THE WHITE HOUSE
Office of the Press Secretary
Immediate Release December 20, 2000
REMARKS BY THE PRESIDENT
ON MEDICAL PRIVACY
Department of Health and Human Services
12:46 P.M. EST
THE PRESIDENT: Thank you. Well, first, I want to thank Jan Lori
Goldman for her wonderful remarks and for her ongoing work in the area of
health privacy. I thank the representatives of the doctors, nurses,
consumers and privacy community who are here today and who add input into
I would like to thank my great friend, Senator Pat Leahy, for being
here and for his strong support of privacy issues in the United States
Congress. As others have said, I want to thank the entire team of people
who worked on this. They worked on this issue for months and months and
months. They worked hard. Some of them worked, I might add, at great
personal sacrifice to themselves, because of developments unrelated to this
issue, to get this out, because they believe so strongly in what they were
I also would like to thank my Chief of Staff, John Podesta, who has
been a fanatic on this issue in the best sense. (Laughter.) Now, I want
to thank all the folks at HHS for -- Donna Shalala went over just some of
the things that we have done in this administration over the last eight
years, thanks to all of you at HHS. And she said you were beginning to
feel like Nebraska. (Laughter.) But, look, there's a big difference.
You know, they say that because of the 24-hour news cycle, we're all
in a permanent campaign. And when you're in a permanent campaign, it's
hard to take the time to go to someplace you have no chance of winning --
Nebraska -- (laughter) -- or someplace you have no chance of losing, the
HHS Building. Right? So -- (laughter) -- (applause.)
I might say, just parenthetically, I had a wonderful time in Kearney,
Nebraska and Omaha, and you would be amazed at all the letters I've gotten.
I have already received more letters than I thought there were Democrats in
the state of Nebraska. (Laughter.) It was quite wonderful. So I'm
I want to thank all of you, and especially Donna Shalala, for these
last eight years. I believe that Donna Shalala is a superb leader, a great
administrator, always full of energy. You will be happy to know, and not
surprised, that she has steadfastly defended the people who work at the
Department of Health and Human Services in pitched battles at the White
House over various issues.
You guys have so much responsibility over so many things, every day
you get a new chance to wreck an administration. (Laughter.) The fact
that you somehow managed to avoid doing so, and along the way to get us up
to record levels of childhood immunization, to get the number of people
without health insurance going down for the first time in a dozen years, to
involve women and seniors in clinical trials to an unprecedented extent, to
add 24, 25 years to the Medicare Trust Fund, and 2.5 million kids to the
ranks of insured, and do so many other things, to be a positive force in
the welfare reform movement, is a real tribute to you, but I think, also,
to Donna Shalala and her remarkable tenure as a leader of this department.
And she makes it fun, you know? Now she's going to become President
of the University of Miami. We're just sort of a weigh station on her move
south. She was at Wisconsin, and then here, and then going to Miami. I
think you can confidently predict two or three things that will flow our of
her tenure there. She will improve the academic quality of the
institution. The football team will get even better. (Laughter.) And
they will do whatever is necessary to clarify the voting procedures in Dade
Look, we're having a good time today, but I want to take a moment to
be very, very serious. We say that we are a free nation in a world growing
increasingly free. And in so many ways, that is literally true. During
the period in which I was President, I was fortunate enough to serve here
at a time when, for the first time in all of human history, more than half
the people on the globe live under governments of their own choosing.
Now, that's a wonderful thing. That's one manifestation of freedom.
Then, there's free speech, the freedom of the press, the right to travel.
And also, I might add, minority rights of all kinds, restrictions on the
ability of government to compromise the fundamental interests and rights of
those who may not agree with the majority.
But we must never forget, in this age of increasing interdependence,
fueled by an explosion in information technology that is completely
changing the way we work and live and relate to each other, that
increasingly, we will have to ask ourselves: Does our freedom include
privacy? Because there are new and different ways for that privacy to be
In 1928, Justice Brandeis wrote his famous words saying that privacy
was "the right most valued by civilized people," and he defined it simply
as the right to be left alone.
Nothing is more private than someone's medical or psychiatric records.
And, therefore, if we are to make freedom fully meaningful in the
Information Age, when most of our stuff is on some computer somewhere, we
have to protect the privacy of individual health records.
The new rules we release today protect the medical records of
virtually every American, they represent the most sweeping privacy
protections ever written, and they are built on the foundation of the
bipartisan Kennedy-Kassebaum legislation I signed four years ago.
This action is required by the great tides of technological and
economic change that have swept through the medical profession over the
last few years. In the past, medical records were kept on paper by doctors
and stored in file cabinets by nurses; doctors and nurses, by and large,
known to their patients. Seldom were those records shared with anyone
outside the doctor's office.
Today, physicians increasingly store them electronically, and they are
now obliged to share those records in paper or electronic form with
insurance companies and other reviewers. To be sure, storing and
transmitting medical records electronically is a remarkable application of
information technology. They're cost-effective, they can save lives by
helping doctors to make quicker and better-informed decisions.
But it is quite a problem that, with a click of a mouse, your personal
health information can be accessed without your consent by people you don't
know who aren't physicians, for reasons that have nothing to do with your
It doesn't take a doctor to understand that is a prescription for abuse.
So, the rules that we release today have been carefully crafted for
this new era, to make medical records easier to see for those who should
see them, and much harder to see for those who shouldn't. Employers, for
instance, shouldn't see medical records, except for limited reasons, such
as to process insurance claims. Yet, too often they do, as you just heard.
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. That is wrong. Under the rules we released
today, it will now be illegal. (Applause.)
There's something else that's really bothered me too, for years, and
that is that private companies should not be able to get hold of the most
sensitive medical information for marketing purposes. Yet, too often, that
happens as well. Recently, expectant mothers who haven't even told their
friends the good news, are finding sales letters for baby products in their
mailboxes. That's also wrong. And under these new rules, it will also be
Health insurance companies should not be able to share medical records
with mortgage companies who might be able to use them to deny you a loan.
That actually happens today, but under these rules, it will be illegal.
Health insurance companies shouldn't be able to keep you from seeing your
own medical records; up to now, they could. Under these rules, they won't
be able to do that anymore. (Applause.)
Under the rules being issued today, health plans and providers will
have to tell you up front who will and won't be allowed to see your
records. And under an executive order I am issuing today, the federal
government will no longer have free reign to launch criminal prosecutions
based on information gleaned from routine audits of medical records.
With these actions today, I have done everything I can to protect the
sanctity of individual medical records. But there are further protections
our families need that only Congress can provide. For example, only new
legislation from Congress can make these new protections fully enforceable,
and cover every entity which holds medical records. So I urge the new
Congress to quickly act to provide these additional protections.
For eight years now, I have worked to marry our enduring values to the
stunning possibilities of the Information Age. In many ways, these new
medical privacy rules exemplify what we have tried to do in this
administration and how we have tried to do it. We can best meet the future
if we take advantage of all these marvelous possibilities, but we don't
permit them to overwhelm our most fundamental values.
I hope that these privacy rules achieve that goal. And again, let me
say, for this and so much more, I am profoundly grateful to the people who
work here at HHS, the people who work with them at OMB and in the White
House. In this action, you have done an enormous amount to reassure and
improve the lives of your fellow Americans.
Thank you very much.
END 1:00 P.M. EST