The Department estimates some of the future costs of the rule in Section E of the Preliminary Regulatory Impact Analysis of this document. The estimates made include costs for the ten years after the effective date. As discussed in Section E, state and local government costs will be in the order of $460 million in 2003 and $2.4 billion over ten years. Estimates for later years are not practical. The changes in technology are likely to alter the nature of medical record-keeping, and the uses of medical data are likely to vary dramatically over this period. Therefore, any estimates for years beyond 2012 are not feasible.