Part of a series on Election 2008 that looks at the candidates’ positions or statements on the privacy of your health records and medical privacy (excluding abortion).

To see what other candidates have done or said, see the other files in this series on Senator Hillary Clinton, Senator Barack Obama, Senator John McCain, Mike Gravel, and Governor Mike Huckabee.

Paul’s campaign responded to my email inquiry with the following reply:

Dr. Paul would repeal the misnamed “medical privacy rule,” and all other federal laws that give third parties access to an individual’s health care records without patient consent.

Many concerns about medical privacy are rooted in the enhanced use of third-party payers, which have caused insurance companies and Health Maintenance Organizations (HMOs) to wrest control over health care from patients and providers. Therefore, his agenda of returning control over the health care dollar to individuals via generous tax credits, tax deductions, and expanded access to Health Savings Accounts (HSAs) will empower individuals to protect their health care information.

He will also protect medical privacy by ending federal persecution on physicians currently being waged in the name of the war on drugs.

For an idea of what Congressman Paul has done in the past about medical privacy, please check out the following article on our site:

http://www.ronpaul2008.com/discover-and-imagine-ron-paul/successfully-fought-hillarycare-lite/

Paul’s proposed legislation in Congress and his statements concerning medical and health-related privacy are extensive and portray a consistent picture of the years. In chronological order, here’s some of what is in his record:

In 2001, Paul introduced the Identity Theft Prevention Act (H.R. 220). He said, in part:

Mr. Speaker, of all the invasions of privacy proposed in the past decade, perhaps the most onerous is the attempt to assign every American a “unique health identifier”–an identifier which could be used to create a national database containing the medical history of all Americans.

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Perhaps the most outrageous example of phony privacy protection is the Clinton Administration’s so-called “medical privacy” proposal, which allow medical researchers, certain business interests, and law enforcement officials’ access to health care information, in complete disregard of the Fifth Amendment and the wishes of individual patients! Obviously, “privacy protection” laws have proven greatly inadequate to protect personal information when the government is the one providing or seeking the information.

In 2001, Paul also introduced the Patient Privacy Act of 2001, H.R. 2615, saying, in part:

Mr. Speaker, I rise to introduce the Patient Privacy Act, which repeals those sections of the Health Insurance Portability and Accountability Act of 1996 authorizing the establishment of a ‘‘standard unique health care identifier’’ for all Americans, as well as prohibiting the use of federal funds to develop or implement a database containing personal health information.

Establishment of such a medical identifier, especially when combined with HHS’s misnamed ‘‘federal privacy’’ regulations, would allow federal bureaucrats to track every citizen’s medical history from cradle to grave. Furthermore, it is possible that every medical professional, hospital, and Health Maintenance Organization (HMO) in the country would be able to access an individual citizens’ record simply by entering the patient’s identifier into a health care database.

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Those who claim that the Patient Privacy act would interfere with the plans to ‘‘simplify’’ and ‘‘streamline’’ the health care system, should remember that under the constitution, the rights of people should never take a backseat to the convenience of the government or politically powerful industries like HMOs.

In 2003, Paul re- introduced the Identity Theft Prevention Act, saying, in part:

This act also forbids the federal government from creating national ID cards or establishing any identifiers for the purpose of investigating, monitoring, overseeing, or regulating private transactions between American citizens, as well as repealing those sections of the Health Insurance Portability and Accountability Act of 1996 that require the Department of Health and Human Services to establish a uniform standard health identifier. By putting an end to government-mandated uniform IDs, the Identity Theft Prevention Act will prevent millions of Americans from having their liberty, property and privacy violated by private-and-public sector criminals.

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Mr. Speaker, of all the invasions of privacy proposed in the past decade, perhaps the most onerous is the attempt to assign every American a “unique health identifier”–an identifier which could be used to create a national database containing the medical history of all Americans. As an OB/GYN with more than 30 years in private practice, I know the importance of preserving the sanctity of the physician-patient relationship. Oftentimes, effective treatment depends on a patient’s ability to place absolute trust in his or her doctor. What will happen to that trust when patients know that any and all information given to their doctor will be placed in a government accessible database?

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Second, the federal government has been creating proprietary interests in private information for certain state-favored special interests. Perhaps the most outrageous example of phony privacy protection is the “medical privacy” regulation, which allows medical researchers, certain business interests, and law enforcement officials’ access to health care information, in complete disregard of the Fifth Amendment and the wishes of individual patients! Obviously, “privacy protection” laws have proven greatly inadequate to protect personal information when the government is the one providing or seeking the information.

On April 9, 2003, Paul re-introduced the Patient Privacy Act, H.R. 1699, saying:

Mr. PAUL. Mr. Speaker, I rise to introduce the Patient Privacy Act. This bill repeals the misnamed Medical Privacy regulation, which goes into effect on April 14 and actually destroys individual medical privacy. The Patient Privacy Act also repeals those sections of the Health Insurance Portability and Accountability Act of 1996 authorizing the establishment of a “standard unique health care identifier” for all Americans, as well as prohibiting the use of federal funds to develop or implement a database containing personal health information. Both of these threats to medical freedom grew out of the Clinton-era craze to nationalize as much of health care as politically possible.

Establishment of a uniform medical identifier would allow Federal bureaucrats to track every citizen’s medical history from cradle to grave. Furthermore, as explained in more detail below, it is possible that every medical professional, hospital, and Health Maintenance Organization (HMO) in the country would be able to access an individual citizens’ record simply by entering the patient’s identifier into a health care database.

The dangers to liberty inherent in the “uniform health identifier” are magnified by the so-called “medical privacy” regulation. Many things in Washington are misnamed, however, this regulation may be the most blatant case of false advertising I have come across in all my years in Congress. Rather than protect an individual right to medical privacy, these regulations empower government officials to determine how much medical privacy an individual “needs.” This “one-size-fits-all” approach ignores the fact that different people may prefer different levels of privacy. Certain individuals may be willing to exchange a great deal of their personal medical information in order to obtain certain benefits, such as lower-priced care or having information targeted to their medical needs sent to them in a timely manner. Others may forgo those benefits in order to limit the number of people who have access to their medical history. Federal bureaucrats cannot possibly know, much less meet, the optimal level of privacy for each individual. In contrast, the free market allows individuals to obtain the level of privacy protection they desire.

The so-called “medical privacy” regulations and uniform health identifier scheme not only reduce individuals’ ability to determine who has access to their personal medical information, but actually threaten medical privacy and constitutionally protected liberties. For example, these regulations allow law enforcement and other government officials access to a citizen’s private medical record without having to obtain a search warrant.

Allowing government officials to access a private person’s medical records without a warrant is a violation of the Fourth Amendment to the United States Constitution, which protects American citizens from warrantless searches by government officials. The requirement that law enforcement officials obtain a warrant from a judge before searching private documents is one of the fundamental protections against abuse of the government’s power to seize an individual’s private documents. While the Fourth Amendment has been interpreted to allow warrantless searches in emergency situations, it is hard to conceive of a situation where law enforcement officials would be unable to obtain a warrant before electronic medical records would be destroyed.

Mr. Speaker, these regulations also require health care providers to give medical records to the Federal government for inclusion in a Federal health care data system. Such a system would contain all citizens’ personal health care information, accessible to anyone who knows the individual’s “unique health identifier.” History shows that when the government collects this type of personal information, the inevitable result is the abuse of citizens’ privacy and liberty by unscrupulous government officials. The only fail-safe privacy protection is for the government not to collect and store this type of personal information.

In addition to law enforcement, these so-called “privacy protection” regulations create a privileged class of people with a federally guaranteed right to see an individual’s medical records without the individual’s consent. My medical office recently received a Model “Privacy Act Compliance” form. This three-page form lists over 20 situations where medical information may be disclosed without individual consent. Medical information may be disclosed to attorneys, business associates of the provider, and Federal agencies conducting “health oversight activities.” Medical information may also be divulged without consent to insurance companies and medical researchers!

Medical researchers claim to be able to protect the autonomy of their unwilling subjects, but the fact is that allowing third parties to use medical records for research purposes runs the risk of inadvertent identification of personal medical information. I am aware of at least one incident where a man had his identity revealed when his medical records were used without his consent. As a result, many people in his community discovered details of his medical history that he wished to keep private!

Forcing individuals to divulge medical information without their consent also runs afoul of the Fifth Amendment’s prohibition on taking private property for public use without just compensation. After all, people do have a legitimate property interest in their private information. Therefore, restrictions on an individual’s ability to control the dissemination of their private information represents a massive regulatory taking. The takings clause is designed to prevent this type of sacrifice of individual property rights for the “greater good.”

In a free society such as the one envisioned by those who drafted the Constitution, the Federal government should never force a citizen to divulge personal information to advance “important social goals.” Rather, it should be up to the individuals, not the government, to determine what social goals are important enough to warrant allowing others access to their personal property, including their personal information. To the extent these regulations sacrifice individual rights in the name of a bureaucratically determined “common good,” they are incompatible with a free society and a constitutional government.

As an OB-GYN with more than 30 years experience in private practice, I am very concerned by the threat to medical practice posed by these privacy regulations and the unique health identifier scheme. The confidential physician-patient relationship is the basis of good health care.

Oftentimes, effective treatment depends on the patient’s ability to place absolute trust in his or her doctor. The legal system has acknowledged the importance of maintaining physician-patient confidentiality by granting physicians a privilege not to divulge confidential patient information.

I ask my colleagues to consider how comfortable you would be confiding an embarrassing physical or emotional problem to your physicians if you knew that any and all information given your doctor may be placed in a government database or seen by medical researchers, handed over to government agents without so much as a simple warrant or accessed by anyone who happens to know your “unique health identifier?”

By now it should be clear to every member of Congress that the American people do not want their health information recorded on a database, and they do not wish to be assigned a unique health identifier. According to a survey by the respected Gallup Company, 91 percent of Americans oppose assigning Americans a “unique health care identifier” while 92 percent of the people oppose allowing government agencies the unrestrained power to view private medical records and 88 percent of Americans oppose placing private health care information in a national database. Congress has acknowledged this public concern by including language forbidding the expenditure of funds to implement or develop a medical identifier in the Federal budget for the past 5 fiscal years. Rather than continuing to extend the prohibition on funding for another year, Congress should finally obey the wishes of the American people by repealing the authorization of the individual medical ID this year as well as repeal these dangerous medical privacy rules.

Mr. Speaker, the misnamed medical privacy regulations and the scheme to assign all Americans a “unique health care identifier” violates the fourth and fifth amendments by allowing law enforcement officials and government favored special interests to seize medical records without an individual’s consent or a warrant. Federal supervision of who can access medical records combined with a federally assigned medical ID also facilitate the creation of a Federal database containing the health care data of every American citizen. These developments could undermine the doctor-patient relationship and thus worsen the health care of millions of Americans. I, therefore, call on my colleagues to join me in repealing these threats to privacy and quality health care by cosponsoring the Patient Privacy Act.

Paul spoke on Feb. 11, 2004 concerning the Rush Limbaugh case and the role of federal government. He said, in part:

Finally, as the Limbaugh case reveals, the prosecution of pain management physicians destroys the medical privacy of all chronic pain patients. Under the guise of prosecuting the drug war, law enforcement officials can rummage through patients’ personal medical records and, as may be the case with Mr. Limbaugh, use information uncovered to settle personal or political scores. I am pleased that AAPS, along with the American Civil Liberties Union, has joined the effort to protect Mr. Limbaugh’s medical records.

On October 5, 2004, Paul opposed the National All Schedules Prescription Electronic Reporting Act, H.R. 3015:

Mr. PAUL. Mr. Speaker, I rise in opposition to H.R. 3015, the National All Schedules Prescription Electronic Reporting Act. This bill is yet another unjustifiable attempt by the Federal government to use the war on drugs as an excuse for invading the privacy and liberties of the American people and for expanding the Federal government’s disastrous micromanagement of medical care. As a physician with over 30 years experience in private practice, I must oppose this bill due to the danger it poses to our health as well as our liberty.

By creating a national database of prescriptions for controlled substances, the Federal government would take another step forward in the war on pain patients and their doctors. This war has already resulted in the harassment and prosecution of many doctors, and their staff members, whose only “crime” is prescribing legal medication, including opioids, to relieve their patients’ pain. These prosecutions, in turn, have scared other doctors so that they are unwilling to prescribe an adequate amount of pain medication, or even any pain medication, for their suffering patients.

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H.R. 3015 also threatens patients’ privacy. A patient’s medical records should be treated according to the mutual agreement of the patient and doctor. In contrast, H.R. 3015 will put a patient’s prescriptions on a government-mandated database that can be accessed without the patient’s permission.

Instead of further eroding our medical privacy, Congress should take steps to protect it. Why should someone not be able to deny the government and third parties access to his medical records without his permission or a warrant?

One way the House can act to protect patients’ privacy is by enacting my Patient Privacy Act (H.R. 1699) that repeals the provision of Federal law establishing a medical ID for every American. Under the guise of “protecting privacy,” the Health and Human Services’ so-called “medical privacy” regulations allow medical researchers, insurance agents, and government officials access to your personal medical records-without your consent. Congress should act now to reverse this government-imposed invasion of our medical privacy.

Please join me in opposing H.R. 3015–legislation that, if enacted, will make us less free and less healthy.

In January 2005, Paul introduced the Identity Theft Prevention Act yet again, repeating his earlier arguments for it.

On July 28, 2006, Paul rose in Congress to oppose [pdf] H.R. 4157 , the Health Information Technology Promotion Act of 2006. He said, in part:

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Those who are concerned with the increasing erosion of medical privacy should also oppose H.R. 4157. H.R. 4157 facilitates the invasion of medical privacy by explicitly making electronic medical records subject to the misnamed federal “ medical privacy” regulation. Mr. Speaker, many things in Washington are misnamed, however this regulation may be the most blatant case of false advertising I have come across in all my years in Congress. Rather than protect an individual right to medical privacy, these regulations empower government officials to determine how much medical privacy an individual needs.

The so-called “medical privacy” regulation not only reduce individuals” ability to determine who has access to their personal medical information, but actually threatens medical privacy and constitutionally protected liberties. For example, these regulations allow law enforcement and other government officials’ access to a citizen’s private medical record without having to obtain a search warrant.

Allowing government officials to access a private person’s medical records without a warrant is a violation of the Fourth Amendment to the United States Constitution, which protects American citizens from warrantless searches by government officials. The requirement that law enforcement officials obtain a warrant from a judge before searching private documents is one of the fundamental protections against abuse of the government’s power to seize an individual’s private documents. While the Fourth Amendment has been interpreted to allow warrantless searches in emergency situations, it is hard to conceive of a situation where law enforcement officials would be unable to obtain a warrant before electronic medical records would be destroyed.

By creating a new federal bureaucracy to establish a “national strategic plan” for the adoption of electronic health care records, H.R. 4157 discourages private sector innovation and expands government control of the medical profession. H.R. 4157 also facilities the violation of medical privacy. Therefore, I urge my colleagues to reject this bill.

On April 25, 2007, opposing [pdf] the Genetic Information Nondiscrimination Act of 2007, H.R. 493, Paul said, in part:

Madam Speaker, the supporters of H.R. 493, the Genetic Information Nondiscrimination Act, are right to be concerned over the possibility that third parties, such as the government or potential employers, will access an individual’s genetic information without consent, and use that information to deny an individual health insurance or other benefits. I have long advocated repealing government laws and polices that allow third parties to access personal information. For example, I have worked to repeal the provision of Federal law giving the Federal Government the power to assign every American a “unique medical health identifier.” I also support repealing the phony “medical privacy” regulations that give law enforcement officials and state-favored private interests the right to access medical records at will.

Because of the Federal Government’s poor record in protecting privacy , I do not believe the best way to address concerns about the misuse of genetic information is through intrusive Federal legislation. Uniform Federal mandates are a clumsy and ineffective way to deal with problems such as employers making hiring decisions on the basis of a potential employee’s genetic profile. Imposing Federal mandates on private businesses merely raises the costs of doing business and thus reduces the employment opportunities for all citizens. A much better way to eliminate irrational discrimination is to rely on state and local regulation. Unlike the Federal Government, states and localities are able to tailor their regulations to fit the needs of their particular populaces. I would remind my colleagues that 34 states currently ban genetic discrimination in employment, while 46 states forbid health insurers from engaging in genetic discrimination. Clearly, the states are capable of addressing this issue without interference from Washington. My colleagues should also remember that Congress has no constitutional authority to forbid private sector employers from making hiring or other employment decisions on the basis of genetic information.

The best way to address the sponsors of H.R. 493’s legitimate concerns is to put individuals back in control of the health care dollar. When individuals control the health care dollar they, not their employers, insurance companies or Health Maintenance Organizations, can make all health care decisions, including whether or not to share individual genetic histories with a potential employer, insurer, or other third party. Therefore, instead of creating more Federal regulations and bureaucracies, my colleagues should increase individual control of health care by passing legislation expanding Health Savings Accounts and individual health care tax credits and deductions.

Paul opposed [pdf] the NICS Improvement Amendments Act of 2007 which became Public Law No: 110-180. That law expanded massive federal government databases. On June 13th, on the floor of the House, Paul said:

Mr. PAUL. Mr. Speaker, I rise in opposition to H.R. 2640, the National Instant Criminal Background Check System Improvements Amendments Act, and I urge caution.

In my opinion, H.R. 2640 is a flagrantly unconstitutional expansion of restriction on the exercise of the right to bear arms protected under the second amendment.

H.R. 2640 also seriously undermines the privacy rights of all Americans, gun owners and non-gun owners alike, by creating and expanding massive Federal Government databases, including medical and other private records of every American.

H.R. 2640 illustrates how placing restrictions on the exercise of one right, in this case, the right to bear arms, inevitably leads to expanded restriction on other rights as well. In an effort to make the Brady background check on gun purchases more efficient, H.R. 2640 pressures States and mandates Federal agencies to dump massive amounts of information about the private lives of all Americans into a central Federal Government database.

Among the information that must be submitted to the database are medical, psychological, and drug treatment records that have traditionally been considered protected from disclosure under the physician/patient relationship, as well as records related to misdemeanor domestic violence. While supporters of H.R. 2640 say that there are restrictions on the use of this personal information, such restrictions did not stop the well-publicized IRS and FBI files privacy abuses by both Democratic and Republican administrations. Neither have such restrictions prevented children from being barred from flights because their names appeared on the massive terrorist watch list. We should not trick ourselves into believing that we can pick and choose which part of the Bill of Rights we support.

If you know of statements or information on this candidate with respect to the issue of privacy of health care information or records, please post it in the comments section for this entry. I will update the files if/when I find more.

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