HIPAA is nothing but a paper tiger that has cost our health care system BILLIONS and MEANS NOTHING. It just means your medical records are between me, thee, and EVERYONE IN THE FEDERAL GOVERNMENT. Maybe folks will finally understand!!
I work in Federal government, and I am here to tell you that HIPAA (and PII... Personally Indentifying Information) are very severely restricted and regulated. Encryption is always used at the database level, so that only authorized individuals in that government can view it, and you must have a very good and justified reason. Generally, requests for access are always reviewed with great skepticism.
Now, that is not to say that a corrupt leader or highlevel person cannot cause great damage to the population by ordering access (without the similar skeptical review) and abusing that access....