Health Record Rights Index · country brief · this country's data as of October 2, 2026
Who holds the health record in the United States?
In 2026, the United States scores 48 out of 100 for how much say a person has over their own health record. It is tied for 55th of 198 countries and territories, and could rank anywhere from 45th to 80th allowing for scoring error, in the Mixed band (45 to 64). Who holds the keys: doctors, hospitals and insurers. Source: Health Record Rights Index, SuperTruth, this country's data as of October 2, 2026.
Doctors, hospitals and insurers decide. Its strongest right, compared with the typical country, is rules for AI in your care (56 out of 100, against 30 for the typical country). The furthest behind is protection from sale and ads (38 out of 100, against 45 for the typical country).
In 2026, getting your full record scores 50 out of 100 in the United States; the typical country scores 40 to 45. HIPAA gives a right to copies within 30 days, and the Cures Act penalizes providers and health IT firms that block a patient's electronic access without a listed exception. OCR has brought 55 access cases, but there is no national record, and 59% of people juggle several portals. Source: eCFR, and the other sources below.
Who controls health records in the United States?
In 2026, doctors, hospitals and insurers hold the keys to your health record in the United States. Control over who sees it scores 35 out of 100 in the United States; the typical country scores 30. HIPAA lets providers and plans share records for treatment, payment and operations without consent, and they may refuse restriction requests. Source: eCFR, and the other sources below.
How does the United States compare?
In 2026, the United States scores 48 out of 100, against 39 for the typical country. This brief compares it with Canada (52 out of 100), United Kingdom (59 out of 100) and Germany (63 out of 100). Source: the ranking of all 198 countries and territories.
Eight rights, compared with Canada, United Kingdom, Germany and the typical country
Scores out of 100, by right
Getting your full record20%
50
50 · 66 · 64
Control over who sees it20%
35
55 · 52 · 66
Privacy and security15%
50
58 · 56 · 58
One record across your care15%
60
50 · 62 · 66
Protection from sale and ads10%
38
45 · 60 · 70
Doctors see it when treating you10%
55
55 · 60 · 62
Your say over research use5%
49
49 · 64 · 50
Rules for AI in your care5%
56
56 · 55 · 50
Black dot: United States. Hollow dots: Canada, United Kingdom, Germany (scores out of 100 on the right, same order). Gray line: the typical country of all 198. Overall: United States 48 out of 100. Scores move in steps of about 5 points, so read a rank with its likely range.
What would the United States need to change to score higher?
The United States sits in Mixed (45 to 64); Strong starts at 65. Its weakest right, compared with the typical country, is protection from sale and ads (38 out of 100, against 45 for the typical country). Every other right is at or above the typical country; the one with the most room to grow, weighted, is control over who sees it (35 out of 100, against 30 for the typical country). Our scoring rules give more points for:
Protection from sale and ads: Clear limits on selling health data or using it for ads, covering apps and data brokers as well as doctors and hospitals.
Control over who sees it: A way to say no to sharing (or to be asked first), a log you can read of who opened your record, and finer choices about who sees what. Together these put this right at 60 to 80 out of 100.
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): Breach notice duties for health apps and similar technologies not covered by HIPAA.
Doctors, waits and private care context, not part of the score
Doctors per 10,000
26.5 2022 · 35th highest of 38 OECD countries
Nurses and midwives per 10,000
124 2024 · 11th highest of 38 OECD countries
Private insurance + out-of-pocket
11.7% 2023 · 35th highest of 35 OECD countries
Record reaches private care?
unknown
Compulsory private insurance, counted separately: 31.6% of health spending (2023).
Real cases
December 16, 2025 · 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
September 30, 2025 · U.S. Department of Health and Human Services, Office for Civil Rights Care provider posted patient stories online without written permission
In 2026, the United States scored 48 out of 100 for how much say a person has over their own health record, tied for 55th of 198 countries and territories (could be 45th to 80th), in the Mixed band. Who holds the keys: doctors, hospitals and insurers. Source: Health Record Rights Index, SuperTruth, this country's data as of October 2, 2026, https://healthrecordrights.com/brief/united-states/
The 32 sources for the United States
Each source appears once, under the first right it supports. Titles are shown as our research agents recorded them, usually in the page's own language; text in square brackets is our machine translation. Links were checked on the date shown.
Getting your full record (4 sources)
“45 CFR 164.524 Access of individuals to protected health information”
eCFR (law or regulation) · Title in English
No date recorded · Link checked October 3, 2026 (opened)
SuperTruth Inc. · 24 S. 24th St., Philadelphia, PA 19103, USA · +1 215 918 4140 · supertruth.ai Something wrong? Tell us · Questions or a briefing: supertruth.ai/on-the-record#contact · Full index: healthrecordrights.com
OECD: Organisation for Economic Co-operation and Development (38 mostly high-income countries). DTI™: the Data Trust Index, which grades the evidence behind each score. SuperTruth makes it and publishes this index. Everything here comes from public information: laws, government and regulator pages, court decisions, published news, WHO, OECD and World Bank data. Full sources: https://healthrecordrights.com/brief/united-states/#sources. SuperTruth built this index and sells health data verification products; no one paid to be included. Research tool, not legal advice. Our scores and our own words are CC BY 4.0; quoted law and source titles stay with their owners.
