1998 Ron Paul 115:1
Mr. PAUL.
Mr. Chairman, I am sorry that
under the rule my amendment to the
Labor-HHS-Education Appropriations bill is not permitted. This simple amendment forbids the
Department of Health and Human Services
from spending any funds to implement 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
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 citizen’s record
simply by entering the patient’s identifier into
the national database.
1998 Ron Paul 115:2
My amendment was drafted to ensure that
the administration cannot take any steps toward
developing or implementing a medical
ID. This approach is necessary because if the
administration is allowed to work on developing
a medical ID it is likely to attempt to implement
the ID on at least a “trial” basis. I would
remind my colleagues of our experience with
national testing. In 1997 Congress forbade the
Department of Education from implementing a
national test, however it allowed work toward
developing national tests. The administration
has used this “development loophole” to defy
congressional intent by taking steps toward
implementation of a national test. It seems
clear that only a complete ban forbidding any
work on health identifiers will stop all work toward
implementation.
1998 Ron Paul 115:3
Allowing the federal government to establish
a National Health ID not only threatens privacy
but also will undermine effective health care. 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?
1998 Ron Paul 115:4
Mr. Chairman, 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.
1998 Ron Paul 115:5
My amendment forbids the federal government
from creating federal IDs for doctors and
employers as well as for individuals. Contrary
to the claims of some, federal-ID numbers for
doctors and employers threaten American liberty
every bit as much as individual medical
IDs.
1998 Ron Paul 115:6
The National Provider ID will force physicians
who use technologies such as e-mail in
their practices to record all health care transactions
with the government. This will allow
the government to track and monitor the treatment
of all patients under that doctor’s care. Government agents may pull up the medical
records of a patient with no more justification
than a suspicion the provider is involved in
fraudulent activity unrelated to that patient’s
care!
1998 Ron Paul 115:7
The National Standard Employer Identifier
will require employers to record employees’
private health transactions in a database. This
will allow coworkers, hackers, government
agents and other unscrupulous persons to access
the health transactions of every employee
in a company simply by typing the
company’s identifier into their PC!
1998 Ron Paul 115:8
Many of my colleagues 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.
1998 Ron Paul 115:9
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.
1998 Ron Paul 115:10
Even the process by which the National
Identifier is being developed shows disdain for
the rights of the American people. The National
Committee on Vital and Health Statistics,
which is developing the national identifier,
attempted to keep important documents hidden
from the public in violation of federal law. In fact, one of the members of the NCVHS
panel working on the medical ID chastised his
colleagues for developing the medical ID “in
an aura of secrecy.”
Last September, NCVHS proposed guidelines
for the development of the medical ID. Those guidelines required that all predecisional
documents “should be kept in strict
confidence and not be shared or discussed,”
This is a direct violation of the Federal Advisory
Committee Act, which requires all working
documents to be made public. Although
NCVHS, succumbing to public pressure and
possible legal action against it, recently indicated
it will make its pre-decisional documents
available in compliance with federal law, I
hope my colleagues on the Rules Committee
agree that the NCVHS attempt to evade the
will of Congress and keep its work secret does
not bode well for any future attempts to protect
the medical ID from abuse by government
officials.
1998 Ron Paul 115:11
The 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 this amendment
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.
1998 Ron Paul 115:12
Mr. Chairman, all I ask is that Congress by
given the change to correct the mistake made
in 1996 when they authorized the National
Health ID as part of the Kennedy-Kasebaum
bill. 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.
1998 Ron Paul 115:13
There can be no justification for risking
the rights of private citizens. I therefore
urge the Rules Committee to take the first
step toward protecting Americans from a medical
ID by ruling my amendment to the
Labor-HHS-Education Appropriations bill in order.
Notes:
1998 Ron Paul Chapter 115
The text of this chapter was inserted in CongressionalRecord and was not spoken on the House floor.
1998 Ron Paul 115:2 congressional probably should be capitalized: Congressional.
1998 Ron Paul 115:4 fifth amendment probably should be capitalized: Fifth Amendment.
1998 Ron Paul 115:5 federal-id probably should be unhyphenated: federal ID.
1998 Ron Paul 115:10
Here there is inconsistency between the unhyphenated
predecisional and the hyphenated form pre-decisional.
1997 Ron Paul 115:12 by given the change probably should have been be given the chance.
