MEDICAL IDs: Will Congress Put Plan On Hold?

      The AP/Dallas Morning News reports that House Republicans "considered -- but rejected -- delaying a program to give every American a computer identification number to track health care from birth to death." A GOP aide said "Members of Congress did not recognize the privacy implications" of the 1996 health insurance portability law "until media reports about the issue came out this week." At a meeting yesterday, House Republicans "considered putting the plan on hold while they looked at it more carefully," but the GOP aide said "they decided to let the law stand" (7/23).

Or Did They?
      The print edition of the AP/Philadelphia Inquirer offers a slightly different account of House Republicans' decision. The report, apparently based on the same Associated Press article that ran in the Dallas paper, says GOP leaders are still "considering putting off" the medical ID proposal. The article says Republicans "are considering attaching the delay to legislation giving patients new rights to counter managed care cost cutting." The AP/Inquirer also reports that the White House may not be opposed to a delay. Health policy adviser Chris Jennings "said the administration was not opposed to a delay in theory since it was already moving slowly." He also noted that Congress has yet to pass legislation protecting the privacy of medical records (7/23).

Uproar
      Under the headline "Proposed Health Database Has Privacy Advocates In Uproar," the Christian Science Monitor looks at the medical ID issue. Dr. Margo Goldman, a member of the Coalition for Patients' Rights is quoted as saying, "The American people are being told that in order to get top-notch health care there is something to be given up, (and) that something is privacy. Our position is it doesn't need to be traded" (Thurman, 7/23).

Editorials Urge Caution
      Below are the latest editorials on the issue:

• Akron Beacon Journal: "The reality of abuse of information systems teaches nothing if not healthy skepticism. Any plan to compile dossiers of highly personal medical information makes everyone vulnerable to those who have access to the information. ... Good intentions and clear benefits have often not been enough to prevent intrusion into private lives and abuse of confidential information in other aspects of civic life. If, as private citizens, we are wary of a patient identifier system, we have cause to be, even as we see how it can be beneficial" (7/22).
• Birmingham News: "Would you really want an employer to know every embarrassing medical problem in your past? That you once had an abortion or a sexually transmitted disease? A lot of people might try to avoid that by being less open with their doctors which only makes their health care worse" (7/22).
• Los Angeles Times: "The government's unique identifiers could be far preferable to the current free-for-all if they were made available only to medical providers and researchers and only after being carefully coded so patients' identities would be revealed only for purposes of treatment. But until Congress passes genuine privacy protections, health identifiers could do more harm than good" (7/22).
• Las Vegas Sun: "[I]f patients fear that their medical records could end up in the wrong hands and be misused, then it is very likely that many will not be as open with their doctors about their medical history. If that happens, then the patient suffers because doctors need to know everything about a patient to make an accurate diagnosis and provide the proper treatment. ... As [HHS] moves forward it should keep privacy issues paramount in its attempt to comply with the law" (7/21).
• Milwaukee Journal Sentinel: The editorial outlines the arguments of proponents and opponents of the Medical IDs, then continues: "The problem with such talk is that so much of it is based on speculation: The codes could achieve some useful goals; they could have harmful consequences. Maybe safeguards could ensure the privacy of medical records; maybe not. ... Properly conducted, the [ongoing HHS] hearings will help the government ensure that the 1996 law making health insurance portable does not transform confidential medical records into open books" (7/23).
• San Antonio Express-News: "The intent is to make it easier and less expensive to access patients' medical records. That makes sense. However, others argue that it smacks of Big Brother. And, they wonder, if hackers can access the Pentagon's computers, why not ordinary Americans' medical histories? ... While we can support efforts to simplify medical records and reduce the cost of health care, doctor-patient privacy must be preserved" (7/21).