Health care providers, insurance companies, and government agencies are once again promoting the idea of a “unique patient identifier (UPI),” a number assigned to every American in order to manage their health care information.
The push for a UPI, also known as a national patient identifier, prompted former U.S. Representative Ron Paul (R-TX), chairman of the Campaign for Liberty, and Sen. Marsha Blackburn (R-TN) to issue a joint statement on November 2.
“As a physician, I know firsthand how much the doctor-patient relationship relies on trust and privacy, which would be undermined by a National Patient ID,” said Paul. “Now, more than ever, it is crucial to protect Americans’ genetic information from theft by foreign actors like China and prevent the government from centralizing patients’ personal health records or interfering with their medical decisions.”
Sen. Blackburn echoed Paul’s concerns. “The federal government has no right to dictate individual medical decisions or gain access to your private medical records,” said Blackburn. “The existing National Patient ID sets a dangerous precedent for Big Brother to exert even more control over your life, and it is paramount that we prevent the Biden administration from creating it.”
Congress Pursues ID Goal
The Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996, called for the creation of a UPI. HIPAA also included an amendment by Paul that barred the government from spending any money to develop a unique identifier. The legislation simultaneously set a goal and blocked government spending money to achieve the goal.
In 2019, at the urging of the American Health Information Management Association, the College of Healthcare Information Management Executives, and other groups, U.S. Reps. Bill Foster (D-IL) and Mike Kelly (R-PA) introduced an amendment to strike Paul’s language from the fiscal year 2020 Labor-HHS Appropriations bill.
The amendment was not included in the final version of the bill enacted in December 2019, but the legislation did require the Office of the National Coordinator for Health IT (ONC) to evaluate the effectiveness of current patient matching methods and make recommendations to more accurately match patients to their personal health data. That report is pending.
More recently, the U.S. House of Representatives passed a 2021 omnibus spending package that would have removed the prohibition on the use of federal funds for a UPI, but the Senate Appropriations Committee subsequently cut the provision from the bill.
Private Sector Ready
The private sector is ready and waiting for lawmakers to approve the UPI, says Experian, a global information service giant.
“While a UPI has yet to be nationally recognized and implemented, a foundation has certainly been made and the industry is perfectly poised to move forward,” said Experian, in a statement published on January 26, 2021.
Experian says a UPI could replace traditional ways of identifying patients, such as Social Security numbers and addresses. “A standardized code like this not only protects sensitive health information but supports the exchange of data between healthcare organizations and states as it is a number and format easily read and recognized by all,” said Experian.
Not So Private
The UPI could be used as a tool to control Americans, particularly in the age of COVID-19 and government mandates, says Paul.
“The result of the identifier will be a medical caste system, where those who refuse to follow the mandates or advice of the ‘experts’ are denied opportunities to work, receive an education, or even go to church or enjoy a night out on the town,” said Ron Paul.
“A unique patient identifier will weaken health care by making individuals reluctant to share personal information—such as drug and alcohol use and past sexual history—with health care providers,” said Paul “It will also discourage sick individuals from seeking medical care for fear their physicians will discover they are unvaccinated, smoke, are overweight, or engage in other unapproved behaviors.”
Electronic Health Records
Current federal law requires health care providers to use digitized health records, and a UPI would add to that burden, says Twila Brase, the president and co-founder of the Citizens’ Council for Health Freedom and advisor to The Heartland Institute, which co-publishes Health Care News.
“The only reason medical records have been digitized is a federal law that penalizes doctors who refuse to use a government-approved electronic health record,” said Brase.
“The UPI will be a single number through which every medical encounter will be recorded,” said Brase. “Given that HIPAA is a data-disclosure rule, not a privacy rule, this means millions of people will be able to have access to the private data of every American without patient consent—all in one place, through a national medical records system called the eHealth Exchange.”
Repeal HIPAA Mandate
Sens. Rand Paul (R-KY) and Blackburn introduced legislation to repeal the section of HIPPA authorizing the creation of a UPI, and U.S. Rep. Chip Roy (R-TX-21) introduced a companion bill in the House in 2019, when their party was in the majority, but neither chamber acted.
Roy, along with U.S. Reps. Thomas Massie (R-KY) and Mary Miller (R-IL) are trying again as they introduced the National Patient Identifier Repeal Act on November 2, 2021.
An attempt to stop a patient I.D. should be tried again, says Brase.
“The current system has been imposed by federal law and should be dismantled by either a repeal of federal laws or through state laws that require informed patient consent and create a strong, enforceable right.”
Kevin Stone (kevin.s.stone@gmail.com) writes from Arlington, Texas.