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May 29, 2019 – Youth Caucus of America
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healthcare data breach yca pic

The Prevalence Of Healthcare Data Breaches

The Prevalence Of Healthcare Data Breaches

Why Vulnerabilities In Healthcare Information Technology Put Your Privacy At Risk

WHAT YOU CAN DO...

By Josette Barrans

Today, it seems like healthcare data breaches have become commonplace. Almost every week we hear a news story about records being compromised on a massive scale, but most people don’t understand what this actually means. Though these data breaches are often quickly forgotten about by the general public, their implications are much more dire than one might expect. Firstly, this data is being targeted at an alarming rate. According to the HIPAA Journal, healthcare data breaches are being reported at a rate of more than one per day[1]. Strong and effective actions are clearly needed to address such a consistent issue. Secondly, these breaches are both expensive and deadly. There is often no way to prevent fraudsters from racking up medical bills under your name and this alteration of your medical information can affect your healthcare treatment and services in the future. Lastly, these thefts are extremely hard to fight, which has caused a standstill of reform efforts for many years.

Healthcare data breaches can include a multitude of private information, including medical records, social security numbers, addresses and both employment and credit card information[2]. These breaches allow criminals to use someone’s identity to access healthcare or insurance worth hundreds of thousands of dollars, resulting in a greater impact than simply stealing credit cards[3]. If your medical insurance is breached, you may have to pay out of pocket for medical procedures or medications in the future. You may even have to cover the costs incurred by these thieves, affecting a patient’s ability to access payment during an emergency. Furthermore, if a thief uses your medical identity to incur costs, these purchases and procedures will go on your permanent medical record. So, this will affect how doctors view your alleged pre-existing conditions as they will also be scrutinizing false information. This can impact your medical treatment, which could have dangerous consequences. These breaches take twice as long to spot as credit card fraud and are much more difficult to address due to the hardship of correcting medical records and the inability of police to accept certain reports out of their jurisdiction[4]. While some private companies have developed medical identity monitoring services, these are available solely to insurance companies rather than individuals.

To address this issue, the Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 to protect the security of healthcare information and ensure confidentiality[5]. Yet, since 2009, data breaches have led to the theft of over 189 million healthcare records, which equates to more than 59% of the population of the United States[6]. Because of HIPAA, healthcare companies are required to pay damages for data breaches, costing the industry around $6 billion each year[7]. Though healthcare organizations don’t want to be spending this money, they seem to lack the ability to prevent breaches considering that no effective changes are being made.

There are many different causes for data breaches. Negligence is a main one, as healthcare workers often can accidentally expose records to predators either through mistakes, falling for phishing scams or partnering with shady businesses. Some organizations claim they lack the resources to fight cyber attacks, as some breaches are caused by skilled hackers. One main issue with the prevention of medical information fraud is that it takes twice as long to spot and is hard to address compared to other types of breaches[8]. If your credit card data is stolen, you can simply close your account. This is obviously not the case with your medical records, as there is no way to wipe your slate clean or easily alter the information due to the fact that they are permanently attached to your identity. While credit card companies usually have measures in place to detect fraudulent activity, insurance companies do not. Therefore, criminals can take advantage of this security flaw in three ways. First, they can steal your identity and receive medical care with your money. Secondly, they can set up fake clinics to bill your provider for fabricated procedures and services. Lastly, they can order prescription drugs through your insurance, which they resell for a higher price.

A mix of technology, education, and leadership is needed to crack down on these breaches[9]. As previously mentioned, there are already policies in place to help medical information and healthcare companies follow these guidelines. In fact, Congress enacted the HITECH Act in 2009, which sought to promote the adoption and meaningful use of healthcare information technology while also reinforcing privacy and security concerns[10].  This Actincreased the potential legal liability for non-compliance with HIPAA standards and provided for more strict enforcement[11]. While the HITECH Act has improved the use of electronic health records, it is hard to tell if it has reduced healthcare breaches, which are still happening at a high rate.

The crux of the problem is the healthcare companies’ inability to defend against and properly address these data breaches. So, more protective or advanced technology would be a great asset in this battle. Education on topics such as proper technology use, scams and proactive due diligence would also be useful to provide these organizations with tools to set their security systems up for success. Considering that 58% of all healthcare data breaches are initiated by insiders, some scholars have suggested adopting a zero-trust security policy to combat data breaches[12]. Zero Trust Security is a new security model based on the four pillars of “verifying the identity of every user, validating every device, limiting access and privilege, and learning and adapting using machine learning to analyze user behavior and gain greater insights from analytics”[13]. This would greatly improve the protection of patient records, as it is based on the idea of verifying every device or access attempt to effectively defend all potential attack surfaces.

Some organizations have started to develop technology specifically designed to allow individuals to take action to prevent medical information fraud. For example, a company called ID Experts developed the Medical Identity Alert System (MIDAS) to closely monitor their medical records and transactions so they can detect potential fraud[14]. Additionally, Blue Cross Blue Shield has made identity protection services accessible for all of its members. While these are steps in the right direction, healthcare companies must also enact more preventive measures on the technological side to block breaches, as the burden of protection cannot fall solely on the customer. More awareness must be raised regarding the impact of data breaches on individuals so that pressure can be put on healthcare organizations to prevent these breaches from occurring in the future.


[1] “Healthcare Data Breach Statistics.” HIPAA Journal, HIPAA Journal, 2019, www.hipaajournal.com/healthcare-data-breach-statistics/.

[2] “Why Data Security Is The Biggest Concern of Health Care.” Health Informatics Online, University of Illinois at Chicago, 27 Oct. 2018, healthinformatics.uic.edu/blog/why-data-security-is-the-biggest-concern-of-health-care/.

[3] Korolov, Maria. “Health Data Breaches Could Be Expensive and Deadly.” CSO Online, CSO, 9 Feb. 2015, www.csoonline.com/article/2882052/health-data-breaches-could-be-expensive-and-deadly.html.

[4] Korolov, Maria.

[5] “50 Things to Know about Healthcare Data Security & Privacy.” Becker's Hospital Review, Becker's Healthcare, 9 June 2015, www.beckershospitalreview.com/healthcare-information-technology/50-things-to-know-about-healthcare-data-security-privacy.html.

[6] “Healthcare Data Breach Statistics.”

[7] “50 Things..”

[8] Korolov, Maria.

[9] Eastwood, Brian. “How to Prevent Healthcare Data Breaches (and What to Do If You're a Victim).” CIO, CIO, 20 Dec. 2012, www.cio.com/article/2389573/how-to-prevent-healthcare-data-breaches--and-what-to-do-if-you-re-a-victim-.html.

[10] “50 Things..”

[11] “What Is the HITECH ACT?” Compliancy Group, Compliancy Group, 7 Jan. 2019, compliancy-group.com/what-is-the-hitech-act/.

[12] Columbus, Louis. “58% Of All Healthcare Breaches Are Initiated By Insiders.” Forbes, Forbes Magazine, 31 Aug. 2018, www.forbes.com/sites/louiscolumbus/2018/08/31/58-of-all-healthcare-breaches-are-initiated-by-insiders/#77864ea0601a.

[13]  Columbus, Louis.

[14] Gregg, Bob. “ID Experts: Mitigating Data Breach and Alleviating Identity Theft and Fraud.” Cyber Security, CIO REview, 2019, cybersecurity.cioreview.com/vendor/2016/id_experts.

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The Rape Kit Backlog

The Rape Kit Backlog

Why Most Assault Cases Never See The Inside Of A Courtroom

WHAT YOU CAN DO...

By Alexandra Bixler

        One in five women will be sexually assaulted in their lifetime.[1] While this is a harrowing statistic, rape remains the most underreported crime with 63 percent of incidents failing to reach law enforcement. This percentage is abysmally low and often representative of survivor’s fears, whether it be retaliation, losing employment or social ostracization. Unfortunately, the news often propagates these fears through its characterization of victims.  Justice Kavanaugh’s accuser, Christine Blasey Ford, received death threats against her family that impeded her ability to return to work. Rapper R. Kelly is facing legal ramifactions for accusations of child sexual abuse and sexual assault only after the documentary Surviving R Kelly detailed over 30 years of ignored accusations from young, low-income black women. Of the past five U.S. presidents, three have been accused of sexual misconduct (George Bush Sr, Bill Clinton, Donald Trump). Sadly, a large majority of these men resumed their careers practically unscathed.

        While external factors such as societal retaliation or indifference contribute to an unwillingness to report assaults, the legal process itself is inefficient and problematic for survivors. Rape kits are important in gathering forensic evidence for sexual assault cases as they collect identifying information on the perpetrator. However, these vital pieces of evidence are often ignored; in Jackson, Mississippi, the Jackson Police Department (JPD) has a backlog of 600 rape kits, with some being up to 10 years old. While some of these victims decided not to pursue charges, the JPD is still mandated to evaluate the evidence and determine whether to pursue prosecution to prevent further attacks from occurring. This is especially relevant in child sexual abuse cases, as Missippi holds no statue of limitations thereby allowing evidence to be used at practically any time.

        This troubling phenomenon is not specific to Mississippi; the United States has over 100,000 backlogged rape kits[2] and the average wait time for a rape kit to be tested in Washington is 14 months.[3]

        The testing of rape kits sends a very clear message to victims: “you matter and your case matters,” just as a rape kit’s neglect sends the opposite message.

        Hania Noelia Aguilar, a 13-year-old girl from North Carolina, was a victim of this indifference after she was kidnapped, raped and murdered in December 2018. Aguilar’s perpetrator, Michael Ray McLellan, committed another assault in 2016. However, the rape kit that implicated him was never investigated and thereby never made it to court. When asked about the incident, the Robeson County District Attorney Johnson Britt said:

        “I don't know what happened, if it got lost at the sheriff's department, if it got buried on somebody's desk, if it got placed in records division there and just vanished...In all likelihood, had this gone forward and we established a case against him at that time, Hania would not have died. And for that, I can't tell you how much that hurts, I can't tell you how sorry I am."

        The rape kit backlog exists for a variety of reasons. Sex crime units are commonly understaffed, often resulting in departments failing to prioritize these cases.[4] Unfortunately, inherent biases also exist against sexual assault victims, resulting in victims often being blamed or not believed. Research shows that officers suspect sex crime victims of lying more than victims of other crimes despite no evidence of such a variation. Many of these issues stem from a lack of trauma training, causing officers to disregard a victim’s credible account because of a lack of knowledge about the impact of trauma.

        In fact, James Hopper, Ph.D, an Instructor in Psychology at Harvard Medical School, wrote a piece on the impact of trauma on memory loss. The prefrontal cortex is responsible for executive functions like attention, thought processes, or impulses. The prefrontal cortex is severely inhibited in traumatic situations, which makes disorientation and memory gaps common. At some point in a very traumatic event the amygdala “takes over,” causing the brain to hyperfocus on irrelevant details like a facial expression or the designs on the ceiling. Additionally, the hippocampus can also impair a survivor’s ability to recall events in a proper sequential order.[5]  This was an especially prevalent issue when Christine Blasey Ford accused Justice Kavanaugh of attempted rape. Kavanaugh supporters looked to the fact that Blasey Ford did not remember specifics of the assault as lying, when in reality large memory gaps relating to trauma are relatively normal.

        Law enforcement can also sometimes lack knowledge in how sex criminals behave. Unfortunately, sex criminals often target individuals that are powerless or less likely to have legal support, placing these demographics at a higher risk. Some of these invidiuals may be non-English speakers (especially immigrants in the agriculture industry, or in the housekeeping industry), sex workers, drug abusers or the homeless. As a result, at-risk groups that need the most support often garner the least due to societal stigmas that tend to deprioritize the testing of kits from these social demographics.[6]

        Ultimately, stigmas that persist in social spheres against victims of sexual assault are not separate from law enforcement but rather seep into their judgements. It is important for these sex crime units to be properly funded and for all assault victims to be treated with respect. Everyone is entitled to a fair and thorough investigation.

 


[1] Black, M. C., Basile, K. C., Breiding, M. J., Smith, S .G., Walters, M. L., Merrick, M. T., Stevens, M. R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. Retrieved from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control

[2] Vicory, Justin. “JPD Has a Backlog of 600 Sexual Abuse, Rape Kits. Here's What It Means for Victims.” The Clarion Ledger, Mississippi Clarion Ledger, 21 Mar. 2019

[3] Porter, Essex. “Lawmakers Confront Price Tag for Rape Kit Backlog.” KIRO, 26 Feb. 2019

[4] Hayes, Christal. “NYPD Ignored Understaffing in Sex-Crimes Units, Told Detectives to Ignore Cases, Probe Shows.” USA Today, Gannett Satellite Information Network, 27 Mar. 2018

[5] Lisak, James Hopper and David. “Why Rape and Trauma Survivors Have Fragmented and Incomplete Memories.” Time, Time, 9 Dec. 2014

[6] Monahan, Jerald, et al. “Police Chief Magazine|Topics|Criminal Justice Reform|The Effect of Cultural Bias on the Investigation and Prosecution of Sexual Assault.” Policechiefmagazine.org

student debt yca 2

Addressing The Student Debt Crisis

Student Debt: The Costs Behind Higher Education

Examining The Financial Burden Of "The Best Four Years Of Your Life"

WHAT YOU CAN DO...

By Gillian Hand

Despite the crucial role of education in American prosperity and individual success, numerous citizens who hope to attend college are discouraged by the threat of debilitating student debt. In fact, Americans currently owe $1.5 trillion in student loans, a continuously growing number that serves as a 350% increase from the debt levels in 2003.[1] While the government grapples with its vision for the alleviation of the crisis, states are pursuing their own plans of action, such as loan forgiveness programs and other forms of financial support. However, it is essential that these efforts are supported by federal reforms that give every citizen an opportunity to pursue higher education without the pressures of lifelong debt. The 2020 presidential election will undoubtedly be a battleground for discussions of student debt reform, with a wide field of potential Democratic nominees voicing their own proposals alongside criticisms of the current administration.

It can be incredibly difficult for students to escape the trap that is a student loan. Weak job opportunities for young graduates often result in these workers frequently struggling to make enough money to pay back their loans, keeping them confined by the crushing weight of student debts. Minority communities have been found to be particularly affected by the debt crisis, with many of these students being unable to pursue a higher education due to the inevitable loans that will follow them throughout their lives.[2] The student debt crisis threatens not only the future of the United States economy but also the financial security and freedom of Americans, 44 million of whom are currently trapped in the depths of this crisis.[3] It is crucial that lawmakers invest efforts and resources in the transformation of the student loan system by offering students an achievable and debt-free path to higher education.

        According to the National Conference of State Legislatures, lawmakers across the nation have set their sights on the student debt crisis. Recent state legislation has produced nearly 200 bills with a variety of debt solutions including loan forgiveness, priority of specific professions and new tax credits. 119 of these bills would create or expand student loan forgiveness programs, with many targeting specific professions in fields such as health care and education.[4] This legislation showcases how states are now taking the initiative in the alleviation of student debt, offering their own solutions in the absence of federal efforts. Should the nation fail to address the student debt crisis as it stands, the loans will only worsen, exacerbating the debt crisis and keeping millions of Americans from financial security and possibly higher education itself.

        In addition to these state reforms, there have also been efforts at the federal level to address this crisis.  The Trump administration recently released several proposed changes to the Higher Education Act, including the reduction of federal loan repayment options as well as the capping of the amount of student loans that parents and graduate students can take on.[5] The White House claims that schools are largely responsible for the student debt crisis, as colleges tend to drive up their tuitions and are often unwilling to work to make education more affordable. The schools themselves, however, argue that they are forced to raise tuition in the wake of funding reductions from state legislatures and insufficient support from the government. This call for greater federal support of institutions of higher education is echoed by many Democrats, including Senator Patty Murray, the top Democrat on the Senate Education Committee. Murray remarked that Trump’s plan does not address the true source of the problem: the skyrocketing college prices that burden students with massive amounts of debt. Murray also noted that the proposal would likely hurt citizens in the long run by reducing the amount of federal aid allocated for students.[6] 

        The Department of Education has also been active in the realm of student loans. Secretary of Education Betsy DeVos has proposed a plan calling for the termination of a Public Service Loan Forgiveness Program and the elimination of subsidized loans for low-income students. Currently, the Public Service Loan Forgiveness Program forgives remaining student debt sums after eligible workers make ten years of on-time payments, particularly helping public service professionals such as social workers, primary care doctors, public defenders, and teachers.[7] The Department under Devos has been attempting to repeal Obama-era policies, arguing that the student loan forgiveness programs under Obama are costly to taxpayers and unfair to colleges. While Devos and other conservatives find existing policies too lenient, federal courts have rebuffed these attempts thus far, forcing the Department to continue the programs.[8] Looking ahead, Devos has requested $130 million in next year’s budget to upgrade the student loan servicing system. Democrats, however, worry that this is not a step to help students afford higher education and pay back student loans but rather a gutting of financial aid money that will worsen the debt crisis in the long run.[9] 

        As we approach the 2020 presidential election, student debt remains a popular issue in the large field of potential Democratic nominees. Senators Elizabeth Warren, Kristen Gillibrand, Kamala Harris, and Cory Booker—all Democratic candidates for 2020—recently co-sponsored the Debt-Free College Act of 2019, which aims to offer federal funding to institutions that commit to helping students pay tuition without burdening them with staggering debt. Other candidates have voiced support for developments similar to Bernie Sanders’ “College for All Act”, which supports tuition-free college for low-income students. Some potential nominees are even drawing attention to Trump’s debt policies in order to highlight their own opposition to his administration, taking advantage of a key issue that might be popular with the Democratic base’s large population of young voters.[10] It is evident that student loan reform will play an important role in 2020 campaigns as Democratic candidates address these debt issues and condemn the deficiencies of the current administration.

        While there might not yet be a clear solution to the problem, steps should certainly be taken to support affected citizens by ensuring that money is not removed from programs designed to help them. There are many faces of the student debt crisis and numerous shortcomings with the higher education system itself; while state action is undeniably important, federal reform is needed to remove this primary barrier to education and financial security. Supporting federal efforts such as Senator Elizabeth Warren’s student debt relief plan will be essential in the alleviation of these enormous burdens, and advancements such as loan forgiveness programs are both necessary and possible. The movement to combat student debt and provide affordable education requires these federal standards as a base that will inspire state efforts going forward. The reform of student loans should be a priority in modern education policy and will play a crucial role in the presidential campaigns of 2020.

 


[1] Hess, Abigail. “Trump Administration Proposes Capping Student Loans, Cutting Repayment Options-Here's What That Means for Borrowers.” CNBC, NBC Universal , 20 Mar. 2019, www.cnbc.com/2019/03/19/trump-proposes-capping-federal-student-loans-cutting-repayment-options.html.

[2] Swig, Mary Green. “A Movement Emerges to Free Former Students from Crushing Loan Debts.” Common Dreams, 23 June 2018, www.commondreams.org/views/2018/06/23/movement-emerges-free-former-students-crushing-loan-debts.

[3] “Our Story.” Our Story | Freedom to Prosper, www.freedomtoprosper.org/our-story/.

Stratford, Michael, et al. “Betsy DeVos Strikes out - in Court.” POLITICO, Politico LLC, 21 Mar. 2019, www.politico.com/story/2019/03/21/devos-roll-back-obama-policies-1288782.

[4] Stratford, Michael, et al. “Betsy DeVos Strikes out - in Court.” POLITICO, Politico LLC, 21 Mar. 2019, www.politico.com/story/2019/03/21/devos-roll-back-obama-policies-1288782.

[5] Hess, “Trump Administration Proposes Capping Student Loans, Cutting Repayment Options-Here's What That Means for Borrowers.”

[6] Binkley, Collin. “White House Proposes Caps on Student Loan Borrowing.” The Seattle Times, The Seattle Times Company, 18 Mar. 2019, www.seattletimes.com/nation-world/nation/white-house-proposes-caps-on-student-loan-borrowing/.

[7]Lobosco, Katie. “DeVos Wants to Cut Budget Funding for Student Loan Forgiveness, Again.” CNN, Cable News Network, 13 Mar. 2019, www.cnn.com/2019/03/13/politics/betsy-devos-student-loan-forgiveness-budget/index.html.

[8] Stratford, “Betsy DeVos Strikes out - in Court.”

[9] Lobosco, “DeVos Wants to Cut Budget Funding for Student Loan Forgiveness, Again.”

 

[10] Norris, Courtney. “Where 2020 Democrats Stand on Student Loans, Teacher Pay and Other Education Issues.” PBS News Hour, Public Broadcasting Service, 15 Apr. 2019, www.pbs.org/newshour/politics/where-2020-democrats-stand-on-student-loans-teacher-pay-and-other-education-issues.

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