October 29, 1999
THE WHITE HOUSE
Office of the Press Secretary
ForImmediateRelease October 29, 1999
REMARKS BY THE PRESIDENT
ON MEDICAL PRIVACY
THE OVAL OFFICE
9:28 A.M. EDT
SECRETARY SHALALA: Mr. President, I am pleased to welcome everyone
here today. We have worked very hard to do what common sense and common
decency says should have been done a long time ago. That is, to come up
with reasonable rules for protecting the privacy of our health care
The President understands that the citizens of this country deserve
health care that is real, that is affordable, that offers choices and that
is there when we need it and he understands that this issue is important to
every American. That's why today's announcement builds on what he has
already done to protect the health of American families. He has fought for
the Patients' Bill of Rights, for Medicare reform, for children's health
insurance, for a prescription drug benefit, to expand biomedical research
and, today, his announcement on health care privacy is historic.
I am very proud to introduce the President. Thank you, Mr. President.
THE PRESIDENT: Thank you, Secretary Shalala. I would like to thank
you for all the work that you and so many people in your department have
done on this issue. I thank the representatives of the various groups who
are here with me today for their concern for, and commitment to, the issue
of medical records privacy.
These health care and consumer advocates support what we are trying to
do to protect the sanctity of medical records. I believe the American
people will support us as well.
Every American has a right to know that his or her medical records are
protected at all times from falling into the wrong hands. And, yet, more
and more of our medical records are stored electronically and as they have
been stored electronically the threats to our privacy have substantially
increased. So has the sense of vulnerability that so many millions of
To be sure, storing and transmitting medical records electronically is
a remarkable application of information technology. Electronic records are
not only cost effective; they can save lives by helping doctors to make
quicker and better-informed decisions, by helping to prevent dangerous drug
interactions, by giving patients in rural areas the benefit of specialist
care hundreds of miles away. So, on balance, this has been a blessing.
But as Secretary Shalala just said, our electronic medical records are
not protected under federal law. The American people are concerned and
rightfully so. Two-thirds of adults say they don't trust that their
medical records will be kept safe. They have good reason. Today, with the
click of a mouse, personal health information can easily and now legally be
passed around without patients' consent to people who aren't doctors for
reasons that have nothing to do with health care.
A recent survey showed that more than a third of all Fortune 500
companies check medical records before they hire or promote. One large
employer in Pennsylvania had no trouble obtaining detailed information on
the prescription drugs taken by its workers, easily discovering that one
employee was HIV positive. This is wrong. Americans should never have to
worry that their employers are looking at the medications they take or the
ailments they've had.
In 1999 Americans should never have to worry about nightmare scenarios
depicted in George Orwell's 1984. I am determined to put an end to such
violations of privacy. That's why I'm honoring the pledge I made in the
State of Union Address and using the full authority of this office to
create the first comprehensive national standards for protection of medical
The new standards I propose would apply to all electronic medical
records and to all health plans. They would greatly limit the release of
private health information without consent. They would require health
plans to inform patients about how medical information is used, and to whom
it is disclosed. They would give patients the right to see their own
health files and to request corrections. They would require health plans
and providers to strengthen internal safeguards. They would create new
criminal and civil penalties for improper use or disclosure of the
These standards represent an unprecedented step toward putting
Americans back in control of their own medical records. These standards
were developed by Secretary Shalala and the Department of Health and Human
Services. Over the next 60 days the Secretary and her department will take
comment from the public before we finalize the standards.
Again, on behalf of all the families in this country, I thank you
Madam Secretary for this work.
Now let me say something that I think is now well known. I am taking
this action today because Congress has failed to act, and because a few
years ago Congress explicitly gave me the authority to step in if they were
unable to deal with this issue. I believe Congress should act. Members of
Congress gave themselves three years to pass meaningful privacy
protections, and then gave us the authority to act if they didn't. Two
months ago their deadline expired. After three full years there wasn't a
bill passed in either chamber.
Even as we put forward our plan today, I think it is important to
point out there are still protections, some of them, we can give our
families only if there is an act of Congress passed. For example, only
through legislation can we cover all paper records and all employers.
So today again I ask Congressional leaders, please help protect
America's families from new abuses of their privacy. You owe the American
people a comprehensive medical privacy law. As we have found out in
working through this order, the issues are complex, difficult decisions
have to be made. But we will work with you in a bipartisan fashion. We
can do this together and we owe it to our families to protect their privacy
in the most comprehensive way possible.
Thank you very much.
Q Mr. President, Senator Helms has offered to schedule a hearing on
Carol Moseley-Braun's nomination next week if you will ensure that the IRS,
the White House and the Justice Department produce a bunch of documents by
Monday. Do you see that as a serious offer or do you think he is just
toying with your nominee?
THE PRESIDENT: I don't know. First of all, I have asked our White
House staff to review the request for information and evaluate it in terms
of what would be proper to forward to the committee and whether there are
some things that wouldn't be. I think we should at least take the request
seriously because I think if she gets a hearing, she will be confirmed.
And I don't think it's right for one of our strongest allies, New Zealand,
to be denied an ambassador or for a former senator who, in my judgment, did
a good job in the United States Senate, to be denied the opportunity to
serve because of a previous dispute with the chairman of the committee over
the proper handling of a patent for the Daughters of the Confederacy. I
think that that's, you know, not an appropriate basis on which to determine
whether someone should serve as an ambassador or not.
So I hope we can work it out and I am going to -- like I said, I have
asked the White House staff to evaluate Senator Helms' request and to see
whether it's possible for us to do.
Q Mr. President, in Kosovo this week, an attack on Serb civilians
has led some military officials to conclude that the peacekeeping force may
need to be expanded. Do you agree with that, Sir?
THE PRESIDENT: Well, I think they have been doing a good job on the
whole. But I think they have to be in a position to protect the civilians
and to act appropriately when people come under fire. We actually have
been in the process of reviewing not only that but also the progress of
political developments there.
I am not sure that more forces will solve the problem. What we see --
let me just say that what we see in Kosovo -- and this is not surprising --
is that there are a lot of communities that are doing quite well. And so
they don't rise to the level of news coverage most days. You know, they
are just good, old-fashioned people in small towns doing their business.
The peacekeepers have found that there are several communities where
the local officials themselves are clearly in control, clearly have the
support of the local population and are clearly committed to minimizing
civilian violence or the exposure of civilians to violence, whatever their
ethnic group. Then there are some places that need more people.
So the first thing I would say in response to your question is, as
regards to all these kinds of incidents, but particularly that one which
concerned me, we ought to make sure that we have deployed the resources
that we have there in the best possible way before we make any decision
that more are needed. Of course, we have a representative on the ground
there, a leader that represents the United Nations, and he can give us some
guidance about whether they need more people.
Q Did you watch the Republican debates last night and what do you
think about the fact that George W. Bush was not there?
THE PRESIDENT: They all have to make their own decisions and I didn't
watch it. I kind of -- I look at them wistfully. I really -- I did, you
know, a slew of them. I don't think I missed a single one in '92 and I
enjoyed them all. (Laughter.)
I do think they're useful. And even though, very often, they are not
news events because you see that the similarities to the candidates are
greater than their differences and that's why, you know, Senator Bradley
and Vice President Gore are Democrats and the other five are Republicans.
But I think it is useful to participate in them because you get a feel
for what the issues are in specific states and also how people react and
they are, I think, a good thing. I think they strengthen democracy, they
get people interested and they make people more interested in voting.
9:40 A.M. EDT