This website provides readers an historical perspective on the evolution of various healthcare laws and regulations affecting healthcare freedom and privacy.
For updated information about healthcare freedom and privacy issues, visit Citizens' Council for Health Freedom's website
Browse by Topic

Coming Soon. . . Every American Will Be Assigned a"Unique Health Identifier"

Did you know that by law, the U.S. Department of Health and Human Services (HHS) must assign each American a "unique health identifier" (an electronic patient ID number) to tag and track his or her electronic medical records?

Not many people are aware of this soon-to-be-enacted plan. The media are busy reporting that the Clinton administration is going to protect people's electronic medical records. Yet the proposed protections are simply a way to lull the American public into a false sense of security.

How did this all come about? How will the unique health identifier be assigned? What is being done to stop this policy from moving forward?

Genesis of the "Unique Health Identifier"

The unique health identifier was part of the Clinton administration's proposed Health Security Act in 1993. Clearly, you can't create a centralized health care system without standardized data in a central database. The Clinton health plan never passed.

But three years later a similar provision was inserted into the bipartisan Health Insurance Portability and Accountability Act of 1996 (HIPAA), which was signed into law in August 1996. HIPAA stipulates that "The Secretary [of Health and Human Services] shall adopt standards providing for a standard unique health identifier for each individual, employer, health plan and health care provider for use in the health care system." That provision is to take effect by February 2000. But the rules for creating the identifier have not been presented to the public.

Who Is Behind the Unique Health Identifier?

Both government and private groups have been pushing for the standardization of medical care and patient records. According to a 1998 report titled "Nothing Sacred: The Politics of Privacy" (published by the Center for Public Integrity), the legislation to assign everyone a "unique personal identifier" was written by a coalition of health care groups, including insurers, hospitals, and providers. Their purported goals are to simplify administrative transactions, conduct medical research, monitor child abuse, track contagious disease outbreaks, and improve many other functions in the health care system. Who could argue with those laudable goals?

How Will the Unique Health Identifier Work?

In a 2001 Cato Institute paper titled "Watching You: Systematic Federal Surveillance of Ordinary Americans," Professor Charlotte Twight of Boise State University explains that "On July 2, 1998, HHS released its lengthy White Paper entitled `Unique Health Identifier for Individuals.' In this chilling document HHS calmly discussed exactly what Orwellian form the `unique health identifier' would take and what degree of encroachment on individual privacy would be compelled."

Twight notes that the federal government will assign every newborn a birth certificate number, a Social Security number, and a health identifier. Six alternatives for the identifier are being considered:

  1. Social Security numbers,
  2. Biometric identifiers,
  3. Directory service,
  4. Personal immutable properties,
  5. Patient identification system based on existing medical record number and practitioner prefix; and
  6. Public key/private key cryptography method. (To view the White Paper, see the following Web site:

While all these systems would require centralization of individually identifiable health information, the most striking is the proposal to use biometric identifiers. Twight reports that "The HHS White Paper describes biometric identifiers as `based on unique physical attributes, including fingerprints, retinal pattern analysis, iris scan, voice pattern identification, and DNA analysis.'"

The public won't know which system will be used until HHS publishes its proposed rule for unique identifiers.

Centralized Data is Centralized Power

"The issue is not just privacy; it is government power," writes Twight. She quotes Dr. Richard Sobel of Harvard Law School, who notes that: "What ID numbers do is centralize power, and in a time when knowledge is power, then centralized information is centralized power. I think people have a gut sense that this is not a good idea."

Who Can Stop the Unique Health Identifier?

Professor Twight points out that "absent congressional reversal of the underlying statutory mandate the die is largely cast." Congress has placed a temporary moratorium on federal spending for unique health identifiers, but that won't stop them from being created. To do that, Congress would have to repeal the section of HIPAA that created unique health identifiers. Representative Ron Paul (R-TX) has introduced legislation (H.R. 220) that would do just that.

Those who care about their medical privacy should voice their own opinions soon!

This article was originally published in the November/December 1999 issue of
Health Freedom Watch.

This page/links were modified/updated May 21, 2009.