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Letters to the Editor 

Week of June 11, 2003

Pissed About Privacy

Don't worry; we'll protect yours: While we share your interest in protecting the privacy of medical information, Peter Byrne's recent article was unfortunately filled with errors and misinformation about both the federal Health Insurance Portability and Accountability Act (HIPAA) and what our office is doing to implement it ["Big Doctor Is Watching," May 28].

Rather than reducing protections for individuals' health information as the article claims, HIPAA creates a high national privacy standard for the first time in the United States. Moreover, this standard is a floor rather than a ceiling. Thus, the public gains the benefit of whichever combination of state law and HIPAA that provides the most protection of health information.

My office is working and consulting with consumer groups and privacy advocates keeping California in the forefront of protecting privacy. The bill referred to in the article, Senate Bill 583, is intended to raise state law standards in areas where HIPAA is stronger. The version of the bill mentioned in the story simply does not exist.

Perhaps the greatest inaccuracy in the article is its implication that HIPAA creates new authority for law enforcement to gain access to a person's records by simply flashing a badge. Not true. Furthermore, the article does not acknowledge either the steps that a plain reading of the privacy regulation require law enforcement to go through to access information in a case, or the severity of the penalties for violation, with the worst offenders facing 10 years in prison and a $250,000 fine.

The right to privacy is precious and must be guarded with vigilance. However, in mischaracterizing HIPAA, your article does a disservice to the public's understanding of the impact of HIPAA and how to use it to further the goal of privacy protection.

Burt R. Cohen
Acting Director
California Office of HIPAA Implementation (CalOHI)

Peter Byrne replies: Cohen says it is not true that a law enforcement official may obtain a medical record by "flashing a badge." Experts quoted to that effect in my article included Paul S. Appelbaum, outgoing president of the American Psychiatric Association and a leading authority on HIPAA, and Robert Gellman, an attorney who helped draft HIPAA. They based their assertion on two provisions in HIPAA.

One authorizes law enforcement officials to simply ask a doctor or an HMO for medical data without obtaining a subpoena. A related provision authorizes doctors and HMOs to hand over medical records to law enforcement upon a verbal request if they can verify that the disclosure "is to a public official or a person acting on behalf of the public official. If the request is made in person, presentation of an agency identification badge, or other official credentials, or other proof of government status [is sufficient verification]."

Cohen says SB 583 "is intended to raise state [privacy] law standards in areas where HIPAA is stronger. The version of the bill mentioned in the story simply does not exist." One of the legal experts quoted in my story, Professor Richard Turkington of Villanova University Law School, a nationally respected expert on this aspect of HIPAA, found that SB 583 "nullifies" strong privacy protections in California's constitution and statutes because it contains the following loopholes: 1) State agencies may disclose personal information "to a governmental entity when required by state or federal law," including HIPAA, or 2) "disclosure is to a law enforcement or regulatory agency [engaged in] an investigation of an unlawful activity."

In other words, SB 583 allows HIPAA to trump more protective California law by allowing state officials to turn over medical records without a court order. According to these experts, the CalOHI authors of SB 583 had an opportunity to reverse HIPAA's deletion of the strong privacy protections enshrined in the Fourth Amendment to the U.S. Constitution but declined to do this. The state legislative counsel agreed that SB 583 needs to be rewritten in this light.

It is interesting that Cohen is willing to talk about SB 583 now. When I asked his office to respond to these critiques, I was informed that CalOHI "does not comment on pending legislation." Nor would Cohen comment on whether state officials must honor verbal requests for medical records from law enforcement or national intelligence officials.

Kudos: Peter Byrne deserves an award for this outstanding story. Pulitzer, Polk, you name it. Tell me where to send in my nomination.

Jeffrey A. Schaler
Silver Spring, Md.

Logic and Illogic

Does your writer know the difference?: Matt Smith's May 21 column "SFO My God" names me in two places, one correctly, and the other incorrectly. I write to demand a retraction of the second, incorrect and potentially libelous statement.

The public records of the city, including Board of Supervisors' legislation and budget analyst's report, do reflect I provided legal advice to the city in about 1997 in connection with the creation of the city's private, for-profit corporation named SFO Enterprises Inc. I simply performed my responsibilities as deputy city attorney. Mr. Smith has that part right.

Subsequently in the article, Mr. Smith states:

"By Martin, Costas, and Rosales' own logic, therefore, the blending of taxpayer and SFO Enterprises money exposed San Francisco to potentially massive liability from the corporation's operations in Tegucigalpa, home of the world's most dangerous airport."

I have not had a conversation with Mr. Smith about any subject which could lead him, in good faith, to make any such statement. Whatever opinion or judgment Mr. Smith may have about city decisions about SFO Enterprises does not give him a license to write falsehoods or misleading statements about anyone. Therefore, I demand that you issue a correction.

Finally, as a San Franciscan of Central American descent, I am personally offended by the blatant disdain your paper and Mr. Smith demonstrate in the article against the Central American country of Honduras.

Mara E. Rosales
Deputy Airport Director
San Francisco

Editor's note: We are happy to provide Ms. Rosales the opportunity to make her views known but find no reason for a correction.

Puttin' a Whammy on Saddamy

Be paranoid, people; be very paranoid: Kudos for the excellent and compelling article by Bernice Yeung ["Regime Changing," May 7]! This is not the first time this information has come to light. One can visit KPFA's Web site for more stories and photos of Rumsfeld shaking hands with Hussein back in '89. It is very easy to be an "asleep-at-the-wheel" flag-wavin' amerikan.

That whole system is set up to receive all the lazy-ass patriots who don't or refuse to acknowledge their own country's recent history in light of the constitutionally malignant maneuvers this administration carts out every day! It continually amazes me how many creeps out there want to shut out resistance to the Pentagon's far-reaching and seditious maneuverings. One can only think they are not paying any attention or they are lazy. Paranoia is a state of heightened awareness; I suggest you get off your ass and get there!

Rik Wisinski

Fairy-tale ending: How touching: the bicultural, Oxford-educated, former D.C.-insider Iraqi-American who had advocated war in Iraq realizes in the end that it was all wrong, that there were "other" ways. Hey Bernice: How much you want to bet that this guy, ambivalent as he'd always been, would have said, if the war hadn't happened, that that was a mistake? But wouldn't that ruin your pretty little ending?

Frank Mosta

The Good, the Bad, and the Stinky

Mirror, mirror on the floor: I know Dog Bites didn't cover hotel restrooms ["The Fine Art of Restroom Rating," May 28]. But still I must say that the women's room in the Sheraton Palace lobby has a polished marble floor so shiny it's almost a mirror -- to the extent, unfortunately, that you can almost tell whether the woman in the stall next to you is an all-over blonde or not. You can see everything going on! Too much information for just a quick pee!

Elizabeth Roberts
Inner Sunset

Gettin' jiggy in the WC: My boyfriend and I get it on constantly in public restrooms. Not so anyone can see us, it's always behind locked doors, but let me tell you it's fantastic. It's quite an experience (especially when anyone can hear you).

Erica Mann
Via the Internet

Gross but fun: Finally, some relevant journalism in this city.

Check out the bathroom at the Toronado on a busy night. Pretty gross. I pity any woman that has to use it, but it has arguably the best graffiti anywhere in the city. It's doubly funny if you know which bartenders the jokes refer to.

Paul Sauer
Via the Internet

This guy gets around: Sadly enough, I've been to all of the worst restrooms on your list, but only out of sheer desperation. The Endup restroom deserves a spot under the worst column the next time you do this list.

I've only been there on a Saturday morning or a Sunday morning, but since it has a piss trough in the "male" bathroom (people usually ignore the signs and turn them into unisex facilities), and they sometimes stay open the next morning without closing down from the previous night, it kind of makes you wonder just what the hell was going on in the stalls the night before.

I feel that this list might even encourage some establishment owners to improve the status of their restrooms in order to avoid future embarrassment. Nice job!

Fredrick Edwards
Daly City

Pissoir with a view: The men's room at Jade on Gough has a great one-way mirror looking onto the main-floor bar.

Brian Haarmeyer
Via the Internet

You're, um, welcome: The mirror at the Eagle isn't all that well placed. To see the other guys' cocks, I have to just look over at them. Now, I have lots of other places to go and lick the piss-soaked floors, being the pisspig that I am. Thanks!

Via the Internet

Hee haw: Siegler's article was so funny it almost made me shit my pants. I don't mean to dump on the other excellent writing [in the issue], but this article wipes out the competition.

OK, enough with my bad pun attempts. I just wanted to thank Siegler for the laughs before heading out to find myself some "free-range" toilet paper.

Don Miguel
Western Addition


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