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Government Privacy Medicine

Are Medical IDs 'The Enemy of Privacy, Liberty, and Health'? (zerohedge.com) 162

83-year-old former U.S. Senatior Ron Paul has published a new editorial on Zero Hedge: Last week, the House of Representatives voted in favor of a Labor, Health and Human Services, and Education appropriations bill amendment to repeal the prohibition on the use of federal funds to create a 'unique patient identifier.' Unless this prohibition, which I originally sponsored in 1998, is reinstated, the federal government will have the authority to assign every American a medical ID.

This ID will be used to store and track every American's medical history.

A unique patient identifier would allow federal bureaucrats and government-favored special interests to access health information simply by entering an individual's unique patient ID into a database. This system would also facilitate the collection of health information without a warrant by surveillance state operatives...

The unique patient identifier system puts the desires of government bureaucrats and politically powerful special interests ahead of the needs of individual patients and health care providers. Instead of further intervening in health care and further destroying our privacy and our liberties, Congress should give patients control over their health care by giving them control over health care dollars through expanding access to Health Savings Accounts and health care tax credits. In a free market, patients and doctors can and will work tighter to ensure patients' records are maintained in a manner that provides maximum efficiency without endangering privacy or liberty.

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Are Medical IDs 'The Enemy of Privacy, Liberty, and Health'?

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  • Too late (Score:5, Insightful)

    by chill ( 34294 ) on Sunday June 23, 2019 @09:46AM (#58808744) Journal

    The private sector has already devoted countless hours and dollars to tracking individuals down to the most trivial information. We've lost that battle.

    Dr. Paul is still stuck in the age where a doctor-patient relationship is a personal, lifelong thing. Very few people live in the same place for long times anymore. A lot of them change doctors like they change socks. Add to that the proliferation of specialists you need the ability to reduce mistakes buy ensuring records are accurately tied to the individual.

    The danger of a government bureaucrat having direct access to my information is nothing compared to the danger of a government bureaucrat incorrectly associating some of my information with somebody else. I've dealt with mis-attributed medical records before, and that is by far the greater hell.

    • YEP!!! If they got it right, it could actually lead to more positive outcomes, reduce misdiagnoses and have a better understanding of long term impact on treatment. But instead it will be a trillion dollar project and end up a site where state senators creep on ex wives last doc visit.
    • by Anonymous Coward

      There would be good and bad with such a system. In my own case, having had a doctor in one state for ten years, where I had an opioid prescription for those ten years under a 'drug contract' where I was monitored with blood and urine tests to prove that I was using the prescription (not selling it on the street) and not using any illegal drugs, all of that could have been entered on such a record. Then when I moved to a different state, perhaps I could have found a doctor willing to continue to give me acc

    • Comment removed based on user account deletion
      • by chill ( 34294 )

        Actually, if you read it closely, they move and then frequently come back to live near family. That article talks about elder care, when people are in their 70s and 80s. That's decades after they had kids, who went off for school and jobs. In fact, the article was based on a study of older Americans on aging.

        Ms. Breckenridge said she returned to Seattle, where she grew up, for business school, largely because she knew she wanted to raise a family near her parents. "I always knew I would go back to work after having a kid, and I actually can’t imagine doing it without my parents close by," she said.

      • by Shaitan ( 22585 )

        Uh huh and very many people do move far.

    • Dr. Paul as an actual medical doctor with relevant insight into the issues of doctor-patient relations.

    • by Shaitan ( 22585 )

      "The private sector has already devoted countless hours and dollars to tracking individuals down to the most trivial information. We've lost that battle."

      Sorry you are wrong. I have adult ADHD. I mostly get by without medication but when I need it I have to find a new doctor who will upon a first visit prescribe the meds I need since I've usually moved in between. The medication is controlled so that is an uphill battle and it is not uncommon for the first doctor I try to be a PITA and for me to try another

  • by QuietLagoon ( 813062 ) on Sunday June 23, 2019 @09:49AM (#58808756)
    Anytime a unique identifier is assigned to everyone, it will be used well beyond its original scope, regardless of what constraints are put upon such extended usage.
    • If that isn't somebody's law, it should be. I vote for you.

    • The gripping hand is that when scope-limited identifiers are not assigned a pre-existing identifier without scope limitations will have its usage extended.

    • by Kjella ( 173770 )

      Well possibly, but I don't quite understand the American aversion to genuinely unique identifiers as opposed to pseudo-unique identifiers like name + DOB. I mean you get 99.9% good data and 0.1% messy data which is really annoying for the two James Smith that happen to be born on the same day but doesn't really stop the tracking for anyone else. Here in Norway we all have a unique 11 digit code (DOB + sequence number + control digits) so both James Smiths get a unique code.

      That code is used pretty extensive

      • I think it's because many Americans tend to have a somewhat adversarial relationship with their government. Which specific parts they distrust most depend on political leanings, of course. This has fairly deep historical roots, with Jefferson famously quipping about the virtues of periodic revolution. And of course, somewhat uniquely at the time, our Constitution was largely about limiting the power of the federal government with both checks and balances, as well as many outright prohibitions to protect

        • by meglon ( 1001833 )
          No.

          .... with Jefferson famously quipping about the virtues of periodic revolution.

          Jefferson wasn't talking about the "virtues" of periodic revolution, he was discussing their inevitability. Read the letter https://founders.archives.gov/... [archives.gov]

          In response to the question of what he thought about the rebellion in the US (Shay's Rebellion), he said that it was unthinkable to him that rebellions wouldn't happen because people are prone to ignorance and gullibility.

          And can history produce an instance of a rebellion so honourably conducted? I say nothing of it’s motives. They were founded in ignorance, not wickedness. God forbid we should ever be 20. years without such a rebellion. The people can not be all, and always, well informed. The part which is wrong will be discontented in proportion to the importance of the facts they misconceive.

          And he laid out his opinion on the function of the government in these times.

          The remedy is to set them right as to facts, pardon and pacify them. What signify a few lives lost in a century or two? The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants.

          What he says outright there is that government

        • by Agripa ( 139780 )

          Due to this quirk of the American collective psyche, we still have quite a few less-than-optimal systems that most foreigners (and even many Americans) probably find rather puzzling.

          This quirk of distrust has been well earned by our government through its lack of responsibility.

      • Well possibly, but I don't quite understand the American aversion to genuinely unique identifiers

        Simple really.

        For example, aside from the need of the Federal Govt. to track my paying of taxes, they really have absolutely NO need or right to know anything else about me really.

        Unless I am under investigation of a crime, they have no need to know of my medical state, how many guns I own, where I come/go or when....nothing.

        Pretty much the same goes for the state, although we do have drivers licenses, but

    • That's only because America lacks a cohesive identification scheme for individuals. Many other countries assign unique identifiers for all sorts of things, and yet only the relevant numbers are required for anything as there is a fixed standard for identifying individuals if needed.

      No one would ever ask me for a tax number unless they handle finances. No one asks for my medicare number unless it's for medical reasons. No one asks for passport numbers, or drivers license numbers. What they do is ask for iden

    • Really? I have two unique IDs that I know of in the UK that everyone else also has - an NHS number for my medical records and a NI number for my government entitlements and tax records. I use my NHS number solely for medical records, and I use my NI number solely for entitlements, tax and employment. I have never been asked for either outside those two scenarios. My utilities company never asks for either, I don't get asked for either for credit checks or anything else.

    • by Anonymous Coward

      When the Social Security act was debated in congress, supporters promised the number would NEVER be used for any other purpose than the retirement program. Opponents of the program argued strongly that the SSN would become a citizen ID number and it would eventually lead to all sorts of problems for average people. Supporters and their dishonest promises won the day.

      Because Social Security "accounts" involved taxation, your SSN became your taxpayer ID number and is associated with all of your income and tax

  • With less government interference, and a bigger role for privacy advocates, health care could be further along than it is today. We've seen what centralizing identification has done for identity theft. The last thing we need is them meddling in health identity. Let's create standards that ensure privacy through decentralization and ownership belonging to the individuals, not larger "trusted" entities.
  • by Anonymous Coward

    How is creating an ID any more of a privacy violation than using the patient's name and SSN they already have? Or driver's license? Does the repeal include the HIPAA laws that prevent the medical industry from arbitrarily sharing patient information with someone like the government?

    Maybe I'm just naive but I would think a unique identifier would make it easier for an individual to share their medical history with a new doctor. Isn't that a good thing? What's the problem here? That the government is trying t

  • by markdavis ( 642305 ) on Sunday June 23, 2019 @09:56AM (#58808800)

    >"Are Medical IDs 'The Enemy of Privacy, Liberty'?

    Yes (I work in healthcare)

    And yes, other numbers, like SSN are already abused. Yet, there has been progress on that front. But do we really want to make it even easier to erode privacy?

  • by Anonymous Coward

    Firstly: I get where this guy is coming from. If the last few decades have taught us anything, it's that any central database will be abused, and the bigger the database, the more likely it is to be abused.

    On the other hand, unambiguously identifying a patient is important. Are you the Gary Burns who is in for the vasectomy, or the lower leg amputation? If I process a blood test for both of you, how do I ensure that they don't get mixed up? I can compare DOB, hospital/insurer issued patient number, but what

  • by flink ( 18449 ) on Sunday June 23, 2019 @10:11AM (#58808884)

    You are already being tracked across state lines and healthcare networks. Right now, score-based heuristics based on demographics, phone #, ssn (if available) are being used to match patient records in an MPI (master patient index) and assign you an ID that rolls up state or region-wide. Industry will continue to expand these healthcare information exchanges until they are linked in a web nation-wide with our without the government coordinating things.

    At least if there are laws on the books then at least you know what can and can't be done with the ID. Yes, HIPAA currently protects you, but no one reads those consent forms when they're being admitted where you grant the right to have your data shared with various entities that track and distribute your information.

  • Old Ron is truly tapping into the very heart of pathos with this latest outburst. Last time I checked every single US citizen already has a unique identifying number that is already in use by the medical, as well as every other US industry.
  • by Qbertino ( 265505 ) <moiraNO@SPAMmodparlor.com> on Sunday June 23, 2019 @10:21AM (#58808920)

    ... degree a society considers personal health to be a personal problem or one where the society as a whole pitches in when help is due.

    If handled well with a working healthcare system digital medical data can be a godsend in managing overall health of a population. In a facist and/or all-out neoconservative capitalist society with no real healthcare in place it probably is a really really bad idea.

    My 2 eurocents.

  • by 0xdeadbeef ( 28836 ) on Sunday June 23, 2019 @10:26AM (#58808934) Homepage Journal

    A crazy person posting a crazy opinion on conspiratorial website is not interesting news.

    Oh, no, they're going to oppress us with...

    CREATE TABLE patients (patient_id integer PRIMARY KEY);

    How will we survive under such tyranny?

    Remember when the wackiest shit on Slashdot were the flamewars between RMS and ESR acolytes?

  • by Applehu Akbar ( 2968043 ) on Sunday June 23, 2019 @10:38AM (#58808996)

    I think online medical records would be a great idea. I should be able to walk into any new doctor's office, grant access to my online medical jacket, and have that practitioner know how old I was when I had chicken pox and when I had my last colonoscopy. When I have to keep remembering ancient details of medical history, I get less certain of the right dates as time goes by. If that information is medically important, it should be captured once and never forgotten by the system. This is especially crucial if that new practitioner contact comes about because I'm found unconscious somewhere.

    I used to have a lot of respect for Ron Paul, but I lost it when he became the one Senator to vote in favor of robocallers. What liberty-promoting point did that stand possibly make?

  • We already get SS numbers practically at birth. The hysterical complainers are decades too late. All a medical identifier will do is improve medical care.
  • by kulaga ( 159303 ) on Sunday June 23, 2019 @11:25AM (#58809286)

    Every hospital system I've seen (as a healthcare IT consultant, it's a lot) has a giant master patient index going back at least twenty years with millions of entries. We are not allowed to use the SSN, so it's an internally assigned medical record number with identity confirmed by name, date of birth, sex and usually phone or address. If you're walking and talking at registration they can positively identify you most of the time, with only the occasional duplicate account or incorrect account being selected. However, if you're senile, confused or unconscious when they wheel you in, good luck. Usually it's a temporary new account that's merged later. Of course then they loose the ability to know your history and allergies. Even looking beyond common names like Smith or Jones, at every medium hospital around there will be hundreds of patients with a common first name and a last name of Thompson, Young, Wu, Nguyen, etc. many with previous diagnoses affecting care (previous cancers, surgical procedures, implants) or life threatening allergies (penicillin, morphine, latex).

    On a side note, if your last name is Test, I recommend never getting sick.

    • I am fortunate to live within an easy commute of four major medical centers. They all use the EPIC EMR (Electronic MedicaL Record) system, so my records are visible to all. But smaller providers - ophthalmologist, retinal specialists, dermatologists, urgent care drop-in places - can't see my medical history, prescription drugs, allergies, vaccinations, etc., nor can their treatments be seen by the big guys using EPIC. A universal healthcare ID should facilitate wider access by providers so they can provide

  • But, in a free society, the government should never endanger privacy or liberty for efficiency.

    Isn't that much like the warnings from Dr. Franklin so long ago?
    I think it was something like, "I've given you a republic, madam. If you can keep it."
    Then there was something like how those that trade liberty for security will receive neither.

    A dictatorship is "efficient". We had a POTUS that just loved to write executive orders to get things done, because that was efficient. No need to go to Congress, because that's just "messy" and inefficient. Now we have a POTUS that is taking an eraser to all those

  • 83-year-old former U.S. Senatior Ron Paul has published a new editorial on Zero Hedge:

    Man, if that isn't a sure portent of idiocy, I don't know what is.

    I'm surprised Stormerhedge took valuable space away from antisemitism, neo-fascism and white supremacy in order to give this cranky old man with an onion on his belt the opportunity to tell his, "Back in my day..." story.

  • by stereoroid ( 234317 ) on Sunday June 23, 2019 @01:01PM (#58809720) Homepage Journal

    You can just stop right there. Healthcare - at least essential care - is not a free market and can never be. Local monopolies form naturally, with many areas being served by a single HMO. Ambulance companies do not compete on price, since a patient that calls 911 has no say over what happens next. You do not have a choice of hospital: they do not compete on price either. A patient on a ward is a captive, essentially, with only the option of refusal of treatment available if he or she is sufficiently conscious.

    The USA needs to catch up with the rest of the world and stop trying to make the "free market" do everything. State healthcare, such as the NHS in the UK, is not even "socialism", since healthcare is not a "means of production". It is a service supporting the overall health of a country, through the health of its people i.e. it's naturally a government role, even if you are a capitalist (as I am).

    • drive by doctoring is an issue as well $100K for assistant surgeon

      https://www.nytimes.com/2014/0... [nytimes.com]

    • You do not have a choice of hospital: they do not compete on price either.

      They may not compete on price, but you do have a choice of hospital. If you are conscious and tell the ambulance crew your preference, and it's not overfull/too far/incapable of treating your condition, they'll take you there.

  • identity theft and each place even the drug store need this id can be an big issue.
    And when you have so many pleases asking for the id people will have an hard time saying no to private companies that may say we need or we may just bill you the full rack rate that no one pays.

  • The story poster writes, "83-year-old former U.S. Senatior Ron Paul".

    Ron Paul was NEVER a US Senator.
    Ron Raul was in the US House of Representatives. He was a Representativ and a Congressman.

    This important distinction and piece of Common Knowledge really impinges on the things that the story poster is trying to communicate. Who wants to communicate with someone who doesn't have basic knowledge of what they are discussing?
  • First, because Betteridge says so.

    Second, writing from a country, where such an ID has been used for many decades, I disagree.

    I got contacted by such 'Bureaucrats' at age 54 because I had been operated at age 3 and apparently they detected a problem with that old operation on many people, so I and all the other people in the case had to get an additional operation.
    For free, evidently.

    As for privacy problems, people who misuse this, they just go to prison.

  • We've all heard terrible stories about pancreatic cancer. Only 9% live beyond five years. I'm around three years in and I look to be in that tiny group. In 2019 pancreatic cancer is incurable. Only a 1930s procedure called Whipple Surgery (there was a Dr. Whipple) has any power and only 1/3 of patients medically qualify and 1/3 of those get my result. Anyway, I've been through anything you can think of medically. I've acquired an army of doctors. Because I'm old I have federally funded Medicare. The
  • There needs to be STANDARDS for medical data storage. And then people should be able to choose where to keep their data. I don't believe I should be forced to go to a doctor under novant and have the entire system have access to my data. I want my data on a device that i own and control and decrypt and give to my doctor on an as needed basis.

  • Remember when they started Social Security, and the card originally said NOT TO BE USED FOR IDENTIFICATION PURPOSES. https://pearlsofprofundity.fil... [wordpress.com] Now, they want a "universal health ID" to have all your health information, stored in a "convenient" database. Anyone believe that crap! It's an end, to a means. Once they do this, then, get rid of cash, the government will OWN YOU!
  • Our O.H.I.P. program in Ontario has had issues for years.
    So much so, that you "can't" use it's green Health Card as photo ID "legally" anywhere but a healthcare provider or service.

    I shudder to think of how many times that ID has been used for purposes other than its intended use.
    Things like Insurance dabbling and data mining.

    Exercise your Google Foo. Just be sitting down...

  • To me, the worst part of this is the warrantless searches.

    Also, as someone with medical issues, the immense trouble transferring medical records to people that I want to see them would vanish.

    So the obvious conclusion is simply to make a law that requires consent or a warrant to access those records - and put in a prison punishment of at least 1 year per person whose records you accessed. The law should specifically mention that police and other government officials that do not get a warrant are subject t

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