If your employer pays for your health insurance, then the employer may be able to obtain your treatment records. Records are also routinely shared with or used by public health authorities, medical researchers, dozens of government agencies at the federal, state, and local levels, schools, courts, fraud and abuse investigators, cost containment managers, outcomes researchers, licensing and accreditation organizations, police, coroners, and others. Some records are routinely sent overseas for transcription. Medical records are simply not confidential. The routine sharing of patient records is an essential feature of the culture of the medical establishment in the United States.
Most disclosures occur without notice to patients and without any patient consent.
Most individuals are completely unaware of the routine sharing of health records, and even many health professionals still think that records are private. However, just about every community of medical record users has asked for some type of exemption from any health privacy rules. Every user believes that its function is so vital and so important that no barriers to access and use should be erected. Of course, every institution is willing to have a law that applies to others. Everyone believes in privacy.