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Roth frames the show as the first of a two-part series on the soul of medicine, beginning with the narrower question of medical record confidentiality. George Bussey, who is both a physician and a lawyer, explains that as healthcare delivery grew more complex—nurses, billing staff, insurers—the old one-on-one doctor-patient model of confidentiality dissolved. Health plans, he argues, legitimately need access to records to verify claims and measure quality. Arleen Jouxson-Meyers agrees that some access is necessary to combat fraud but contends the balance has shifted too far toward insurers: patients with sensitive conditions such as HIV infection or family abuse histories cannot protect their privacy without paying entirely out of pocket. The two dispute clinical practice guidelines—Bussey calls them physician-developed tools; Jouxson-Meyers responds that HMSA once linked non-compliance to termination from the plan. She also criticizes contractual language that lets health plans direct care while disclaiming legal responsibility. Callers raise pharmacy disclosures of patient prescriptions to employers and the cost burden of government regulations on physician practices. Hawaii's concentrated insurance market, with HMSA commanding over 60 percent of the state, makes patients more vulnerable than in markets where people can simply cross a state line for care.
Transcript
Read or download the full transcript (.txt). Speaker labels were assigned automatically and may contain errors.
Companion newspaper commentaries
Commentaries by the guests, published in The Honolulu Advertiser around the broadcast.
