[Congressional Record Volume 149, Number 57 (Wednesday, April 9, 2003)]
[Extensions of Remarks]
[Pages E712-E713]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          PATIENT PRIVACY ACT

                                 ______
                                 

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                        Wednesday, April 9, 2003

  Mr. PAUL. Mr. Speaker, I rise to introduce the Patient Privacy Act. 
This bill repeals the misnamed Medical Privacy regulation, which goes 
into effect on April 14 and actually destroys individual medical 
privacy. The Patient Privacy Act also 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, as well as prohibiting the use of federal funds to 
develop or implement a database containing personal health information. 
Both of these threats to medical freedom grew out of the Clinton-era 
craze to nationalize as much of health care as politically possible.
  Establishment of a uniform medical identifier would allow Federal 
bureaucrats to track every citizen's medical history from cradle to 
grave. Furthermore, as explained in more detail below, 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 a 
health care database.
  The dangers to liberty inherent in the ``uniform health identifier'' 
are magnified by the so-called ``medical privacy'' regulation. Many 
things in Washington are misnamed, however, this regulation may be the 
most blatant case of false advertising I have come across in all my 
years in Congress. Rather than protect an individual right to medical 
privacy, these regulations empower government officials to determine 
how much medical privacy an individual ``needs.'' This ``one-size-fits-
all'' approach ignores the fact that different people may prefer 
different levels of privacy. Certain individuals may be willing to 
exchange a great deal of their personal medical information in order to 
obtain certain benefits, such as lower-priced care or having 
information targeted to their medical needs sent to them in a timely 
manner. Others may forgo those benefits in order to limit the number of 
people who have access to their medical history. Federal bureaucrats 
cannot possibly know, much less meet, the optimal level of privacy for 
each individual. In contrast, the free market allows individuals to 
obtain the level of privacy protection they desire.
  The so-called ``medical privacy'' regulations and uniform health 
identifier scheme not only reduce individuals' ability to determine who 
has access to their personal medical information, but actually threaten 
medical privacy and constitutionally protected liberties. For example, 
these regulations allow law enforcement and other government officials 
access to a citizen's private medical record without having to obtain a 
search warrant.
  Allowing government officials to access a private person's medical 
records without a warrant is a violation of the Fourth Amendment to the 
United States Constitution, which protects American citizens from 
warrantless searches by government officials. The requirement that law 
enforcement officials obtain a warrant from a judge before searching 
private documents is one of the fundamental protections against abuse 
of the government's power to seize an individual's private documents. 
While the Fourth Amendment has been interpreted to allow warrantless 
searches in emergency situations, it is hard to conceive of a situation 
where law enforcement officials would be unable to obtain a warrant 
before electronic medical records would be destroyed.

  Mr. Speaker, these regulations also require health care providers to 
give medical records to the Federal government for inclusion in a 
Federal health care data system. Such a system would contain all 
citizens' personal health care information, accessible to anyone who 
knows the individual's ``unique health identifier.'' History shows that 
when the government collects this type of personal information, the 
inevitable result is the abuse of citizens' privacy and liberty by 
unscrupulous government officials. The only fail-safe privacy 
protection is for the government not to collect and store this type of 
personal information.
  In addition to law enforcement, these so-called ``privacy 
protection'' regulations create a privileged class of people with a 
federally guaranteed right to see an individual's medical records 
without the individual's consent. My medical office recently received a 
Model ``Privacy Act Compliance'' form. This three-page form lists over 
20 situations where medical information may be disclosed without 
individual consent. Medical information may be disclosed to attorneys, 
business associates of the provider, and Federal agencies conducting 
``health oversight activities.'' Medical information may also be 
divulged without consent to insurance companies and medical 
researchers!
  Medical researchers claim to be able to protect the autonomy of their 
unwilling subjects, but the fact is that allowing third parties to use 
medical records for research purposes runs the risk of inadvertent 
identification of personal medical information. I am aware of at least 
one incident where a man had his identity revealed when his medical 
records were used without his consent. As a result, many people in his 
community discovered details of his medical history that he wished to 
keep private!
  Forcing individuals to divulge medical information without their 
consent also runs afoul of the Fifth Amendment's prohibition on taking 
private property for public use without just compensation. After all, 
people do have a legitimate property interest in their private 
information. Therefore, restrictions on an individual's ability to 
control the dissemination of their private information represents a 
massive regulatory taking. The takings clause is designed to prevent 
this type of sacrifice of individual property rights for the ``greater 
good.''
  In a free society such as the one envisioned by those who drafted the 
Constitution, the Federal government should never force a citizen to 
divulge personal information to advance ``important social goals.'' 
Rather, it should be up to the individuals, not the government, to 
determine what social goals are important enough to warrant allowing 
others access to their personal property, including their personal 
information. To the extent these regulations sacrifice individual 
rights in the name of a bureaucratically determined ``common good,'' 
they are incompatible with a free society and a constitutional 
government.
  As an OB-GYN with more than 30 years experience in private practice, 
I am very concerned by the threat to medical practice posed by these 
privacy regulations and the unique health identifier scheme. The 
confidential physician-patient relationship is the basis of good health 
care.
  Oftentimes, effective treatment depends on the patient's ability to 
place absolute trust in his or her doctor. The legal system has 
acknowledged the importance of maintaining physician-patient 
confidentiality by granting physicians a privilege not to divulge 
confidential patient information.

[[Page E713]]

  I ask my colleagues to consider how comfortable you would be 
confiding an embarrassing physical or emotional problem to your 
physicians if you knew that any and all information given your doctor 
may be placed in a government database or seen by medical researchers, 
handed over to government agents without so much as a simple warrant or 
accessed by anyone who happens to know your ``unique health 
identifier?''
  By now it should be clear to every member of Congress that the 
American people do not want their health information recorded on a 
database, and they do not wish to be assigned a unique health 
identifier. According to a survey by the respected Gallup Company, 91 
percent of Americans oppose assigning Americans a ``unique health care 
identifier'' while 92 percent of the people oppose allowing government 
agencies the unrestrained power to view private medical records and 88 
percent of Americans oppose placing private health care information in 
a national database. Congress has acknowledged this public concern by 
including language forbidding the expenditure of funds to implement or 
develop a medical identifier in the Federal budget for the past 5 
fiscal years. Rather than continuing to extend the prohibition on 
funding for another year, Congress should finally obey the wishes of 
the American people by repealing the authorization of the individual 
medical ID this year as well as repeal these dangerous medical privacy 
rules.
  Mr. Speaker, the misnamed medical privacy regulations and the scheme 
to assign all Americans a ``unique health care identifier'' violates 
the fourth and fifth amendments by allowing law enforcement officials 
and government favored special interests to seize medical records 
without an individual's consent or a warrant. Federal supervision of 
who can access medical records combined with a federally assigned 
medical ID also facilitate the creation of a Federal database 
containing the health care data of every American citizen. These 
developments could undermine the doctor-patient relationship and thus 
worsen the health care of millions of Americans. I, therefore, call on 
my colleagues to join me in repealing these threats to privacy and 
quality health care by cosponsoring the Patient Privacy Act.

                          ____________________