Christine Hall, CNSNews.com
Thursday, Aug. 16, 2001

The number was crucial to the Clinton plan of centralizing all individual health care information in a collective government database. In 1996, Congress helped that cause along through a provision in the Health Insurance Portability and Accountability Act concerning patient privacy protections.

The law requires that unique health identifiers be assigned to every individual, health care provider, employer and health plan to make electronic transactions easier.

Though Congress has since denied funding for the part of the project dealing with individual identifiers, what worries Rep. Ron Paul, R-Texas, and his allies is that the requirement is still on the books, so to speak.

"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.

That's why Paul recently introduced a bill that would repeal parts of HIPAA calling for identifying numbers. It would also prevent federal tax dollars from being used to construct or maintain a federal health care database.

House Majority Leader Dick Armey, R-Texas, recently said he would support an effort to repeal the provision this year. "I'm very worried about this," he said, "and we'll continue to work on that."

"But one of the things I've learned the hard way is don't predict what will be in the bill," Armey cautioned.

Paul fears that future Congresses may not be successful in staving off such a national ID system, so he wants to act now.

"We're just trying to proactively, before that happens, prohibit it," said Deist.

"It's been proposed by folks in both the Senate and the House in the past - 'Let's have a health ID number for everybody so that we can track and fight disease,'" he said. "We don't accept that explanation."

In fact, Rep. Nancy Pelosi, D-Calif., is getting ready to introduce a bill that would do just that.

"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," read a "Dear Colleague" letter circulated by Pelosi and Rep. Peter King, R-N.Y., this month.

"Despite these significant health risks, there is no national system that explores the relationship between chronic diseases and potentially associated environmental factors," Pelosi's letter continues.

'National Health Tracking System'

Her forthcoming bill would, according to the letter, create a "national health tracking system" to collect, analyze and report data on the rate of chronic disease along with 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.

"I understand the good intentions, which are that a national database would absolutely improve access to information to treat you in emergency situations," said Sue Blevins, president of the nonprofit Institute for Health Freedom.

"But I still think it should be up to the individual to decide whether they want to be part of a government database," said Blevins, who believes the private sector should take up the idea voluntarily.

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 Health Care

Blevins is also concerned that 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 appropriation 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."

The next step, she warned, could be a federal regulation that says, "if you don't have a unique health care identifier for your patient, you're not going to get Medicare reimbursement, or you can't qualify to get Blue Cross/Blue Shield reimbursement."

"It's hard to say," Blevins said, "because we don't know what the final compliance part of HIPAA looks like."

Copyright CNSNews.com

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