Standards for Privacy of Individually Identifiable Health Information. Final Privacy Rule Preamble.. Increasing Public Concern About Loss of Privacy


Today, it is virtually impossible for any person to be truly "let alone." The average American is inundated with requests for information from potential employers, retail shops, telephone marketing firms, electronic marketers, banks, insurance companies, hospitals, physicians, health plans, and others. In a 1998 national survey, 88 percent of consumers said they were "concerned" by the amount of information being requested, including 55 percent who said they were "very concerned." See Privacy and American Business, 1998 Privacy Concerns & Consumer Choice Survey ( These worries are not just theoretical. Consumers who use the Internet to make purchases or request "free" information often are asked for personal and financial information. Companies making such requests routinely promise to protect the confidentiality of that information. Yet several firms have tried to sell this information to other companies even after promising not to do so.

Americans' concern about the privacy of their health information is part of a broader anxiety about their lack of privacy in an array of areas. A series of national public opinion polls conducted by Louis Harris & Associates documents a rising level of public concern about privacy, growing from 64 percent in 1978 to 82 percent in 1995. Over 80 percent of persons surveyed in 1999 agreed with the statement that they had "lost all control over their personal information." See Harris Equifax, Health Information Privacy Study (1993) ( A Wall Street Journal/ABC poll on September 16, 1999 asked Americans what concerned them most in the coming century. "Loss of personal privacy" was the first or second concern of 29 percent of respondents. All other issues, such a terrorism, world war, and global warming had scores of 23 percent or less.

This growing concern stems from several trends, including the growing use of interconnected electronic media for business and personal activities, our increasing ability to know an individual's genetic make-up, and, in health care, the increasing complexity of the system. Each of these trends brings the potential for tremendous benefits to individuals and society generally. At the same time, each also brings new potential for invasions of our privacy.