HON. RON PAUL OF TEXAS
IN THE HOUSE OF REPRESENTATIVES
April 9, 2003
Repeal the So-Called Medical Privacy Rule
2003 Ron Paul 49:1
Mr. Speaker, I rise to introduce the Patient Privacy Act. This bill repeals
the
misnamed Medical Privacy regulation, which went 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 health care as much as politically possible.
2003 Ron Paul 49:2
Establishment of a uniform medical identifier would allow federal bureaucrats to
track every
citizens 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 citizen’s records simply by entering an identifier into a
health
care database.
2003 Ron Paul 49:3
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
protecting the individual’s 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. Some 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.
2003 Ron Paul 49:4
The so-called medical privacy regulations and uniform health identifier
scheme not
only reduce an individual’s ability to determine who has access to his
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 citizens
private medical
records without having to obtain a search warrant.
2003 Ron Paul 49:5
Allowing government officials to access a private persons 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 governments power to
seize an
individuals 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.
2003 Ron Paul 49:6
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.
2003 Ron Paul 49:7
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
individuals medical records without the individuals 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!
2003 Ron Paul 49:8
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 increases 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!
2003 Ron Paul 49:9
Forcing individuals to divulge medical information without their consent also
runs afoul
of the Fifth amendments 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
individuals 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.
2003 Ron Paul 49:10
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 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.
2003 Ron Paul 49:11
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.
2003 Ron Paul 49:12
Oftentimes, effective treatment depends on the patients ability to place absolute
trust in
his doctor. The legal system has acknowledged the importance of
maintaining
physician-patient confidentiality by granting physicians a privilege
not to
divulge confidential patient information.
2003 Ron Paul 49:13
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?
2003 Ron Paul 49:14
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 acknowledge 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 five 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
repealing these
dangerous medical privacy rules.
2003 Ron Paul 49:15
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 individuals consent or a
warrant.
Federal supervision of who can access medical records, combined with a
federally-assigned medical ID, 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.