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October 27, 2009


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Since the passage of the tough federal medical privacy laws and rules in HIPAA, The Health Insurance Portability and Accountability Act of 1996, almost all doctors and pharmacist no longer leave messages except maybe for appointments. They will talk to you if you answer, but they will not leave answering machine messages.

Your experience is the result of an unintended consequence of a federal medical mandate and a busy office, which because of tremendous administrative paperwork (again a federal and state law consequence) did not have the time to call back. Before HIPAA, the doctor's office would have left a message that your lab results are in, but they are no longer allowed to do that.

HIPAA will not change under any proposed health reform and the same things will still happen, even if health reform is passed.

Since a previous federal law (HIPAA) caused your complaint, a new federal law (health reform) will likely create more unintended problems and more reasons for patients to complain.

Milton: Sort of. In my experience, doctors' offices will leave messages about things besides appointments if you OK it, and if you have been a patient for sufficient time. And you hit on part of the point: HIPAA has had all sorts of ridiculous consequences, like requiring hospitals to tear out all existing doorways and make them bigger. There has been some talk in the reform debate about "integrated care" a la the Mayo Clinic. But you probably can't mandate integration. As you point out, we can't solve bureaucracy with bureaucracy without creating an entirely new tangle of unintended administrative consequences. I'm sure that whatever gains we're making w/r/t longevity and healths are eaten into (albeit in small amounts) by the time expended on navigating the labyrinth and the frustration such time-wasting produces.

Interesting article, let me just add that, a fundamental problem in evaluating reform proposals is the difficulty of estimating their cost and potential impact.


The comments seem to be talking all around the question but not addressing the heart of the entreprenurial debate. The issue should be: How to get state capital around the financial logjam and into the hands of the entrepreneur.

I hope that world poverty is eradicated completely. Is it ok to accept that in the future only only 1 billion people will be in poverty? should we be happy with that? sounds like 1 Billion people too many if you ask me!

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