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November 24, 1993

Privacy and Security of Personal Information in a New Health Care System

Author Affiliations

From the American Society of Law, Medicine, and Ethics, Boston, Mass, and the President's Task Force on National Health Care Reform, Washington, DC (Mr Gostin); the Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services (Dr Turek-Brezina) and Kennedy Institute of Ethics, Georgetown University (Dr Powers), Washington, DC; Kunitz and Associates, Rockville, Md (Dr Kozloff); Department of Health Policy and Management, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md (Dr Faden); and National Institute of Standards and Technology, Gaithersburg, Md (Mr Steinauer).

JAMA. 1993;270(20):2487-2493. doi:10.1001/jama.1993.03510200093038

A COMPLEX health care information infrastructure will exist under a reformed health care system as proposed in the American Health Security Act of 1993. The success of the new system will depend in part on the accuracy, correctness, and trustworthiness of the information and the privacy rights of individuals to control the disclosure of personal information. All participants in the new system (consumers and patients, health plans, health alliances, and a national health board) will need access to high-quality information for informed decision making. At the same time, everyone must have confidence that information of a private nature is adequately protected.

American society places a high value on individual rights, autonomous decision making, and the protection of the private sphere from governmental or other intrusion. Concerns about privacy transcend the health care setting.1-3 Americans believe that their privacy rights are not adequately protected. In a 1993 Harris-Equifax poll4