Cheers: HIPAA is for the insurance company, not the employer or the business

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DEAR DR. ROACH: I don’t understand how HIPAA applies to my health information. Some people say they don’t have to tell people if they’ve been vaccinated or not or respond to an employer who requires the vaccine to return to work or to businesses that may require the vaccination to enter. I’ve always believed that HIPAA applies to doctors and insurance companies, and it’s about providing my health information to third parties without my permission, not providing that information directly. Can you please explain who is right? – DLG

RESPONSE: The Health Insurance Portability and Liability Act was adopted by Congress in 1996 and promulgated by the president Bill clinton. It was designed to protect health coverage for people who change jobs, required health care providers to give patients access to their personal health information, and health care providers to protect the privacy of health information. . HIPAA applies to health plans, clearinghouses and providers. In my role as a doctor, I must comply with HIPAA. However, most employers and businesses, such as cruise lines, are not HIPAA covered entities, so HIPAA does not apply. A business is free to require vaccination, and you are free to refuse and take your business elsewhere, if you wish.

DEAR DR. ROACH: You recently told a reader who had just been diagnosed with diabetes that type 2 diabetes is a “stable” diagnosis: once the diagnosis is made you are still diabetic, even if your blood sugar levels return to perfectly normal and you do not take any more medication.

Is prediabetes also a stable diagnosis? If someone has never been diagnosed with type 2 diabetes, but probably would have been without careful monitoring of their diet, exercise, and weight, is it important that they be diagnosed as? being diabetic? If so, what tests are appropriate to diagnose this? – AA

ANSWER: Prediabetes and type 2 diabetes are on the same spectrum: it’s a matter of seriousness. The same underlying problem – insulin resistance, also known as impaired glucose tolerance – is responsible for both prediabetes and type 2 diabetes.

Most people with prediabetes can bring their blood sugar back to the normal range by carefully controlling the three factors you have identified: a diet low in simple sugars and starch, regular moderate physical activity, and weight control. Unfortunately, these behaviors must be permanent. You don’t “cure” yourself of diabetes by reaching your target weight, eating a healthy diet, and exercising. That is, if the weight loss is appropriate. Some people with type 2 diabetes are normal or underweight.

As soon as you stop the behaviors, or if the weight returns to the area where you had prediabetes, you are likely to have prediabetes again. In fact, insulin resistance tends to worsen as people get older, so the degree of weight control as well as a healthy lifestyle need to be improved over time to keep diabetes away. forever. Even people with prediabetes have a higher risk of heart disease compared to someone without prediabetes. But the risk in general is not as high as a person diagnosed with diabetes.

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