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Comment by EatingWithForks | Hacker News Reader

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.

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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.

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.

> 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.

> Who are these "good guys" you speak so highly of

Anyone who wants to use the records to improve healthcare. There are plenty of these folks in the medical field, based on my time in medical school and brief stint in a medical research group.

I would also include anyone involved in your direct care, i.e. the front-desk personal at the various doctors offices we visit, who have no way of easily obtaining your medical history if you aren't already in their system.

> Anyone who wants to use the records to improve healthcare.

This is so nebulous. Anyone can claim they want to improve healthcare. The removal of abortion access has also been repeatedly been justified as improving healthcare. The Tuskeegee experiments (where they just let black men live with a curable, debilitating disease and continually lied to them about their suffering, some of them to their graves) was justified as improving healthcare. "Wanting to improve healthcare" does not preclude people from horrifically unethical behavior. Get better standards if you want to be accessing the private information of people without their consent.

I don't know why you're bringing up direct care. HIPAA specifically allows access to PHI for treatment, payment, and health care operations.

https://www.hhs.gov/hipaa/for-professionals/faq/authorizatio...

When providers fail to obtain medical histories for new patients that's not due to any legal restrictions. In most cases they simply haven't bothered to implement the open interoperability industry standards which make it easy to exchange such data, or haven't joined networks that facilitate such exchange. For example, the majority of physicians still don't have a publicly listed DirectTrust Direct Secure Messaging address even though they could have one at a very low cost.

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