These goals conflict with privacy, and the trade-offs can be sharp. The single worst part of the rule is the marketing language. No one wants a telemarketing call from someone who knows whether one has been treated for cancer, syphilis, hemorrhoids or anything else. HHS went out of its way to allow use of health records for marketing. Patients can't even opt out of marketing lists until after they have been marketed to.
Marketers can actually have broader access to records than a patient's next of kin.
The marketing provision is just awful. I see three scenarios for the new HHS review. First, Thompson could let the rule go into effect as written. That wouldn't satisfy the health industry. Second, Thompson could suck the little remaining substance out of the rule.