[Congressional Record Volume 144, Number 98 (Tuesday, July 21, 1998)]
[Extensions of Remarks]
[Pages E1369-E1370]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        THE PATIENT PRIVACY ACT

                                 ______
                                 

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                         Tuesday, July 21, 1998

  Mr. PAUL. Mr. Speaker, I rise to introduce the Patient Privacy Act, 
which repeals those sections of the Health Insurance Portability and 
Accountability Act of 1996 authorizing the establishment of a 
``standard unique health care identifier'' for all Americans. This 
identifier

[[Page E1370]]

would then be used to create a national database containing the medical 
history of all Americans. Establishment of such an identifier would 
allow federal bureaucrats to track every citizen's medical history from 
cradle to grave. Furthermore, it is possible that every medical 
professional, hospital, and Health Maintenance Organization (HMO) in 
the country would be able to access an individual citizens' record 
simply by entering the patient's identifier into the national database.
  As an OB/GYN with more than 30 years experience in private practice, 
I know better than most the importance of preserving the sanctity of 
the physician-patient relationship. Oftentimes, effective treatment 
depends on a patient's ability to place absolute trust in his or her 
doctor. What will happen to that trust when patients know that any and 
all information given their doctor will be placed in a data base 
accessible by anyone who knows the patient's ``unique personal 
identifier?''
  I ask my colleagues, how comfortable would you be confiding any 
emotional problem, or even an embarrassing physical problem like 
impotence, to your doctor if you knew that this information could be 
easily accessed by friend, foe, possible employers, coworkers, HMOs, 
and government agents?
  Mr. Speaker, the Clinton administration has even come out in favor of 
allowing law enforcement officials access to health care information, 
in complete disregard of the fifth amendment. It is bitterly ironic 
that the same administration that has proven so inventive at protecting 
its privacy has so little respect for physician-patient 
confidentiality.
  Many of my colleagues will admit that the American people have good 
reason to fear a government-mandated health ID card, but they will 
claim such problems can be ``fixed'' by additional legislation 
restricting the use of the identifier and forbidding all but certain 
designated persons to access those records.
  This argument has two flaws. First of all, history has shown that 
attempts to protect the privacy of information collected by, or at the 
command, of the government are ineffective at protecting citizens from 
the prying eyes of government officials. I ask my colleagues to think 
of the numerous cases of IRS abuses that were brought to our attention 
in the past few months, the history of abuse of FBI files, and the case 
of a Medicaid clerk in Maryland who accessed a computerized database 
and sold patient names to an HMO. These are just some of many examples 
that show that the only effective way to protect privacy is to forbid 
the government from assigning a unique number to any citizen.
  The second, and most important reason, legislation ``protecting'' the 
unique health identifier is insufficient is that the federal government 
lacks any constitutional authority to force citizens to adopt a 
universal health identifier, regardless of any attached ``privacy 
protections.'' Any federal action that oversteps constitutional 
limitations violates liberty for it ratifies the principle that the 
federal government, not the Constitution, is the ultimate arbitrator of 
its own jurisdiction over the people. The only effective protection of 
the rights of citizens is for Congress and the American people to 
follow Thomas Jefferson's advice and ``bind (the federal government) 
down with the chains of the Constitution.''
  For those who claim that the Patient Privacy Act would interfere with 
the plans to ``simplify'' and ``streamline'' the health care system, 
under the Constitution, the rights of people should never take a 
backseat to the convenience of the government or politically powerful 
industries like HMOs.
  Mr. Speaker, the federal government has no authority to endanger the 
privacy of personal medical information by forcing all citizens to 
adopt a uniform health identifier for use in a national data base. A 
uniform health ID endangers the constitutional liberties, threatens the 
doctor-patient relationships, and could allow federal officials access 
to deeply personal medical information. There can be no justification 
for risking the rights of private citizens. I therefore urge my 
colleagues to join me in supporting the Patient Privacy Act.

                          ____________________