A Discussion on the Sensitivity of Ones Personal Information and the HIPAA Act

Privacy is a sensitive topic and largely depends on the individual. Some people prefer for their information to be kept as confidential as possible, and don't like disclosing any information about themselves to anyone unless absolutely necessary. Others don't mind sharing a wealth of personal information as long as no direct harm befalls them as a result. Because of this myriad of different opinions regarding privacy preferences, it is often difficult to gain an aggregate, overall opinion of the populace. This becomes especially difficult in making legislation, when the overall sentiments of the population are supposed to be reflected in law. This issue becomes even more important in the field of healthcare. One's health information is particularly sensitive, and most people don't want to share with stranger's their health background. That is why there is such an importance placed on doctor-patient confidentiality. However, there is another side to this issue that deals with releasing medical information when it could benefit the individual, or even the entire population.

HIPAA, a healthcare act passed over fifteen years ago, deals directly with this issue, and it is becoming more and more controversial as technology and its use in transmitting information becomes more prevalent. The following essay will explore the administrative issue of enforcement of HIPAA in the context of its vague guideline, referencing the scholarly article "The HIPAA Headache." (Hall, Hoffman and Sobel, 2008) HIPAA is made up of two distinct sections. Title I is focused on protecting citizens with healthcare as they change or lose their jobs. From the average citizen's perspective, Title I is beneficial and an example of positive healthcare reform. (Ladenheim, 1997) Title II, however, is very controversial. The main issue surrounds the privacy of sensitive healthcare information. Specifically the act discusses the regulation of the electronic transmission of this information and when it can and cannot occur. (Ladenheim, 1997) This issue affects basically everyone with health insurance and a healthcare background, and this is why HIPAA has been such a publicized and debated act for so long. Extremely simplified and at face value, HIPAA details that healthcare information should be released only when the patient specifies that their permission is given. Even then, the information released should be at only what is necessary to the situation at hand. However, as was already stated, this is an extremely simplified summary of HIPAA.

The actual act itself is long and tedious, with many vague references and seemingly contradictory statements. Because of this there has been much confusion over what HIPA A dictates individuals and healthcare companies can and can't do. One of the solutions mentioned in the article "The HIPAA Headache" is that the rules and guidelines surrounding the release of healthcare information are extremely specific, but contradictory at the same time. This leads to unnecessary complications and wasted time while people try to navigate the difficult arena of healthcare privacy. One of the authors likens the situation to driving laws. She explains that although there are many car accidents, we do not make laws for every specific aspect of it, such as car spacing, acceleration speed, etc. She argues that if we did, "gridlock would surely prevail." (Hall, Hoffman and Sobel 2008) Thus, her solution is to lessen all of the specific protections that protect against a problem which is mostly theoretical and replace them with general, overarching guidelines for consent. Another author, later in the article, proposes three specific solutions for HIPAA's controversial issues surrounding ambiguity.

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First of all, HIPAA only covers healthcare companies that want to submit information electronically. It does not cover businesses that have health information about their employees, drug manufacturing companies who wish to gain data on the effectiveness of their products, or lenders who want to make sure their clients are in good enough health to pay them back. His solution is to extend HIPAA's coverage to these companies as well. Second, HIPAA outlines no specific legal course of remedy for those whose rights have been violated under the act. The author says that there needs to be a clear path of remedy so that more organizations are likely to comply. Third, the author says that HIPAA's language in general must be less vague so that it is clear when healthcare providers are or are not following these guidelines. The ethical problems surrounding this issue center on the enforcement of HIPAA.

Because the language is so unclear and confusing, it is difficult for individuals to receive the protection they deserve in an administrative setting. Furthermore, there are ethical issues surrounding the original enactment of the act simply because there is such vague and contradicting language it seems that legislators may have simply been trying to quell the pressure surrounding the issue rather than the actual issue of healthcare privacy itself.

The legal problems dealing with this issue have already been mentioned. That is, enforcement of HIPAA. First of all, there is no clear path for victims of HIPAA violations to take. Thus, there have only been a handful of lawsuits brought before the court that claim HIPAA was violated. Secondly, the vague language makes it extremely unclear how information should be protected. For example, the act references encrypting information the necessary amount, but it does not mention any methods for encryption or what the necessary amount entails. (Hall, Hoffman and Sobel 2008)

In the article, there were no managerial responsibilities mentioned specifically, however they are implied when examining the ethical issues. In a managerial sense, organizations should not simply ignore HIPAA and its provisions simply because the language is vague enough to get away with it. The legislation was passed for a reason, and organizations should keep that in mind when dealing with their employees and clients. Further responsibilities would entail informing individuals of their rights under HIPAA, not simply assuming that everyone knows what their rights are. In addition, individuals should be made aware of specific methods for working with their healthcare information under HIPAA.

While these mentioned solutions are possible remedies, it is unclear how effective they will be. The debate and controversy of HIPAA has gone on since the legislation was passed in 1996. (Schneider, 2006) Clearly, there is no obvious solution that will satisfy everyone at the moment. Optimistically, legislators will soon realize the administrative issues that arise due to the vagueness of HIPAA and make efforts to correct it. One can only hope that lawmakers wil re-examine HIPAA soon and come up with a more effective, and less vague law.

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