| Washington Watch | Vital Signs | Quality Watch |
By Connie Helmlinger
Connie Helmlinger is the periodicals manager at the American Nurses Association.
As debate over patient protection legislation continues in Congress and plays out in the national media, much newsprint and air time have also been devoted to a closely related issue: patient privacy. Its roots lie in the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which includes a provision for setting standards of uniformity and privacy for electronic transmission of health information. Controversy has arisen over the act’s requirement that all Americans have an electronic code known as a “unique health identifier.” Assigned at birth, the identifier would track each person’s health encounters but also could enable the creation of a national data bank with links to involved health plans and providers.
The ANA testified following the HIPAA’s passage that the assignment of a unique identifier will enable each nurse’s contribution to patient outcomes to be identified and will improve quality in all settings. The ANA raised serious concerns, however, about the identifier’s potential for abuse. For example, dangers are inherent in the ability to link individual providers with specific patient outcomes if that information is used punitively, illegally, or unethically. And without appropriate regulatory and security measures, patient privacy and confidentiality could be seriously violated under such a system.
Concerns over patient privacy erupted in July while the House of Representatives was considering patient protection legislation. In the wake of this, the Clinton Administration delayed plans to create the identifier system until Congress adopts legislation to protect patients’ privacy. This move resulted in further controversy as the House rejected the Patients’ Bill of Rights Act (HR 3605) and adopted the Patient Protection Act (HR 4250), which includes a less stringent privacy provision that actually overturns stronger state protections (see Washington Watch, September 1998). While the bill would require hospitals, providers, and insurance companies to reveal to patients their confidentiality practices, it would not require patient consent for the release of records, and would permit the release of patient records for “health care operations.”
As the Senate considers its versions of the Patients’ Bill of Rights Act (the Democratic bill, S 1890, and the Republican bill, S 2330), the ANA is pushing for passage of S 1890, which includes more comprehensive privacy and confidentiality provisions and substantially broader patient protections. It’s important that nurses share their support for S 1890 with their senators by using the bill number, because both bills have the same title. To reach your senators, call the U.S. Capitol switchboard at (202) 224-3121.
In next month’s elections, nurses from diverse specialties and backgrounds are running for offices ranging from lieutenant governor to member of Congress. Five state nurses association members, all endorsed by the ANA-PAC, are running for the U.S. House of Representatives.
Incumbent Representative Eddie Bernice Johnson, RN (D-TX), first elected to Congress in 1992, faces GOP nominee Carrie Kelleher in November. Fellow incumbent, Representative Carolyn McCarthy, LPN (D-NY), a lifelong Republican, entered politics in 1996 when she switched political parties and challenged then-incumbent Representative Daniel Frisa (R-NY), after he voted against an assault weapon ban. (Representative McCarthy’s husband was killed and son left seriously disabled in the Long Island Railroad Massacre of 1993.) She faces the winner of last month’s GOP primary election. In March of this year, Representative Lois Capps, RN (D-CA), defeated GOP nominee Tom Bordonaro in a special election to replace Capps’s late husband, Representative Walter Capps (D-CA). Representative Capps will again face Bordonaro in next month’s election.
In addition to the incumbents, two other nurses are running for Congress. In her second attempt to represent Wisconsin’s First Congressional District, Democrat Lydia Spottswood, RN, is running for the open U.S. House seat of retiring Representative Mark Neumann (R). An operating room nurse, Spottswood first became active in politics when she moved to Kenosha, Wisconsin, in 1985. “Nurses are the best-prepared professionals to respond to a changing health care system because nurses offer unique clinical and management skills to deal with the wellness end of the wellness– illness continuum,” says Spottswood.
Running in Washington’s Second Congressional District, retired Army Colonel Margarethe Cammermeyer, PhD, MA, RN (D), served in the military for 26 years, receiving the Bronze Star for her exemplary service as a nurse in Vietnam. The 1994 recipient of the ANA’s Honorary Human Rights Award, she is best known for successfully challenging her dismissal from the military, which resulted from the U.S. policy prohibiting lesbians and gays from serving.
“We need to add diversity to Congress so that people from broad backgrounds can contribute. Health care providers have seen people at their best and their worst. This creates another perspective,” Cammermeyer said.
Nurses can become active in these or any other political campaigns by becoming part of the ANA’s historic Nurses Campaign Activity Night 1998 (Nurses CAN ’98) on October 14. The ANA is urging nurses across the country to flex their political muscles by lending a helping hand to the candidates of their choice. For more information, visit the ANA’s Web site at <http://www.nursingworld.org>, or call (202) 651-7081.