Death, Taxes and Medical Records

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)

The Internal Revenue Service (IRS) is being charged with the illegal search and seizure of 60 million medical records from about 10 million Americans. It is suspected that these records contain personal medical information on people from all walks of life.

The claim charges 15 IRS officials with unlawful seizure of the medical records during an investigation at a California company. The IRS was investigating a former employee for a financial issue. The company is requesting $25,000 in damages be paid for each unauthorized record, but this case would also serve as a precedent case and provide future guidance for similar situations.

The unauthorized seizure of medical records is a major concern for several reasons:

  1. Our medical records contain confidential and sensitive information about us. The records contain psychological history, sexual history, drug and alcohol history, etc. Anything you tell your doctor ends up in your chart and I think it is safe to say that most, if not all of us, have at some point told our doctor something we would not like to end up on the network news, or in the hands of a government agent.
  2. The IRS has been given a vital role in the management of President Obama’s heath care reform. In this position they will likely be frequently placed in situations like the one mentioned above. Because of their position, we will need to trust the IRS officials to maintain the confidentiality of our health information. This means they will need to only view the records absolutely necessary, and extract only the information they directly need for their investigation. Many security measures are built into EMR (Electronic Medical Records) systems to keep your medical information safe. To access medical records at the hospital where I word, I have to enter two different password screens and every record I view is recorded. Also, my name is listed right on the screen in the patient’s electronic file. This means that I can see the names of the last several people who have viewed the chart for each patient and they will be able to see mine. This provides extra incentive to only view the records that you have a workplace need to view and allows other employees to see if you have been poking around records you have no reason to be viewing.
  3. When taken from the hospital system information in the medical record is no longer as tightly protected. When moved to another computer there is always the risk that the information will be misused and the confidentiality compromised.

So, ask yourself: Would you trust each individual employee of the IRS with every aspect of your life and the most intimate details of your personal health history? No? Then, we need to be extra vigilant as healthcare reform rolls out over the next few years. I do recognize that I have a hearty dose of skepticism of the government, but like the old adage says, “plan for the worst and hope for the best.” I think we need to do a bit more of the planning when it comes to the new IRS responsibilities under the Health Care Reform Act.

[This blog entry was originally posted in a slightly edited form on Ms. Spranger’s blog on June 2, 2013. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

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