Concerns raised over federal workers' health care database

performance, said reducing annual premium growth by 0.1 percent for three consecutive years would save the FEHBP $1.25 billion over 10 years. The agency, on average, picks up 70 percent of the cost of premiums; workers pay the rest.

But privacy advocates aren't assuaged. They note that the data collected by OPM will include names, birthdates and other personal identifying information. In addition, they say it's unnecessary for OPM to set up its own database, since insurers already store health information.

"One of the big concerns here is the duplication," said Chris Calabrese, legislative counsel to the ACLU. Calabrese would rather see OPM use a "pointer system" to locate the information it needs. "Instead of having all the information in one database, if you want info on Patient 'X' a?¦ go directly to the record source," he said.

OPM officials counter that the privacy concerns are overblown. The senior OPM official said researchers won't be permitted to see personal identifiers. The agency had said earlier that the health data could be subject to the "routine uses" that apply to most federal databases under the Privacy Act of 1974. That means the records could be pulled by law enforcement officials in a criminal investigation or used in a congressional inquiry. Now, the official said, the agency is considering narrowing the list of agencies that would be granted special access to its records. Within OPM, the data will only be made available to analysts with the proper clearances, the official said.

In addition, the OPM official said asking insurance companies to independently analyze their own data would defeat a key purpose of the database - which is to compare health plans. For example, one health plan might charge more than another for prescription drug programs and the data might help OPM decide whether to drop one pharmacy benefits manager in favor of another. About 30 percent of FEHBP's spending goes for prescription drugs.

OPM's plans aren't unprecedented - TRICARE, the military's health care program, has data on its participants, and the federal Centers for Medicare and Medicaid Services keeps information on Medicare beneficiaries. But TRICARE, Medicare and Medicaid are public health programs; OPM's database will be collecting health information from private plans. The California Public Employees' Retirement System maintains a database on the private health plans it manages. OPM's project would be similar.

Kaiser Health News (www.kaiserhealthnews.org) is an editorially independent news service of the Kaiser Family Foundation, a nonpartisan health care policy organization that isn't affiliated with Kaiser Permanente.

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