Tuesday, February 13, 2001
need to be correctedThe issue: Medical-privacy rules approved in the waning days of the Clinton administration go further than first envisioned.
Our view: The Bush administration should take the scalpel to unreasonable and costly requirements.
FEDERAL rules protecting the privacy of people's medical records are scheduled to go into effect in less than two weeks, but health-care officials are concerned that they go further than anyone anticipated. The result could be an onerous system that could disrupt health care and send costs soaring. The rules should be modified by the Bush administration.
Congress asked for the privacy protections and they were welcomed by consumers. But health-care industry groups voiced concerns during their drafting when it became apparent they were becoming more restrictive than the Clinton administration had proposed initially.
The rule cited most for its impracticality is the requirement for health-care providers to obtain written consent from patients for the use or disclosure of medical information. Virtually every doctor, patient, hospital, pharmacy and insurance plan in the country is to be bound by the rule.
At the most basic level, pharmacists ask how they can obtain written consent from a patient whose doctor phones in a prescription that is picked up by a neighbor or relative. "Thirty-five to 40 percent of all prescriptions are picked up by someone other than the patient, in most cases a family member," says Todd Andrews of the CVS Corp., a major prescription-medicine company.
Also every health-care provider must appoint a "privacy official" to develop policies and procedures, entitling patients to inspect and copy their medical records, propose corrections and even demand an accounting of all disclosure in the last six years. Doctors had pleaded for strong federal privacy rules but not ones that would be so difficult to comply with.
"The rules miss the mark," says Dr. Donald J. Palmisano, a trustee of the American Medical Association. "They will increase costs and paperwork for physicians without improving patient care."
The Hawaii Legislature is considering a delay in the implementation of state medical-privacy rules while federal action is pending. The adoption of strong yet reasonable federal rules could render state privacy restrictions unnecessary.
As part of their review of many rules approved in the final days of the Clinton administration, Bush officials are examining ways to revise and simplify the regulations. These medical privacy rules seem to warrant corrective surgery before they take effect.
U.S. will pay back
dues owed to U.N.The issue: The Senate has voted to release $582 million in back dues owed to the United Nations in response to reductions in U.S. assessments.
Our view: The action should make support for the U.N. more palatable to Americans.
FOR more than a decade, Congress withheld part of Washington's dues to the United Nations, producing criticism of the United States as an international deadbeat. Supporters of the action argued that the United States was paying too much for peacekeeping missions and that the U.N. was mismanaging its funds.
Now the Senate has voted to release $582 million in back dues in recognition that the world organization has acted to correct some of its policies. The measure goes to the House, where passage is expected. So is approval by President Bush.
The agreement could mean an improvement in relations with the United Nations. By modestly reducing the U.S. portion of the world organization's budget, it should reduce Americans' resentment that they are bearing a disproportionate financial burden.
This is a victory for Jesse Helms, the cantankerous senator from North Carolina and chairman of the Foreign Relations Committee, who spearheaded the campaign to reform the U.N. Helms said he was willing to release the bulk of the $926 million that Washington owes.
The tough spadework of negotiating the first reduction of U.S. dues in 28 years was done by Richard Holbrooke, the Clinton administration's ambassador to the U.N. The deal worked out by Holbrooke reduces the American share of the U.N.'s $1.1 billion administrative budget to 22 percent from 25 percent.
Under the agreement, the U.S. contribution to the U.N.'s $2.5 billion annual peacekeeping budget will be reduced from 31 percent to 26.5 percent by the end of next year and eventually to 25 percent.
At a critical point the television magnate Ted Turner stepped in with a $34 million contribution to several nations to induce them to accept the deal.
In withholding the U.N. dues, Congress sparked criticism of the United States by other governments as an arrogant superpower that makes its own rules.
But the tactic, combined with Holbrooke's patient diplomacy, eventually paid off. The United States is the U.N.'s 800-pound gorilla, and it used its clout to achieve constructive change. In an organization with nearly 200 member nations, it is unacceptable that the United States be required to pay such a large share of the expense.
Jesse Helms, Richard Holbrooke and Ted Turner -- an odd trio, but in this case an effective one.
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