Baylor University Medical Center Proceedings April 2014, Volume 27, Number 2 | Page 89

HIPAA: a flawed piece of legislation
Allen B. Weisse, MD

physician who always insisted that, as a sign of respect, his
office staff address patients by their surnames arrives one
morning to find that, to conceal identities, someone like
“Mr. or Mrs. so-and so” is now being greeted as “Harry”
or “Mary” or, worse, “Grandpa” and “Granny.”
A physician well known to the local pharmacy writes a prescription for his wife, who drops it off on her way to work. Shortly
thereafter, the pharmacy calls about a problem concerning it. The
physician, who is home alone at the time of the call, offers to resolve
the problem. Despite the fact that he had written the prescription, he
is informed that the pharmacy will speak to no one but his wife.
A neurologist arrives on a medical ward to perform a consultation. All the charts on the chart rack are turned facing the wall
so that no names are visible on viewing it. He must then remove
each one individually until he finds the name of the patient on
the proper chart.
A physician has brought his pet dog to the local veterinary
hospital to have certain blood work performed. The next day he
calls to determine the results of this testing, but they will not be
revealed to him unless he appears at the hospital with proof that
he is, indeed, owner of the “patient.”
In collecting these bizarre vignettes occurring after the 1996
passing of Public Law 104-191, better known as the Health
Insurance Portability and Accountability Act (HIPAA), and
then complaining about it, I thought that the least I should do
was to read it. And, even more importantly, since I planned to
comment upon its outsized successor, the Omnibus Final Rule
of 2013, a similar chore would be required. The original HIPAA,
as suggested by its title, was concerned mainly with insurance
matters, although in its preamble it promised a lot more:

A

To amend the Internal Revenue Code of 1986 to improve
portability and continuity of health insurance coverage in the
group and individual markets, to combat waste, fraud and
abuse in health insurance and health care delivery [italics added],
to promote the use of medical savings accounts, to improve
access to long-term care services and coverage, to simplify the
administration of health insurance, and for other purposes [italics added].

Much of the 167 pages of legislative gobbledygook about
health insurance was pretty much unintelligible to one without the proper background in these matters, but despite such
Proc (Bayl Univ Med Cent) 2014;27(2):163–165

shortcomings, the general impression received was that some
positive measures were in the offing regarding the workings of
the medical insurance system and related issues. As for patients’
privacy rights, only about a single page in toto was included
and, in this respect, the content of the message was crystal clear.
Under the subtitle concerning data collection, the secretary of
the Department of Health and Human Services (HHS