From: owner-roc-digest@lists.xmission.com (roc-digest) To: roc-digest@lists.xmission.com Subject: roc-digest V2 #110 Reply-To: roc-digest Sender: owner-roc-digest@lists.xmission.com Errors-To: owner-roc-digest@lists.xmission.com Precedence: bulk roc-digest Saturday, April 11 1998 Volume 02 : Number 110 ---------------------------------------------------------------------- Date: Fri, 10 Apr 98 18:39:23 PST From: roc@xpresso.seaslug.org (Bill Vance) Subject: Tactical Notes, was: Inspiration... (fwd) Recently on the FAP list, (Firearms And Politics), someone mentioned that in order to weed the jerks out of Politics, we had to get out and Vote in the Primary/Secondary Elections. This doesn't cut it in that the proper Political entry point for this is at the _Caucuses_ not the Elections. At the Caucuses, the Agendas, Party Planks, and Candidates are approved or rejected, Incumbents garner support or not etc., _then_ the Elections happen. As I've mentioned before, if enough like minded folks flood a Local Caucus, they set the Agenda, Party Platform, and Election choices for the Local Party Apparat. Do that in enough Precincts, and you control that Party's State Level setup. Do that across the Country and you control that Party's choices all down the line. It's been further posited that the Republican Party needs to be, "Taken over", in order to get rid of those who aren't carrying out the Agenda they were elected to implement. While this is to some extent true, _both_ Parties need a physic. Why leave a voice for those trying to destroy the Promise of the American Dream in _either_ Party? We have to face the facts that until _both_ Parties clean up their act, things will continue to get worse, and that _WE_ are the ones whose job it is to do it. Many of us have been garnering experience in, "Third Parties", and other Groups. Unfortunately, many of us have also garnered some level or other of disapointment at how marginalized our efforts can be at times, our Agendas and/or Candidates ignored or even vilified by other Parties and their Media lapdogs etc., etc. Whether we belong to Christian Coalition, Constitution Party, 2nd Amendment Groups, Libertarian Party, Property Rights Groups, Tax Payer Party, Special Interest Groups, (Pilots, Motorcyclists, Smokers and so on), or United We Stand America, or some other Group/Party, there are some things we can all agree on: We are over Regulated, over Taxed, and far afield from the Constitutional, Civil Government of Laws, not men, we all need and desire, and that those doing these things are doing them with _our_ Tax Dollars. What we can do about it: 1. Get a copy of Robert A. Heinlein's, "How To Take Back Your Country". It's only $6 bucks, and well worth it even if you have to order it. 2. Get in touch with as many of the above Groups/Parties as possible, and have them do the same with the ones they know of. 3. Organize a Coalition Pre-Caucus and prepare to flood _both_ major Parties Caucuses, (if we have enough people), with our own folks. A. Those Issues agreed upon become the Local Agendas that will be pushed. B. Those Issues not agreed upon may still be worked for individually, but aren't properly part of the Coalition Agenda. C. Take note of what Offices are/will be open for new Candidates, and determine if the Democrat-Republican Candidate(s) are suitable. 1. If suitable, organize possible support. 2. If not suitable or unknown, choose and support a Candidate of our own. D. Take note of what Offices have Incumbents we want to support or dump. 1. If suitable, organize possible support. 2. If not suitable or unknown, choose and support Our own Candidate. 4. Choose Representatives to do the above at the State Level Caucuses. 5. Have them do the above at the Part(y/ies) National Caucuses. 6. Most Important: Support and work for the above with mailings, door belling, fund gathering and anything else needed. 7. The goal is to have one of _our_ Candidates as the Primary Election choice in _both_ Parties, for all available Offices for the next several Election Cycles. The means is grassroots networking together, (Coalitions). 8. Pass this around to all the Patriotic Americans you know. 9. As a general rule, Suspect Incumbents, Support a New Guy. 10. Those on the NoBan list take note of the following: Time to gather in all those Coalition building, "Virtual Chips(tm)". The Ol' Blue Wolfie's watching so lets do him proud. - ---------- Original Forwarded message ---------- Date: Wed, 08 Apr 1998 20:42:41 -0500 From: Ed Lawson Reply-To: texas-gun-owners@Mailing-List.net To: texas-gun-owners@Mailing-List.net Subject: Inspiration... Posted to texas-gun-owners by "Ed Lawson" - ------------------------------------------------------------------------ Members of TGO: I just recently learned of a great loss to our cause, Jim Bohan, from Paul Watson. Jim Bohan, aka loboazul was a real 'sleeper' if you weren't paying attention. He wasn't into high profile to a lot of people, but his demise is a significant loss and was not reported on TGO unfortunately. Jim was instrumental in the defeat of Tom Foley (x Dem Speaker of the House), pro Second Amendment, and he lived in Yoakum, Texas. It can be done. The following is just one of several pieces he wrote. If you are interested in more, or more on who Jim was, just let me or Paul Watson know. Paul sent me several of the comments made on NOBAN from people who range from the new Governor of Louisiana to Tanya Metaksa, to Fortune Magazine and many more, all of which knew him personally. I met with Jim several times and talked with him via e-mail frequently. For those of you who didn't know him, I offer the following in his own words for inspiration. Ed - ---------------------------------------------------------------------------- - ----------- GRASS ROOTS REALITY--A Blue Wolf Editorial by Jim Bohan (loboazul@icsi.net) [Editor's Note: Jim Bohan co-manages NoBan, and was recently described by Fortune Magazine as "a master of the new world of cyberpolitics."] It's less than twelve full months until the '96 elections. It's time to get to work. Right now everyone is paying attention to the Presidential candidates and that's to be expected. They get all the ink and electrons and, yes, they're important. But they aren't ALL-IMPORTANT, especially in terms of RKBA. There are two recent examples that make the point. During his presidency, Reagan was a sincere friend of RKBA, yet because of the congresses he had, little was done to secure our rights. On the other hand, Bill Clinton is as great an enemy of the Second Amendment as exists. His first two years proved that, in spades. However, since the Republicans took over Congress, not one single piece of gun control legislation has been presented for his signature. That's one of the reasons I'm going to concentrate my efforts on congressional races in '96. The other reason is that all the sharks, heroes and other forms of major players concentrate on the presidency. Yes, grass roots groups have their influence, but their impact is muted because of the activities of the show horses. A strong, well organized and highly motivated grass roots group, working in concert with (or at least staying out of the way of) a candidate's organized efforts can determine the outcome of an election. If you don't believe it, ask Tom Foley (Tom who?). A lot of the new congressmen, including two of the best (imo) are going to need a lot of help finding their way back to D.C. I'm speaking of Barr of Georgia and Stockman of Texas. In Barr's case, it's because of redistricting; in Stockman's case, it's because a lot of pxxxed off Democrats are putting together a serious war chest dedicated to unseating him. I'm sure there are many others in the same spot. We know internet activism can work, we've made it work. However, in order for it to work, there has to be a viable organization working its buns off in the district. The net is a great way to communicate, but there are better ways to raise money, and all those folks telling you what a wonderful job you're doing can't vote in YOUR district. So, for those of you (all both of you) who aren't part of existing Second Amendment organizations in your district, here's what you do: Leave your monitor screen long enough to go out and find five people in your district who either want to re-elect your pro gun congressperson, or want to defeat the gun-grabbing scum your tax money is sending to Washington D.C. The six of you form some sort of organization, then each of you go out and find five more people, and elicit a promise from them that they'll do the same. And so on. First thing you know, you got a helluva lot of people working together to get someone elected ... or defeated. Once you have a core group, contact other groups. United We Stand America (UWSA) usually supports candidates that are also good on gun rights. It's not that RKBA is a part of their program (it isn't). However, UWSA's generally conservative/reform candidates are usually pro-RKBA. Not always, but it's worth checking with them and working with them where possible. The same with the Christian Coalition. When I first got into this, I assumed they were all nuts. I was wrong. And I doubt there is a single candidate anywhere in the country endorsed by the Christian Coalition that isn't pro-RKBA. We have many of them involved in NOBAN and other RKBA groups, and they're among the hardest and most dedicated workers in the bunch. Where you can, work with them. The same with Libertarians, another group I used to think was nuts. In some areas they run their own candidates, but they're realists and will generally support a candidate who reflects a Libertarian point of view--even if they call themselves something else. Pick up the phone, call them, and then work with them where you can. The main thing is to keep your own agenda simple. I use RKBA as a litmus test for politicians for a very simple reason. A politician who isn't afraid of RKBA isn't figuring on screwing you over so bad you feel the need to destroy government (start a revolution) because he knows you have the means to do it. A politician who wants to take your guns away is figuring on taking away everything you've got. It really is that simple. But some things are simple without being easy. This is one of them. The hard part is just getting off your butt and doing it. And having to go through twenty of your close friends to find the five who will actually work with you, and then learning just how apathetic many, many people seem to be about what's happening today. It's tough as hell getting almost anyone to get up off a dollar bill to support a candidate or your independent expenditure, but that's just how it is. And don't forget the Federal Election Commission (FEC). If you're going to take in money, you have to have an organization. And that organization has to register with the FEC and abide by its rules. So keep your paperwork straight. You already know the why's and the what's, and now you've just read some of the who's and how's. The "where" is in your district if you want a new congressman or to keep the one you've got; or it's in your state if your senator is up. A large number of Democrats are retiring from the Senate. We don't want them replaced with new Clintonites. That only leaves the "when." "When" is now. If you and/or your group figure on being a player in the coming election, it's time to drag yourself out of hot chat on AOL and even cut back on unnecessary e-mail. It's time to pick up the telephone and start taking care of business. - -- - ---------------------------------------------------------------------------- ***** Blessings On Thee, Oh Israel! ***** - ----------------+----------+--------------------------+--------------------- An _EFFECTIVE_ | Insured | All matter is vibration. | Let he who hath no weapon in every | by COLT; | -- Max Plank | weapon sell his hand = Freedom | DIAL | In the beginning was the | garment and buy a on every side! | 1911-A1. | word. -- The Bible | sword.--Jesus Christ - ----------------+----------+--------------------------+--------------------- - - ------------------------------ Date: Sat, 11 Apr 1998 11:29:36 -0400 (EDT) From: Brad Subject: Analysis of Jeffords Bill (fwd) - ---------- Forwarded message ---------- From: "Joel R. Reidenberg" Thought you would be interested in this analysis of the Jeffords Health Privacy Bill. I received it from a very knowledgeable and reliable source and find it to be a very thoughtful assessment that raises many troubling issues. JRR *********************************************** Joel R. Reidenberg Professor of Law and Director of Graduate Program Academic Affairs Fordham University School of Law 140 W. 62nd Street New York, NY 10023 (USA) Tel: 212-636-6843 Fax: 212-636-6899 Email: Web: *********************************************** + + + + + + + + + + + + + + + + + + + + + + + + + Analysis of S.1921 Health Care Personal Information Nondisclosure Act of 1998 SIGN OR DIE NOTE: This analysis was independently prepared by an individual who wishes to remain anonymous and may be circulated without limit provided that this disclaimer is included. This analysis may not be quoted or attributed to anyone. At the beginning of April, Senator Jeffords introduced a new health privacy bill (S.1921). Like other health privacy bills, Jeffords' proposal is long and complex. It contains one especially notable and troublesome new feature, and this analysis focuses on that feature and a few others. This is not a comprehensive review of the proposal. Coerced Consent - The biggest single problem with the bill is the patient authorization language in section 202. The effect of this language is to give health plans, employers, and providers the power to decide how patient information can be used and disclosed AND to force patients to agree to whatever the plans, employers, and providers decide. The proposal lacks clear statutory or regulatory limits on the power of health plans, employers, and providers to use and disclose identifiable health information to suit their own interests. Section 202 section provides that every employer offering a health plan, every health plan, and every provider MUST obtain from every individual a signed authorization. As a result, each individual covered by health insurance provided by an employer will be required to sign at least two separate authorization forms: one from the health plan and one from the employer. These are separate authorizations. The spouse of a worker must also sign an authorization, and a parent must sign on behalf of each covered child. Any individual seeking care from a provider may also be required to sign a separate authorization for each provider. Section 202 provides that the signed, written authorization "is a legal, informed authorization concerning the use and disclosure of protected health information for treatment, payment or health care operations." Thus, the terms of the law proclaim that the authorizations are both "legal" and "informed." However, nothing in the bill gives an individual any ability to refuse to sign or to bargain over the contents of the authorization. The law REQUIRES an employer, health plan, and provider to obtain an authorization. What happens if an individual refuses to sign an authorization? The bill would make signing an authorization a condition of enrollment in a health plan or of the provision of health care. As a result, it appears that an individual who refuses to sign loses health insurance or can be denied treatment. The legal requirement to obtain an authorization falls on the employer, health plan, and provider. Without an authorization, each would appear to be legally justified to deny insurance or treatment to anyone who refused to sign an authorization or who modified it in any way. For those who require either health insurance or health treatment, the policy in the Jeffords bill is sign the form or forego treatment or insurance. In other words, SIGN OR DIE. There is no opportunity for bargaining, for customizing an authorization to meet individual needs, or for opting out of a particular disclosure. This is not informed consent. There is nothing consensual about signing. The consent is coerced as a matter of federal law. SIGN OR DIE. Every employer, health plan, and provider can force an individual to sign an authorization form that permits a wide and nearly unlimited variety of uses of health information. Employers, plans, and providers can draft authorization forms to suit their own needs and requirements, without any regard for the interests of patients. Because patients have no choice but to sign, there is no meaningful external constraint on the scope of the authorizations. Scope of Authorizations - The bill provides expressly that the authorization obtained by employers must cover "treatment, payment, or health care operations." Authorizations obtained by health plans and by providers appear to have no similar limitations. Nothing in the Section 202 seems to limit use and disclosure to treatment, payment, or health care operations. However, the title of Section 202 suggests that the authorizations are for treatment, payment, or health care operations so it is likely that the intent is that authorizations obtained by plans and providers under this section are for those purposes. This may just be a drafting error. Disclosures for Treatment - The authorizations under Section 202 would cover disclosures for treatment. Some other health privacy proposals would permit nonconsensual disclosures for treatment. But they provide patients with an opt-out. Under other proposals, if a patient objects to a disclosure for treatment, that objection is effective. Under the Jeffords bill, a patient has no ability to object to any disclosure for treatment. Suppose, for example, that a patient does not want his/her record disclosed to a particular doctor because the patient and the doctor are related. Writing that restriction on the authorization form, however, could result in cancellation of insurance or denial of treatment. Under section 202, patients are afforded no opportunity to modify the authorization forms presented by employers, plans, and providers. A provider or health plan is under no obligation to agree to a patient's request to limit disclosures for treatment. Another hypothetical: Suppose that an employer's authorization form permits disclosure of all patient information as a treatment disclosure to the employer's in-house medical staff. The authority would allow the staff to obtain records of treatment obtained by the employee anywhere else. The employer will say that the disclosure is justified because in-house staff may be called upon to provide treatment in emergencies or otherwise. The consequence is that an employer could force an employee to consent to the routine disclosure of an entire medical record to the employer. An individual cannot refuse to sign an authorization form for treatment. However, an individual can apparently revoke an authorization for treatment. Section 202(c) allows for revocation of authorizations. If a patient signs an authorization and then revokes it in whole or in part, it is not clear what the consequences are. The bill makes signing an authorization form a condition of enrollment in a health plan. If an individual can revoke consent for disclosures for treatment, then the concerned individual could do so immediately after signing the required form. This would make the federally mandated consent a nullity. It is unclear how the "condition of enrollment" language meshes with the revocation authority. Disclosures for Payment - The authorizations required under section 202 would cover disclosures for payment. Some other legislative proposals would permit nonconsensual disclosures for payment. But they provide that if a patient and provider arrange for payment other than through an insurance company, then disclosures for payment are not permitted. In other words, a patient can agree to pay out of pocket without an insurer or employer learning about it. The Jeffords proposal does not allow an individual to refuse to sign a consent for disclosure for payment under any circumstances. However, the individual may later revoke that consent. Section 202(c)(1) says that an individual may revoke an authorization unless disclosure is necessary for payment for health care already provided and for which the individual has not agreed to assume financial responsibility. The requirement for signing and later revocation is crucial because it makes it much more difficult for a patient to exercise control. Suppose, for example, a patient pays for psychiatric care without relying on insurance. The careful patient, having signed the initial, required authorization form, then revokes it in part so that it no longer covers the psychiatric care. This appears to be permissible. But if on renewal of the health policy or on a subsequent visit to the psychiatrist's office or to another health care office, the patient signs the standard authorization again, failure to renew the revocation will vitiate the initial revocation and make the records now available for a subsequent payment disclosure. The structure of the Jeffords bill makes it particularly difficult for patients who want to pay for their own care to prevent information from slipping into the payment system. Disclosures for Health Care Operations - This is the biggest loophole in section 202 because of the lack of specific definitions. Health care operations are defined to include any services provide by or on behalf of a health plan or provider for the purpose of carrying out the management function or implementing the terms of a contract for benefits. In other words, an individual can be required to "agree" to disclosures for any management functions without restriction. Health care operations include (but presumably are not limited to): quality assurance activities and outcomes assessments; reviewing competency of health care professionals; accreditation, licensing, or credentialing activities; analysis of health plan claims or health care records data; evaluating health plan and provider performance; utilization review and precertification; underwriting; and auditing. The long list of permissible disclosures uses terms that are mostly undefined and could include virtually any type of use or disclosure that an employer, plan, or provider might want to make to satisfy its own institutional needs. For example, a disclosure for outcomes assessment could allow the entire medical record of an employee or an employee's family to be disclosed to the employer without notice, restriction or limitation. Similarly, disclosures to employers could fall under evaluating plan and provider performance. An employer might even disclose patient information to an employee's supervisor by claiming that it wants to obtain the supervisor's opinion on the performance of the employee's provider. Pharmacy Disclosures - Recent press stories highlighted how some pharmacies were making disclosures of patient information without consent for marketing purposes. It appears that the Jeffords bill wants to make it impossible for a provider to use the Section 202 authorization procedure to collect patient authorization for this purpose. Section 202(f) provides that authorization may not authorize disclosures "with the intent to sell, transfer, or use protected health information for commercial advantage." But this language may not provide adequate protection for patients. First, the language of section 202(f) limits disclosure and not use. The Jeffords bill is not clear on whether a distinction between internal use and external disclosure is meaningful. Assuming that it is a real difference, a drug manufacturer that owned a pharmacy could obtain the information because it is still within the same company. Another way to accomplish the same purpose might be for the manufacturer or the third party company to become an agent of the health plan. Then the disclosure might not be restricted because it is an internal use. Second, the term "commercial advantage" is not defined. Regardless, it provides no real limitation since any disclosure for disease system management could be justified -- rightly or wrongly -- as a treatment disclosure benefitting the patient or as part of a management function. As long as there is another intent for the disclosure, the restriction on disclosures for commercial advantage might not apply. Third, given the complex relationships between health care institutions, a disclosure of patient records might involve no overt payment or identifiable commercial advantage, but a pharmaceutical manufacturer could provide hidden discounts or benefits to cooperating plans or providers. The limitation in Section 202(f) offers little assurance that patient data will not be widely circulated to marketers or used for marketing purposes by a provider, plan or employer. If a pretext is found for including the disclosure in the authorization form that must be signed, then the disclosure with be "authorized." Revocation - Section 202(c)(2) discusses the revocation of an authorization given to a health plan. It is not clear whether a patient can revoke an authorization for disclosures for health care operations. Nothing in this section appears to restrict a patient's ability to revoke. A careful patient required to sign an authorization form might immediately revoke it. Whether this would permit a health plan to terminate coverage is not clear. However, other revocation language suggests that revocation of the authority is not an allowable result. When an individual cancels or fails to renew enrollment in the plan, the authorization is deemed to be revoked, except as may be necessary to complete health care operations and payment requirements related to the individual's period of enrollment. This suggests that the intent of the bill is that an affirmative revocation might not be able to cover health plan operation disclosures. It is not clear. Still, the revocation provision has several different consequences for both patient and health plans. First, when a patient switches a health plan, any existing authorization for treatment disclosures is revoked. So when an individual moves to another plan and another doctor, the previous authorization that would have permitted transfer of treatment records is no longer valid. New paperwork is required for the treatment disclosure. Second, revocation-by-cancellation places health plans in a precarious position. Suppose that a health plan want to use the record of a former enrollee in auditing, licensing, outcomes assessment, or for other health care operations purposes. Records of current enrollees (active revocation aside) could be used because of the signed authorization. But for former enrollees, use is permitted only "as may be necessary to complete health care operations." Each former enrollee's record would have to be identified, and a determination made that the record is "necessary" for the proposed use. Further, the term "complete" suggests that the exception to revocation is limited. Thus, it would be hard for a health plan to argue that a two, three, or ten year old patient record is needed to "complete" an outcomes assessment. Each patient could argue that any health care operation could be accomplished just as well without his or her individual record. The result is that health plans have a problem if they want to use records of former enrollees for operational purposes other than payment. They could easily be sued by patients who object that the uses no longer fall under the revoked authorization even with the statutory limitation. Because the disclosure authority for all health care operations is based SOLELY on each patient's authorization, that authority can and will expire. The revocation provision could also affect treatment. A treatment authorization may cover the treatment of patients other than the record subject. A physician treating a patient may look at records of other patients with similar conditions to learn what treatments were effective. Some other proposals would allow this type disclosure for treatment of other patients unless the subject of a record has objected. Once the authorization is revoked by cancellation of the health plan, the disclosure of a health record for treatment of others would no longer be permitted. Coerced consent does nothing to protect the privacy rights of patients. As proposed in S.1921, it also places health plans and employers at risk if they use the records of former enrollees. Conclusion - Not all of the disclosures that a patient would be forced to consent to under the S.1921 coerced consent language are necessarily objectionable. Many other proposals authorize similar disclosures. What is objectionable is the legal requirement that patients MUST sign consent forms authorizing disclosure. A patient who seeks to modify a mandatory authorization form or to question its content runs the risk of having insurance coverage terminated or being denied treatment. Section 202 of the Jeffords bill provides employers, health plans, and providers with nearly unlimited ability to use and disclose patient records as they see fit. As a result, it does little to improve privacy protections for individuals. Patients will be forced to sign away their possible privacy interests. The coerced consent model offers the appearance of patient privacy while really only protecting the interests of those who seek to exploit patient data in nearly any way that they see fit. Other proposals define uses and disclosures in statute. By relying on a statute for definitions, there will be an objective, external standard to regulate patient records. Under the coerced consent model, the employers, plans, and providers are able to make choices about how records are used and disclosed, without regard for patient need or statutory limitations. They can force patients to agree and make it difficult or impossible to for patients to challenge the authorization forms or to hold anyone accountable for uses and disclosures. The fundamental issue is not whether there should be limits on the use of health records. Everyone agrees that there should be. The real issue is who sets those limits. S.1921 allows health plans, employers, and providers to define how records can be used without any participation by patients or external controls. A better answer is to establish limits in legislation so that privacy policy is made by the Congress and so that patients have a greater say in nonessential uses. Coerced consent abdicates the responsibility of Congress to establish protections for patient privacy. S.1921 turns the responsibility over to health plans, employers, and providers. This is a fundamental flaw in approach, and it will not further patient privacy interests at all. In some ways, it is even a step back from the current rules that afford few protections to patients. Audit Trails - Suppose that health care information is disclosed to an employer and shared by the employer with an employee's supervisor. How can an employee find out that this has occurred? Section 112 requires the maintenance of audit trails. But the requirement only applies to EXTERNAL disclosures. In the workplace, there is no way to learn if records have been seen by any person who works for the entity maintaining the record. In a hospital setting, this mean that if a celebrity is admitted, the hospital need not keep track of any hospital employee who looks at that celebrity's record. If the record then becomes public, the celebrity will have no way to document who saw the record. Law Enforcement - Those who follow health privacy issues will recall that the proposal from the Secretary of Health and Human Services was heavily criticized by some members of Congress and in the press. The objection was that the proposal would allow law enforcement access to and use of patient records without any change from current practice. The Jeffords bill has some features that represent a marginal improvement over the Secretary's proposal. Nevertheless, the bill fails to meaningfully restrict law enforcement access and use and adds a new element that manages to produce a result even worse that the Secretary's proposal. Section 210 permits disclosures for law enforcement purposes. Disclosures pursuant to subpoenas and warrants require probable cause to believe that the information sought is relevant to a law enforcement inquiry. But Section 210(a)(3) allows disclosures in response to "a request otherwise authorized by State or Federal law." This has virtually no meaning. Law enforcement agencies will argue that they are authorized to request any health record under their general investigative authority. A law enforcement officer may claim that he or she is entitled to enter any hospital and ask for any patient record. Section 210(a)(3) authorizes the hospital to make the disclosure. No process is required. There is no probable cause requirement, no new standard, no new procedure, or no notice to the patient. Section 210(f) includes language excluding from evidence any information obtained unlawfully. This is, for the most part, present law. However, because the bill makes it so easy to obtain information without any standards or procedures under Section 210(a)(3), the exclusion has little effect. Further, it does little to protect patients. Consider a patient whose physician is the target of a fraud investigation. The patient's record is lawfully obtained by the law enforcement agency. The record is not excludable under the Jeffords exclusionary rule. Anything that a patient tells a physician can be used against the patient. The exclusionary rule affords no real protection to any physician-patient communication. Because federal law enforcement agencies have authority to obtain EVERY health record in the country, every revelation by a patient to a doctor may be accessed and used against the patient in all circumstances. The worst new law enforcement feature of the Jeffords bill is found in Section 215. Law enforcement officers who violate the law would not be personally liable unless the violation was a result of intentional conduct committed with the intent to sell, transfer, or use information for commercial advantage, personal gain, or malicious harm. A law enforcement official who illegally and negligently disclosed health care records would not be liable. An investigator who exposed millions of health records to public view by negligently leaving the records in a public file on the Internet would not be liable to anyone. No other person who obtains health information under the bill would be immune from responsibility for their conduct. ########################## - - ------------------------------ Date: Sat, 11 Apr 98 16:13:22 PST From: roc@xpresso.seaslug.org (Bill Vance) Subject: Fw: [Fwd: [RightNow] Press Release: 1997 NTU Ratings] (fwd) Following the money..... On Apr 11, Donald Walker wrote: [-------------------- text of forwarded message follows --------------------] Date: Fri, 10 Apr 1998 13:34:55 -0400 To: RightNow Mailing List From: National Taxpayers Union Subject: [RightNow] Press Release: 1997 NTU Ratings For Release April 9, 1998 For Further Information, Contact: Pete Sepp (703) 683-5700 Pro-Taxpayer Ratings in U.S. House Continue To Slide, Non-Partisan Study = of 171 Votes Shows (Washington, DC) =96 Pro-taxpayer scores last year in the U.S. House of Representatives continued their decline from record-setting levels two years ago, while Senate scores showed only a minuscule improvement, according to a comprehensive study released today by the 300,000-member National Taxpayers Union (NTU). =93In 1997, many members of Congress partied hearty with our tax dollars,= =94 said NTU President John Berthoud. =93The trouble is, taxpayers are the on= es left with the fiscal hangover.=94 In 1997, the average Taxpayer Score in the House of Representatives was 4= 3 percent, down from 1996=92s mean of 54 percent. Averages actually rose fo= r the Senate, from 52 percent in 1996 to 53 percent in 1997. The high point for averages over the Rating's 25-year history came in 1995, when typical scores reached 58 percent in the House and 57 percent in the Senate. The record low of 27 percent and 28 percent for the House and Senate, respectively, occurred in 1988. Party averages have also taken an interesting turn since the Republican Party took control of both Houses of Congress. In the three-year period from 1995 to 1997, the average House Democrat's score remained consistent= ly low =96 from 28% in 1995 to 29% in 1997. House Republican averages, howev= er, fell dramatically over that same period, from 83% to 56%. Senate party averages for Republicans declined less, from 86% to 75%. Even though Democrat averages in the senior chamber rose three points -- from 23% to 26% -- they remained well below the =93F=94 grade cut-off score of 33%. =93Although some of the Republicans have drifted lower, most Democrats in Congress continue to earn =93D=94 and =93F=94 grades from taxpayers,=94 B= erthoud observed. There were a total of 183 =93Big Spenders=94 in the House and S= enate, all but one of whom (Sanders, I-VT) were Democrats. =93Big Spenders=94 re= ceive the grade of =93F.=94 However, in this Rating, more than 80 Republicans w= ound up with =93C+=94, =93C=94, =93C-=93 or =93D=94 grades. On the top of the = scale, just 70 Republicans earned =93A=94s, and hence received the coveted =93Taxpayers=92= Friend=94 Award. In 1995, 121 lawmakers were named =93Taxpayers=92 Friends=94 for t= heir outstanding voting records. Berthoud attributed some of the decline in Republican scores and grades t= o the fact that the two parties narrowed much of their policy differences b= y passing the 1997 Balanced Budget And Taxpayer Relief Acts: =93Last year Congress reached what was advertised as a =93consensus=94 on lowering tax= es and erasing the deficit. Unfortunately, the =93consensus=94 ended up giving taxpayers one penny in relief on every dollar they send to Washington, an= d the economy deserved more credit for balancing the budget than politician= s did. It's therefore no wonder that our scores reflected an overall declin= e.=94 The top scorers in the House and Senate, respectively, were Ed Royce (R-C= A) with an 85% and Jon Kyl (R-AZ) with an 87%. At the bottom of the heap in the House and Senate, respectively, were Alan Mollohan (D-WV) with a 14% and Paul Sarbanes (D-MD) with a 6%. =93The drumbeat of 1995=92s fiscal revolution in Congress was barely audi= ble in 1997,=94 Berthoud concluded. =93The Clinton Administration's previous vet= oes and constant push for more spending have taken a toll.=94 The NTU Rating, which includes every roll call vote affecting fiscal policy, assigns a =93Taxpayer Score=94 to each member of Congress that indicates his or her commitment to reducing federal taxes, spending, and debt. For 1997, a total of 171 House and 138 Senate Votes were selected. National Taxpayers Union is a non-profit, non-partisan citizen organizati= on with 300,000 members who are dedicated to lower taxes, less wasteful spending, taxpayer rights, and accountable government at all levels. The 1997 Rating is available via fax or on-line at www.ntu.org. 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If you cannot access the World Wide Web, send an e-mail message to RightNow-Request@MailList.Net a= nd on the SUBJECT LINE put the single word: unsubscribe [------------------------- end of forwarded message ------------------------] - -- - ---------------------------------------------------------------------------- ***** Blessings On Thee, Oh Israel! ***** - ----------------+----------+--------------------------+--------------------- An _EFFECTIVE_ | Insured | All matter is vibration. | Let he who hath no weapon in every | by COLT; | -- Max Plank | weapon sell his hand = Freedom | DIAL | In the beginning was the | garment and buy a on every side! | 1911-A1. | word. -- The Bible | sword.--Jesus Christ - ----------------+----------+--------------------------+--------------------- - - ------------------------------ End of roc-digest V2 #110 *************************