Who holds the health record in the United States?

Can I get my health records in the United States?

Access to the full record scores 50 of 100 in the United States, against a median of 43 across 198 countries. HIPAA gives a right to the whole designated record set within 30 days at a cost-based fee, and OCR has brought 55 right of access enforcement actions. There is no national record: 65% used a portal in 2024, and 59% had more than one.

Can I control who sees my health record in the United States?

Control and consent scores 35 of 100 in the United States, against a median of 30 across 198 countries. HIPAA lets providers and plans share records for treatment, payment and operations without consent, and they may refuse restriction requests. A block on items paid in full and a six-year disclosure log that omits routine sharing put the cell at the top of its band.

What would the United States need to change to score higher?

The United States sits in Mixed (45 to 64); Strong starts at 65. The two rights furthest below the 198-country median, weighted, are protection from commercial use (38, median 45) and research and trial consent (49, median 46). The published rubric reads:

• Protection from commercial use: Clear limits on selling health data or using it for marketing, covering apps and data brokers as well as providers.
• Research and trial consent: A general opt-out that is honoured, or dynamic or opt-in consent, with a public register of research uses: 55 to 85.

Which laws give health record rights in the United States?

• HIPAA Privacy Rule, right of access (45 CFR 164.524) (2000): Right to the designated record set within 30 days, cost-based fee, electronic format if readily producible.
• 42 CFR Part 2, substance use disorder records final rule (2024): Single revocable consent for future treatment, payment and operations uses; compliance from February 16, 2026.
• FTC Health Breach Notification Rule (2024 update) (2024): Breach notice duties for health apps and similar technologies not covered by HIPAA.

Strain and split context, not scored

Doctors per 10,000

26.5 2022 · OECD 35 of 38

Nurses and midwives per 10,000

124 2024 · OECD 11 of 38

Private insurance + out-of-pocket

11.7% 2023 · OECD 35 of 35

Record reaches private care?

unknown

Compulsory private insurance, counted separately: 31.6% of health spending (2023).

Published stories

• 2025-12-16 · U.S. Department of Health and Human Services, Office for Civil Rights Six requests and more than a year before a patient got his records
• 2025-09-30 · U.S. Department of Health and Human Services, Office for Civil Rights Care provider posted patient stories online without written permission