Why is the American Psychoanalytic Association expending so much of its energies and resources on the legislative process, addressing the issue of privacy and confidentiality? We cannot forget that there is a real danger to the welfare of our patients because of the loss of privacy. This danger is the central issue facing our profession this year.
The President and the rest of his administration state that they endorse strong privacy provisions in medical records legislation. However, their statements ring hollow when one looks at what will be implemented by the administration if Congress does not pass a strong privacy bill by August 21, 1999. We have to educate our legislators about the crucial role of privacy in quality care as affirmed by the Supreme Court in Jaffee v. Redmond in 1996. How can we do this? How can we be sure that our voices and the voices of our patients will be heard by our representatives and senators?
In March, a group of members of the American spent a weekend learning how to lobby from our legislative consultants, Powers, Pyles, Sutter & Verville, particularly Jim Pyles and Judith Buckalew. These two professionals formulated a strategy for us to address the issues and taught us how to communicate to our legislators and their aides.
Jim was able to distill our message to three simple phrases:
Privacy is vital to quality care.
The Supreme Court recognized the same thing in 1996, and this is consistent with our experience.
There can be no preemption of state laws, many of which have more effective privacy standards than would be allowed under some bills that will be considered by Congress.
Armed with these three statements on a note card that we could easily memorize as we walked or rode to the Hill, we went, individually and in groups, to meet with our representatives' and senators' legislative aides who were responsible for health care. Judi and her staff had scheduled appointments for us, and we all found the legislative aides extremely receptive to our ideas. All understood that quality psychotherapy requires assurances of privacy. Some were clearly knowledgeable; others needed more education from us. All eagerly accepted our written privacy principles.
It was gratifying to learn of Jim Pyles's impact on the legislative process. In a discussion with a professional staff member from the Senate Committee on Finance, I asked whether Congress was aware of the Jaffee decision. She answered, “All of those with whom Jim Pyles has spoken, and he speaks with everyone he can.”
Our visit to the Hill and the subsequent events (the Health Care Financing Administration reversing its position on eliminating privacy for home health-care patients as a result of Jim's work) have demonstrated our potential impact on the legislative process. Despite our numbers and our relatively meager resources, we have a great deal of power. We need to wield it.