Ohio Legislators Shaft Patients’ Rights to Medical Records

By passing House Bill 508 at the end of 2000, the Ohio General Assembly catered to deep-pocketed special interests in a disgusting way. To keep corporate lobbyists happy, legislators hamstrung the people’s ability to obtain crucial medical information.

Under HB 508, patients who ask health-care providers for a copy of their own medical records can be charged a fee. Access to the records may be denied if no fee is paid – regardless of whether the requestor is homeless or otherwise in financial straits.

According to the bill, the charges can start with a $15 search fee. On top of that, the charges may include $1 a page for the first 10 pages, 50 cents each for pages 11-50, and 20 cents per page thereafter. If the records are mailed, the requester also pays the postage.

Those fees are grossly exorbitant. Most state agencies in Ohio charge 5 cents a page for copies of public records. Several years ago, the Ohio Highway Patrol set its price at 5 cents per page after doing a cost analysis.

For-profit companies, such as Kinko’s Copies, thrive by charging 7 cents a page. Even the chairman of SmartCorp, a company used by hospitals to handle requests for medical records, testified in a lawsuit that the cost of providing copies is 15 cents per page. Many believe the cost is closer to 5 or 6 cents a page at a lot of institutions.

Under Medicare regulations, hospitals can charge only 7 cents a page for copies of medical records they supply to peer-review organizations. Moreover, the policy of many health-care providers is to give free copies of patients’ records to other providers who request them.

In the Senate, Scott Oelslager (R-Canton) cast the lone vote against HB 508 and called the bill “a ripoff to patients.” He said “there is nothing more personal and private than an individual’s medical records.” In arguing for the right of patients to obtain a copy without charge, he maintained they have already paid for the records through related medical fees.

Louis Blessing Jr. (R-Cincinnati), who introduced the bill in the Senate, was sympathetic to Oelslager’s position and agreed that the bill was unfair. But he said it was an improvement over the prior law. He had a point there, because patients had been charged as much as $32.67 a page and total costs of hundreds or thousands of dollars for their records.

On the other hand, many attorneys believe that if the previous law had been enforced, patients would have been entitled to a free copy of at least their hospital records. But the Ohio Attorney General’s “Consumer Protection Section” showed no interest in enforcing the law – despite repeated requests from consumers. One former assistant attorney general told The Ohio Observer that there was no way the office would ever take on such a case. He explained that the hospital lobby is just too powerful.

Although Blessing supports much lower fees than those contained in HB 508, he said the bill is the best that could be accomplished in the current legislative environment.

The sordidness of that environment was shown when Blessing, an attorney, complained that the fees were being kept high to prevent patients from filing medical malpractice lawsuits. In his words: “If there are no medical records, there’s no malpractice suit.” His observation is particularly true for patients who have hundreds of pages of records.

Thus, the legislative intent in enacting the law was to deny poor and middle-class patients equal justice with the rich. The law prevents them from learning about and obtaining a remedy for harms to their health – or deaths to family members – caused by incompetent medical providers. In the process, they are also denied important information about their medical condition and history.

All those restrictions were placed on them by a nearly unanimous vote of their elected “representatives.”

The legislators who supported HB 508 represent the people in name only. The sad truth is that the health-care industry is one of the top sources of campaign contributions in Ohio politics. It’s no coincidence that the industry’s lobbyists were able to exert a great deal of influence over the bill.

This bill’s enactment supports what Arianna Huffington argues in her book How to Overthrow the Government: “It’s time to realize that our government is no longer merely ‘influenced’ by corporate contributions – for all practical purposes its every move is predetermined by them.”

It’s especially disappointing that Democrats in the legislature did not oppose or speak out against HB 508. Their silence supports another claim made by Huffington: the current leadership of the Democratic Party is also in the pocket of corporate lobbyists.

As Huffington puts it: “American politics is broken – under the thumb of a small corporate elite using its financial clout to control both parties’ political agendas.” As a result, she says, our “governmental system . . . has gone rotten at the core. . . .”

In his book No Island of Sanity, Vincent Bugliosi takes a longer-range view of the problem. He asserts: “Big business and special-interest groups have been financing federal, state, and even local elections for both parties in America for decades, and getting substantial benefits in return that are directly antithetical to the general public’s interest and welfare. . . .”

Any reasonable person can see that the fees allowed by HB 508 are obscene, are a substantial windfall to the health-care industry, and are “directly antithetical to the general public’s interest and welfare.” Only greedy and coldhearted corporate interests, and their lackeys in government, could support those fees after learning the relevant facts.

In view of the legislators’ willingness to serve corporate lobbyists instead of the public on this issue, there is little reason to believe they have the will to limit other mounting health-care costs. No wonder those costs have risen substantially in recent years, and many working Ohioans cannot afford health care.

This shafting of patients is an example of the need for campaign finance reform. Under the present system, most members of the General Assembly – and a former Attorney General – seem far more concerned about campaign contributions from deep-pocked special interests than about corporate gouging and the resulting injustice to the public.

Ralph Nader, we need you in Ohio.

[Update: The current fees, which are generally even more outrageous, are set forth at Ohio Revised Code Section 3701.741. The power of the health-care lobby over Ohio’s public officials continues.]