‘Individual Identifier’ Controversy Resurfaces

Published October 1, 2001

Eight years after then-President Bill Clinton failed in his attempt to put the federal government in charge of all matters health care, critics of the scheme are still doing battle with it, piece by piece. The latest feature of the plan making its way into law: the health care “identifier number.”

The identifier is a crucial part of efforts to centralize all individual health care information into a government database. Congress authorized the creation of a personal identifying number for every man, woman, and child through a provision in the Health Insurance Portability and Accountability Act (HIPAA), passed in 1996.

HIPAA requires a unique health identifier be assigned to every living person, health care provider, employer, and health plan in an effort to assemble all health care transactions into a single database. Although federal legislators have to date denied funding for implementation of the individual identifier plan, Congressman Ron Paul (R-Texas) and several colleagues are concerned the identifier requirement remains on the books.

“We think it’s an invasion of privacy, and we think it’s a number that’s going to be abused like the Social Security number has been,” said Paul’s spokesman, Jeff Deist, in a CNN interview.

Paul recently introduced a bill that would repeal those parts of HIPAA calling for identifying numbers. The measure would also prevent federal tax dollars from being used to construct or maintain a federal health care database. Paul says he fears a future Congress may wish to pass a national ID system.

Big Brother Wants to Track You

Congresswoman Nancy Pelosi (D-California) is getting ready to introduce a bill that would put the individual identifier system into practice. In a September “Dear Colleague” letter co-signed by Congressman Peter King (R-New York), Pelosi wrote, “Chronic disease is responsible for seven out of every ten deaths in the U.S. each year and costs our nation $325 billion in annual health care expenses and lost productivity. Despite these significant health risks, there is no national system that explores the relationship between chronic diseases and potentially associated environmental factors.”

According to CNN News and other accounts, Pelosi’s forthcoming bill would create a “national health tracking system” to collect, analyze, and report data on the rate of chronic disease and the presence of certain environmental factors. The bill would also “coordinate national, state, and local efforts to bolster our public health system’s capacity to investigate and respond to” health risks.

Sue Blevins, president of the nonprofit Institute for Health Freedom, told CNN News she understands that good intentions are behind the measure. And she acknowledges a national database would improve access to information to treat patients in emergency situations.

“But,” Blevins adds, “I still think it should be up to the individual to decide whether they want to be part of a government database.” Like Paul, she fears that information in a centralized database would be wrongly accessed and used by computer hackers, profiteers, and would-be blackmailers.

Denial of Care

Blevins is also concerned health care could be denied to patients who refuse to disclose their number, much the way financial and other services are sometimes denied to people who do not disclose their Social Security numbers.

“HIPAA and the privacy rule codify the fact that a physician can refuse to treat you for not sharing your information,” she said. “That’s written into the privacy rule. That has not been a federal standard” . . . until now.

“Right now in the current Department of Health and Human Services appropriations bill, there’s a proposal to penalize doctors and impose a $1.50 charge for every claim that’s filed with the government that isn’t processed electronically,” Blevins added. “That’s a way to move everybody into a national electronic system without mandating it.”