Medical record privacy laws and the role of interest groups

In my dissertation, I examine the role of interest groups in influencing medical record privacy at both the federal and state level (Maine and Hawaii). I specifically examine the questions: what were the roles of interest groups in influencing HIPAA; how did the passage of HIPAA affect the legislative actions of the medical record privacy laws in both Maine and Hawaii; what were the roles of interest groups in the implementation of medical record privacy laws in Maine and Hawaii; did the arguments surrounding HIPAA resonate at the state level, and did they change from the federal to the state level?;Interest groups played a large role in the HIPAA hearings and the subsequent Privacy Rule hearings. In addition, HIPAA affected the two states quite differently. HIPAA had relatively little impact on the legislative actions in Maine, but had a considerable impact on the legislative actions in Hawaii. However, interest groups played a large role in the legislative histories in both Maine and Hawaii. The interest groups involved in Maine's legislation were successful at drafting privacy legislation, successful at getting the legislation suspended, and the interest groups were able to strengthen the law by removing the sunset provision. The interest groups involved in Hawaii's legislation were similarly successful at drafting privacy legislation. They were also very successful at getting Hawaii's legislation suspended, and subsequently repealed. HIPAA's Privacy Rule arguments resonated differently in Maine and Hawaii. HIPAA's Privacy Rule arguments did not resonate in Maine as the enactment hearings were held eleven months prior to publication of the final Privacy Rule. HIPAA's Privacy Rule arguments did, however, resonate in Hawaii's repeal hearings. Hawaii's repeal hearings began about one week after the Privacy Rule was published.;A compelling argument emerged in this dissertation: the need for privacy versus other societal needs. Medical record privacy is one of many issues where these interest clash, and valid arguments can be made for both sides. However, absolute privacy is neither achievable, nor desirable.