The Medical Care ID Card

All the major medical insurance companies in the state of New Hampshire have joined in an effort to encourage the adoption of a new Medical Care ID system as part of the national effort to reduce healthcare costs. Each insured person in the country is to be issued a Medical Care ID card that contains all the insured's medical history together with that person's insurance coverage information. The Medical Care ID card can be read by an inexpensive device that will be made widely available to all doctor's offices, hospitals, and pharmacies that will communicate with a central database operated by the Department of Health and Human Services in Washington, DC. (The deivces are expected to be similar to the credit card readers in retail establishments.) The cards can be updated by these devices to reflect the latest information about the patient.

It is hoped that the cards will provide extra information to assist in medical diagnosis, but most importantly the use of the cards is expected to reduce insurance administrative costs. In addition, the information and its subsequent analysis can be used to reduce insurance fraud, assess the efficacy of various treatments, track subtle adverse reactions, and may even be helpful in the development of new treatments and drugs.

You have been asked by one of the New Hampshire Senators to help devise a system that can accommodate the needs of society and individuals, as well as the medical care and insurance industries. The Senator has also informed you of the following to be included in your considerations and suggestions:

1. Arnie Anxious, a prominent contributor to the Senator's last campaign, has a medical condition about which he is severely embarrassed (so much so that he will not even disclose the nature of the ailment to the Senator). He would like to have any information about his condition excluded from the card.

2. A New Hampshire company has a patented technique to capture and store medical information in manner that can help preserve confidentiality. The company would like to see its technology "selected" for use in the system.

3. The researchers at the medical school of a famous New Hampshire college would like some assurance, either through system design or operating rules, that they will be able to "mine" whatever data are collected by the system.