When Bill Clinton proposed his national health-care plan on September 22, 1993, he held up to the television audience a proposed new Health Security card. Your name and your ID number (probably your Social Security number) would appear on the front. Though it looks like a credit card with a magnetic strip, it may well be an interactive “smart card.”
Clinton health-care advisor Ira Magaziner said that whatever health plan Congress enacts, it will include a smart card. Don’t think this high-tech intrusiveness is unique to Democrats. The Bush administration had a never-enacted legislative proposal for a medical billing system with smart cards.
Smart cards come in several forms. One sort has inside it a microprocessor and memory chip. It is a very small computer wrapped in a credit-card-style package. Another contains an optical recording strip, again encapsulated in a credit-card format.
One maker of “optical memory” smart cards, Drexler Technology Corp., says in its 1992 annual report that its 4.1 megabyte smart card has the capacity to store “the equivalent of 1,200 to 1,600 pages.” Drexler has since announced an improved version with about one and a half times the capacity. A smart card is a portable personal data base. People with the right equipment can read this information or change it.
With cradle-to-grave health security, you the citizen get cradle-to-grave privacy insecurity. We know that government officials say: “We’re from the government, and we’re here to help you.” But can we trust these people with our medical histories or whatever else they decide to load onto these smart cards?
The government currently leaks like a sieve. Some government employees treat government-held information like a treasure trove. In recent years, law enforcement agencies have cited people from state and local police departments, the FBI, the Social Security Administration and the IRS for stealing information and selling it to information brokers, credit bureaus and skip tracers, or for inquisitively prying into the files of neighbors and celebrities.
Can we count on medical records (psychiatric visits, sexually transmitted diseases, abortions, genetic make-up, drug and alcohol history) staying private? Look what happened to tennis champion Arthur Ash. He was sick with AIDS, but he did not want to make his illness public. Yet the word got out. With even more people gaining access to information via smart cards, both the average person and people like Arthur Ash don’t stand a chance.
National policy currently forbids using a Health Security ID number to tie together health information in government hands with information in tax records or Social Security records or elsewhere. But can we trust government officials to resist temptation?
What about a case like the following: On May 6, 1992, sheriff’s deputies and federal agents raided Dr. Jonathan Wright’s clinic in Tacoma, Washington. As part of his practice of alternative medicine, Dr. Wright prescribed mineral and vitamin supplements to patients who came to him from across America.
The Food and Drug Administration believes that the supplements were not made according to the FDA’s rules. How private will the records of Dr. Wright’s patients be in this case? With the coming of smart cards, can we now look forward to seeing the federal government use computer technology to systematically crush alternative medicine?
Can I as a health-care consumer be sure that the information on my card is correct? Can I as a taxpayer be sure that other people have not altered their cards in order to fraudulently obtain services and drugs? Can we as citizens be confident this smart card won’t be turned into a national ID card to be produced on demand for all government agencies? The risk of abuse is too great.
All lovers of individual liberty and all defenders of personal privacy must unite to block implementation of the health smart card.
This article originally appeared in the November 6, 1993, issue of The Cleveland Plain Dealer. Reprinted by permission of the author.