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
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
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
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