Awhile ago, I received an anonymous E-mail from a reader arguing that the real reason the Bush administration is pushing so hard for a national E-health information highway is that it wants to quickly track down would-be bio and chemical terrorists who hopefully end up in an E.R. somewhere coughing up clots and bleeding out of their eyeballs before they're able to pull off an event of mass suffering and death.

Claiming to be "in the know," the E-mailer also asserted that the federal government wants a national health data highway to do a little more "special" bio-surveillance than monitoring for the first signs of bird flu, including keeping an electronic eye on anyone it deemed suspicious or dangerous. The E-mailer charged that could include anyone with a Middle Eastern-sounding name or demographics--to women who have abortions, and the doctors performing them. Sounds like a pretty broad definition of "terrorist," no?While some could discount that E-mailer as paranoid, extremist, or maybe just a raging member of the ACLU, it does weirdly spotlight a very real fear of many Americans--which is that their personal health information could electronically fall into-or be snatched by--the wrong hands.

In fact, a new IDC survey of nearly 1,100 consumers showed that while a majority of Americans thinks E-health records would ultimately improve the quality of care they get from doctors, almost 90% worry about health-care providers' ability to keep those electronic records private and safe.

Certainly, paper records can be thumbed through by nosy people and even worse, lost. They can also be handed to the wrong people-as was the case recently when a Boston hospital erroneously and repeatedly faxed several female patients' private health records to a bank.

However, while accusations ranging from paranoid to plausible are starting to spring up from here and there about the "real" motives behind the Bush administration's E-health push, the American public's worry about the privacy and security of their health records is valid.

As Americans debate other big privacy and security issues, such as whether the President should be able to secretly order electronic eavesdropping of suspected terrorists--or even whether Google is evolving into a new breed of Big Brother, the U.S. government and health industry need to iron out some very big wrinkles about what exactly "private and secure" means when it comes to digitized medical data.

Otherwise, the nation's difficult transition to E-health records, which is already challenged by "real" technology, cultural, financial, legal, ethical, and yes--privacy issues--will be hampered even further by conspiracy theories that Oliver Stone would envy.