I guess the devil is in the details. Who is allowed to be an identity provider. How much information do you have to give to the Attribute Provider before this system is usable to you? Is there tracking? Who, besides hospitals, will require this? Who will be able to get these ID's? US citizens obviously, but what about green card holders? H1B's? Visitors? What if the woman in the example lives in the UK and her husband happened to be in the US when he was admitted to the hospital? Is there a fallback to this system? Can you host my own identity provider in some fashion?
The Trustmark—some kind of image, logo, badge, or seal that authenticates participation in the Identity Ecosystem. "To maintain trustmark integrity," the report explains, "the trustmark itself must be resistant to tampering and forgery; participants should be able to both visually and electronically validate its authenticity."
Maybe we don't need to worry about this. It will never succeed.
