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May 18, 1994

Security of Personal Information in a New Health Care System

JAMA. 1994;271(19):1484. doi:10.1001/jama.1994.03510430036027

To the Editor.  —Gostin et al1 offer to add patient privacy protection to the Clinton nationalized medicine proposal.2 The authors say the issue is one of competing interests: "all participants" in nationalized medicine "need access to high-quality information for informed decision making," while individual patients "must have confidence" that their private information "is adequately protected."The discussion clarifies the major assumptions. The government is a key participant. A government computer network will provide high-quality data. Only certain kinds of data deserve privacy, eg, sexual disease or drug abuse history, embarrassing facts, and other health information that might affect employment, insurance, and housing options. Privacy protection means patients may give informed consent to allow legitimate uses of private data.The federal government becomes the all-knowing protector of everyone's health and privacy. The authors' privacy protection plan would enact a federal "code of fair information practices," assign universal identifying numbers