The Guardian 22 February, 2006
Medicare smartcard —
backdoor national ID card?
Bob Briton
Within weeks the Federal Cabinet will be considering a proposal to issue Medicare smartcards to as many as 15 million Australians. The card would contain biometric data (like finger prints, DNA, facial profiles or iris scans) and would be required to receive Medicare and Centrelink payments. The plan would cost hundreds of millions of dollars and oblige millions of citizens to turn up at government offices to be photographed and agree to have personal information stored on the card. Attorney General Philip Ruddock’s department is already preparing a review of the costs and benefits of a national identity card.
While various plans are being fleshed out and costed, Australians continue to reject the notion of any card that could be used to compile dossiers on them and restrict their civil liberties. Their opposition sank the Hawke Government’s Australia Card in the 1980s. They are justifiably suspicious of pledges from governments that cards would be used for worthy purposes only, such as clamping down on welfare fraud or defending the public against terrorism.
Privacy Commissioner Karen Curtis has been warning Medicare Australia (the new, commercial-sounding name for the Health Insurance Commission) that the scheme would be subject to "function creep" when other agencies or even private companies discover a use for the highly personal details to be kept on the card. As Selina Mitchell pointed out her report in The Australian, the US social security card started as a means to determine entitlement to government retirement benefits but has become the ubiquitous form of personal ID. Curtis has called on the Government to give "a clear articulation of why the card is needed".
The Medicare smartcard proposal is being floated at the same time as the results of a report from the Australian National Audit Office into Centrelink payments are being publicised. The understaffed, dismembered and constantly reshaped agency is being held up to ridicule for the inaccuracy of its records. The report maintains that about a third of its 23.2 million "customer" records were incorrect and that the database includes 1.5 million dead people — some of whom were still receiving payments.
Accounting firm KPMG has told the Department of Human Services that the huge cost of the Medicare smartcard would be recovered over time in savings on health and welfare overpayments. Additional savings could be made on items not factored in like state health and concession payments.
Human Services Minister Joe Hockey is pushing for the card but is emphasising its consumer-friendly features. The new cards (which could be in use within two years) would apparently enable holders to do Medicare and welfare transactions from their home computer and to get instant Medicare rebates by swiping their card through the EFTPOS machine in their doctor’s surgery. Questions and scepticism abound. No one has attempted to explain how the new card would open up possibilities denied the public with the existing card. The private health system already offers instant rebates without a smart card for dental, physiotherapy and other services.
A Productivity Commission Report has made a scathing assessment of an earlier government scheme that also promised to ease the out-of-pocket suffering of patients. Since 1999, the Government has spent $600 million on subsidies to doctors for computer equipment that, it was claimed, would allow patients to get their Medicare rebate paid directly into their bank account at the time of their visit. But while more than 60 per cent of doctors use the equipment to access their payment from the system, only 3.8 per cent of payments are being made to patients electronically. They are still being forced to go to Medicare offices to collect their rebate or wait weeks for a cheque in the post.
Health Minister Tony Abbott himself pointed out that "Almost every doctor’s surgery now has EFTPOS facilities — which can swipe everything except the Medicare card". The Productivity Commission report has established that not much is being done for the convenience of patients or welfare recipients. What is not clear is how the storage of biometric data and personal records on the Medicare card would help facilitate the sorts of transactions that are done with ease with the simplest of ATM cards.
Opposition legal affairs spokesperson Nicola Roxon has called on the Government to come clean on the proposal and to explain whether the proposal for the smartcard is related to the review by the Attorney General’s Department of the national ID card. That scheme is encountering some unexpected heavy weather. The Australian Chamber of Commerce and Industry (ACCI) has estimated that the cost of the ID proposal could be as high as $750 per person or $15 billion in total.
ACCI chief Peter Hendy has said he is yet to be convinced that an ID card would reduce the incidence of serious crime or terrorism. "The prospect that once introduced … an identity card would be used for far more extensive purposes than originally intended means that a card should only proceed after a long and considered analysis", Mr Hendy told the media. The "more extensive purposes" include the enhanced ability of the Government to spy on citizens, including political opponents. The national ID card must be resisted and backdoor snooping cards like the Medicare smartcard should be rejected on the basis.