Congress Holds Hearing
Repealing Unique Health Identifier and
Limiting Use of Social Security Numbers
June 14, 2000
The House Subcommittee on Government Management, Information
and Technology held a hearing on May 18, 2000 to examine
the Freedom and Privacy Restoration Act (H.R. 220).
The legislation would forbid the federal government
from assigning identifiers to citizens and it would
help protect Americans against government surveillance,
said Rep. Ron Paul (R-TX), sponsor of the legislation.
Specifically, H.R. 220 would repeal the section of the
Health Insurance Portability and Accountability Act
of 1996 (HIPAA) that requires the U.S. Department of
Health and Human Services (HHS) to assign a unique health
identifier to each American. It would also prohibit
the use of Social Security numbers (SSNs) for purposes
not related to Social Security.
Rep. Paul pointed out that federal funding for establishing
a unique health identifier has been put on hold for
the past two years. However, it could take effect this
coming fall unless Congress acts to stop it.1
Increasing Use of Social Security Numbers
Rep. Paul told the subcommittee that since the creation
of Social Security in 1935, there have been almost 40
congressionally authorized uses of the number as identification
for non-Social Security programs. "Such congressional
actions do not reflect the intent of the Congress that
created the Social Security system as that Congress in
no way intended to create a national identifier," he said.
"In fact, Congress never directly authorized the creation
of the Social Security number, they simply authorized
the creation of an `appropriate record keeping and identification
scheme.' The Social Security number was actually the creation
of the Internal Revenue Service!"
Remember the IRS and FBI Abuses?
"I am sure I need not remind the members of this Committee
of the sad history of government officials of both parties
using personal information contained in IRS or FBI files
against their political enemies," continued Paul. "Imagine
the potential for abuse if an unscrupulous government
official is able to access one's complete medical, credit,
and employment history by simply typing the citizen's
`uniform identifier' into a database. The history of abuse
of personal information by government officials demonstrates
that the only effective means of guaranteeing Americans'
privacy is to limit the ability of the government to collect
and store information regarding a citizen's personal matters.
The only way to prevent the government from knowing this
information is to prevent them from using standard identifiers,"
Encroaching Use of Social Security Numbers
Charlotte Twight, a professor of economics at Boise State
University, also testified in support of H.R. 220. She
explained that the SSN has become a key to our personal
information. "Even the Secretary of Health and Human Services
(HHS) now describes American Social Security numbers as
a `de facto personal identifier,'" Twight said.
She also noted that every child must acquire a Social
Security number at birth or shortly thereafter. "How was
this radical change accomplished?" Twight asked. "Much
as one conditions dogs: a bit at a time-and always with
a reward attached," she explained. "First, Congress required
by statute in 1986 that every child claimed as a dependent
on federal tax forms have an SSN by age five. Then in
1988 Congress reduced it by statute to age 2; in 1990
Congress reduced it to age one. "Finally, in 1996, Congress
passed a requirement that an SSN must be presented for
anyone of any age claimed on federal tax forms
as a `dependent.' No SSN, no federal tax exemption. In
general, to obtain any federal benefit today, tax-related
or otherwise, one must present the SSNs of all parties
Professor Twight concluded, "The quest for information
about private citizens is a by-product of the vast substantive
powers now wielded by the federal government. Dr. Richard
Sobel of Harvard Law School has stated that `centralized
information is centralized power.' I would add that
the converse is also true: with today's technology,
centralized power is centralized information." She said
that H.R. 220 would be a first step toward reducing
both centralized information and centralized power.
Another witness, Robert Smith, publisher of The
Privacy Journal, argued that being known as a number,
not a name, is dehumanizing. "It allows people in authority
as well as our neighbors and co- workers to treat us
as less than human," he said. Smith also stressed that
Congress should repeal the law requiring a Social Security
number for children 16 years or younger unless they
earn reportable income.
Efficiency Versus Privacy
Government witnesses expressed concern that H.R. 220 would
interfere with the efficiency of government programs.
Fritz Streckewald, the Social Security Administration's
(SSA) associate commissioner for program benefits, testified
that the legislation would make it difficult for the SSA
to exchange data with other federal, state, and local
Streckewald pointed out that such exchanges are necessary
for ensuring accurate payments. "In the use of SSNs,
we must carefully weigh the balance between protection
of individual privacy rights and the integrity of the
Social Security programs and other benefit paying programs,"
General Accounting Office (GAO) representative Barbara
Bovbjerg testified that health care organizations always
ask patients for their SSNs, but do not deny services
if refused. She based that information on GAO's contact
with officials representing hospitals, a health maintenance
organization, and a health insurance trade association.
Bovbjerg also reported that officials in the health
care industry expect use of SSNs to increase due to
growing coordination among networks of health providers.
Bovbjerg also acknowledged that the widespread use
of SSNs provides a means for building and sharing databases
of personal information-and can lead to identity theft.
She stressed that Congress must weigh concerns about
both individual privacy on the one hand and accuracy,
fraud and abuse on the other.
How Much is Your Privacy Worth?
One of the most disturbing arguments presented at the
hearing was the cost-benefit argument. Some government
officials and members of Congress are apparently willing
to strip Americans of their right to privacy in order
to make government programs efficient. During the question-and-answer
session, a member of Congress asked Rep. Paul how much
his bill would cost taxpayers. Paul responded that an
official cost estimate hadn't been completed yet, but
the cost of individual liberty must be factored into the
equation. This leads one to ask, "How much is privacy
worth?" Until that question is asked of the 277 million
individuals holding Social Security numbers, the government
can't say for sure whether unrestricted use of Social
Security numbers is truly cost-effective.
as of June 14, 2000: The House of Representatives passed
an amendment on June 13, 2000 to delay federal funding
for a unique health identifier. If the amendment
is signed into law, it would delay federal funding for
one year only; it does not repeal the unique health
This article was originally published in the May/June
2000 issue of Health
Imagine the potential for abuse if an unscrupulous
government official is able to access one's complete
medical, credit, and employment history by simply
typing the citizen's 'uniform identifier' into a