The document discusses unique patient identifiers and proposals for a universal healthcare identifier system. It defines a unique patient identifier as a single value permanently assigned to an individual for identification across the entire national healthcare system. Currently, medical record numbers only identify patients within a single provider organization. The document presents several proposals for a universal identifier, including enhancing the social security number, using biometrics, and the ASTM E1714 standard. It also discusses whether participation in a universal identifier system should be voluntary or mandated by the government.