we don't like. So maybe we should consider re-working HIPPA so the information can be used by the good guys instead.
  - EatingWithForks 3y ago
    If anything your Devil's advocate is that it should apply to way, way more people than just healthcare providers, and I would thoroughly agree with that. Facebook messages have already been used to arrest women for abortions, which should be huge violation of someone's privacy and totally verboten. You cannot say the protections it provides are overstated if you are not the people who were victimized by a lack of such protections in the first place. I do not want the "good guys" collecting panels on jews. I certainly don't want the "good guys" collecting panels of info on trans kids without involvement from parents. The idea there is a "good guys" in this scenario is ridiculous. The idea that it might save lives is a cold comfort to the status of my minor child's birth control prescription status being accessible to the government.
  - deleted 3y ago
    [deleted]
  - rangerelf 3y ago
    > So maybe we should consider re-working HIPPA so the information can be used by the good guys instead. Who are these "good guys" you speak so highly of? CA gov? FL gov? Federal gov? FBI? Planned Parenthood? Some church? I'm curious about these mythical "good guys" that you, the NRA, and other people with an agenda repeatedly handwave about.
nradov 3y ago
That is totally wrong. There is nothing in HIPAA which would prevent healthcare providers from reporting infectious disease outbreaks to public health agencies. In fact, under some circumstances they are actually required to report. https://www.cdc.gov/nndss/about/index.html https://www.cdc.gov/nndss/about/index.html And it's not "HIPPA". For some reason, people who are deeply ignorant about what the law actually does also seem to get the acronym wrong. https://www.hhs.gov/hipaa/index.html https://www.hhs.gov/hipaa/index.html
- cloverich 3y ago
  > There is nothing in HIPAA which would prevent healthcare providers from reporting infectious disease outbreaks to public health agencies. I see. So if three patients visit three separate physicians (with three separate healthcare systems) with the same illness (outbreak), these records may be aggregated to detect the outbreak? I was under the impression this kind of thing was not possible, or very difficult / limited, and would require some kind of patient authorization, and that HIPAA played a role in this. (I expect this exists for known serious things like Ebola, but was thinking more directly about things like strep or typical viruses in a school. It seems like the outbreak information is put together after the fact, or after it gets grossly bad) > For some reason, people who are deeply ignorant about what the law actually does also seem to get the acronym wrong. Probably that HIPPA reads more like a word than HIPAA.

JohnFen 3y ago

> We shouldn't pretend HIPPA is a good thing, or the current system is doing a good job. Honestly, my problem with HIPAA is that it's not really adequate. There are too many loopholes in it. I'd like to see it strengthened quite a lot. > much more open and connected medical records is certainly a part of that transformation. As long as the patients those records are about are in full control over their disclosure and use.

EatingWithForks 3y ago

HIPPAA doesn't just cover, say, the spread of tuberculosis. It also bars things like collecting a panel of homosexuals, transgenders, women who are on birth control or have abortions, people seeking treatment for schizophrenia or a personality disorder or addiction, or just fat poor smucks that don't adequately treat their diabetes. Any number of highly stigmatized things or things that Palantir would love to own to sell to a private company. I would start freaking the fuck out if my primary care physician gets to sell my diagnosis for money to Facebook, and I don't give a rat's ass if some 3 year old could've been cured of epilepsy if my doctor was able to do so. HIPPAA prevents my doctor from doing so and I'm glad for it.

cloverich 3y ago
What I'm saying is, the protections it provides are overstated, and the damage it does is (greatly) understated. I am not saying lets discard privacy protections all together. I am saying lets not let bad implementations of good intentions convince us to be ok with an extremely expensive system that is not very useful and results in a great deal of physical and economic harm. > I would start freaking the fuck out if my primary care physician gets to sell my diagnosis for money to Facebook, To play Devil's advocate, do you think Facebook doesn't know who is gay and who has diabetes? If Target can figure out when you're pregnant, Google can certainly figure out on which day you plan to go the abortion clinic. This information is already out there and used in ways we don't like. So maybe we should consider re-working HIPPA so the information can be used by the good guys instead.
- EatingWithForks 3y ago
  If anything your Devil's advocate is that it should apply to way, way more people than just healthcare providers, and I would thoroughly agree with that. Facebook messages have already been used to arrest women for abortions, which should be huge violation of someone's privacy and totally verboten. You cannot say the protections it provides are overstated if you are not the people who were victimized by a lack of such protections in the first place. I do not want the "good guys" collecting panels on jews. I certainly don't want the "good guys" collecting panels of info on trans kids without involvement from parents. The idea there is a "good guys" in this scenario is ridiculous. The idea that it might save lives is a cold comfort to the status of my minor child's birth control prescription status being accessible to the government.
- deleted 3y ago
  [deleted]
- rangerelf 3y ago
  > So maybe we should consider re-working HIPPA so the information can be used by the good guys instead. Who are these "good guys" you speak so highly of? CA gov? FL gov? Federal gov? FBI? Planned Parenthood? Some church? I'm curious about these mythical "good guys" that you, the NRA, and other people with an agenda repeatedly handwave about.

nradov 3y ago

That is totally wrong. There is nothing in HIPAA which would prevent healthcare providers from reporting infectious disease outbreaks to public health agencies. In fact, under some circumstances they are actually required to report. https://www.cdc.gov/nndss/about/index.html https://www.cdc.gov/nndss/about/index.html And it's not "HIPPA". For some reason, people who are deeply ignorant about what the law actually does also seem to get the acronym wrong. https://www.hhs.gov/hipaa/index.html https://www.hhs.gov/hipaa/index.html

cloverich 3y ago
> There is nothing in HIPAA which would prevent healthcare providers from reporting infectious disease outbreaks to public health agencies. I see. So if three patients visit three separate physicians (with three separate healthcare systems) with the same illness (outbreak), these records may be aggregated to detect the outbreak? I was under the impression this kind of thing was not possible, or very difficult / limited, and would require some kind of patient authorization, and that HIPAA played a role in this. (I expect this exists for known serious things like Ebola, but was thinking more directly about things like strep or typical viruses in a school. It seems like the outbreak information is put together after the fact, or after it gets grossly bad) > For some reason, people who are deeply ignorant about what the law actually does also seem to get the acronym wrong. Probably that HIPPA reads more like a word than HIPAA.