Invasion of Medical Privacy

October 7, 1998

President Clinton is up to something that will surely put the American people's love of liberty to the test. He wants to assign every citizen a "unique health identifier," an identification number that would permit the government to gather information about our health and compile it into a national database.

No one noticed when Congress approved, and Clinton signed, the mandate for a health ID system. This fits a disturbing pattern. There has been an essentially surreptitious move toward a national identification system the last several years. Several bills, approved and signed, contain pieces of an emerging system that will require every American to carry a photo ID that would include personal history stored on a magnetic strip or computer chip.

This ought to disturb everyone. Who can be comfortable at the thought that the government will be collecting personal information about us and storing it in a central place? That has always been the stuff of science fiction and futurist novels featuring pervasive and oppressive governments. Is that day just around the corner?

Supporters of the proposal say it will be an efficient way to create a data bank that will be valuable in providing medical and insurance services and in advancing medical research. The proponents include insurance companies and researchers.

Let us not be fooled by this siren song of efficiency and science. If private firms were proposing the data bank and asking people to participate, that would be one thing. But here we are talking about the government imposing this system on all of us, compiling the information, and using it for who knows what purpose.

We cannot trust government with that kind of power.

Here is a revealing sidelight to this story. The proposed system would not use Social Security numbers. The reason is that too many agencies already have access to that number. But when Social Security was debated in the 1930s, Americans were assured the number would be used for no other purpose. Today, the Social Security number is used for virtually everything.

What assurance would we have that the new number wouldn't become as accessible as the old one? None. And citizens jealous of their liberty and wary of government should always err on the side of caution.

There are many grounds for fighting the Clinton proposal. First, there is no constitutional authority for setting up this vast machinery for gathering medical information about citizens. Congress was delegated a few specific powers; it was forbidden to exercise any powers not delegated.

It won't do to invoke the general-welfare or commerce clause. If those were meant to be general grants of power, the framers would not have bothered to enumerate powers in Article I, Section 8. The database, falling outside of this framework, is unconstitutional.

Second, this plan is simply part of the piecemeal takeover of health care by the federal government. President Clinton failed to accomplish the takeover in one grab in 1993, so he switched to the backup plan, the gradual absorption of the system into the government. New regulations on insurance, new programs for children's care, and new mandates on health maintenance organizations add up to a slow-motion power grab. It stands to reason that if the government is to control health care, it will need a data bank with health profiles on each of us.

To the extent that the health-care system in the United States is deficient, it is the fault of the government. Through Medicare and Medicaid, government is the major buyer of health services. It has badly distorted the market, first by forcing up prices and then by fostering ominous cost-control devices, including HMOs.

Moreover, the government's meddling with medical insurance (beginning in World War II when employers first started offering it to get around controls on wages) has removed the cost-conscious consumer from the equation, leading to spiraling prices and new government pressure to contain costs. The result is a pricey, inefficient government-saturated system that people are increasingly worried about.

Let's hope that the outrageous medical ID now being planned will wake Americans up to the threat that government control of medical care holds.

Sheldon Richman is senior fellow at The Future of Freedom Foundation in Fairfax, Va., and editor of The Freeman magazine, published by the Foundation for Economic Education.