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Going Blind On Our Watch
PREFACE: Public health is where medicine and law intersect. As might be expected, there sometimes are conflicting opinions—and actions—at the nexus of the two cultures. Physician Toni Martin works both in a city health clinic and as a medical consultant in the Social Security Administration’s disability program. What saddens her are the claimants (in official Social Security parlance) with preventable diseases that aren’t prevented because the claimant couldn’t pay for treatment. What kind of nation, she wonders, allows citizens to become blind if their blindness could have been prevented? Next, former Los Angeles Times staffer Irene Wielawski details how confusion about HIPAA—and fear of its fines and jail terms—contributed to a lapse in public health vigilance during a TB scare at her daughter’s college. After some head knocking and a good deal of regulation reading, she offers up a three-point plan to make HIPAA more comprehensible and more effective.
EVERY WEDNESDAY and Thursday I drive to the Frank Hagel federal building in Richmond, California. This edifice is a faux-brick fortress in the Iron Triangle, a neighborhood infamous for crime. I park in a patrolled parking lot and show my badge to the security guard downstairs before I punch my timecard. Then I take my seat in one of dozens of cubicles on the fourth floor. There’s no window to distract me in my cubicle, which I share with a psychologist who works there on the days I’m not in. I pull up a computer file and start to
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