The underlying goals of a health system involve the improvement and equal distribution of health, responsiveness to the expectations and needs of the population, and fairness in financial contribution in obtaining necessary health care (1). The health of an individual is a personal matter, which most take very seriously in the United States today. Personal choice in providers and types of care, provider sensitivity and non-judgment, and respect for the privacy of personal health information are aspects of our healthcare system that are often taken for granted. HIPAA laws protect the privacy of our individually identifiable health information. When I worked within the legal department of a large HIV/AIDS organization in Los Angeles, any instance of a breach of confidentiality within any capacity was handled with utmost care, concern, and investigation. Employees were trained quarterly on proper practices and any changes to HIPAA in order to respect the privacy of every patient in accordance with the laws.
Murray and Frenk (2000) address such issues of responsiveness and respect for the individual during interactions with the health system. Individuals should have the right to the confidentiality of their personal health information in order to openly discuss medical history with their provider and preserve individual power over such information. Such avenues of respect also include a properly trained physician who is receptive and sensitive to potentially embarrassing disclosures of health information or physical treatment. Individuals should also have the ability to decide what health interventions and treatments they receive and do not receive (1).
I was struck by the concept that health systems in developing countries may often lack such aspects of responsiveness, confidentiality, and respect for the dignity of the individual – common expectations of our health system today. These gaps have the potential to produce stigma and a lack of social authority, which may compound broader issues of access and usage of healthcare services. The existence of proper responsiveness among all levels of society is rooted within differences of social, cultural, demographic, and economic factors (1). How do we elevate the importance of responsiveness and quality of care in developing countries? Do individuals in developing countries deserve an equal right to protection of personal health information?
1. Murray, C. & Frenk, J. (2000). A Framework for Assessing the Performance of Health Systems. Bulletin of the World Health Organization, 78(6), 717-731.