A little-noticed regulatory announcement from last month is prompting increasing alarm from privacy advocates who worry its vision of a sprawling federal database to house the medical records for tens of millions of Americans could be a privacy nightmare.
The announcement, from the Department of Health and Human Services, vaguely outlined plans to keep extremely sensitive medical records – including a list of diagnoses, doctors seen and prescriptions issued – in a central database of the federal government.
Such a database poses significant peril.
First, given the government’s difficulty protecting private data, you can expect the database would be hacked. Putting all of the information in a single database creates a single point of failure that makes it a much more enticing target for nefarious hackers in Russia and China.
Secondly, unscrupulous government employees could abuse the information. We saw how the IRS targeted the Tea Party. Would you be shocked to learn the Hillary Clinton administration used a vast database of private medical records to silence critics? I wouldn’t be.
Thirdly, you create a real risk that the government begins enforcing laws and regulations based on what you tell your doctor. Right now, the nanny state can be pretty annoying. But imagine if the tax code were based in part on how healthy your diet is? Right now that’s impossible. With a federal medical records database, it’s not nearly as far-fetched.
Fourth, many observers believe one of the goals behind why Obama is pushing this now, as he’s about to head out of office, is to lay the groundwork for single-payer health care.
The president recently published a 7,000 word article on health care under his own name, and the article raised the prospect of the “public option,” basically single-payer health care competing with private plans after Democrats had largely dropped the idea for several years.
The president is clearly planning his last moves as a way to ensure the country remains “fundamentally transformed” even when he’s no longer president.
With a central medical records database, it becomes much easier for bureaucrats to begin the planning work for single-payer. That preparation would make it easier to transition to the system when a Democratic president decides that like immigration law, the law is no hurdle to aggressive unilateral action.
Part of that risk includes another specific part of the database: proprietary pricing and other business data from health care providers.
Such businesses have done plenty of craven things to help facilitate Obamacare, but they’re also a buffer against radical unilateral actions by the president, since they have resources to publicize problems and mobilize the public against anything too draconian.
Forcing those companies to disclose data that could ruin their competitive advantage leaves the government holding a lot of cards in any such battle, weakening a pillar of civic society in any future push to single-payer.
It’s crucial to get the word out know about the database to kill this idea before it gets any further. In the UK, the government tried something similar, only to drop the idea when the public outcry became too great to bear. One of the major turning points in the debate was when a private consulting group uploaded the entire database to Google, vindicating the worst privacy fears critics had expressed.
And while the long-term risks are deeply worrying, there’s ample short-term concerns to show why this is just a terrible idea. People don’t want their medical records in the hands of government bureaucrats, nor Russian hackers. A central government database of patient records is just dangerous.