Protecting us from the terrors of unhealthy lifestyles

If a mosquito lands on someone’s head and you hit the mosquito with a shovel, is the death of the guy under the mosquito considered an unintended consequence?

So now we know that the government of the United States of America is spying on its own citizens, not specifically on any one in particular, but massively and indiscriminately collecting troves of data on all American people. All perfectly legal, complete with secret courts that must approve each wholesale transaction with government data providers, which they do 4 times every day and twice on Sunday (or something like that). It’s not clear if the government pays for volume or value, or if the data providers are just donating this electronic bounty to the government as an expression of their patriotic duty, and perhaps in lieu of taxes which most of these technology giants (e.g. Microsoft, Apple, Google, Yahoo, Verizon, etc.) are successfully, and also legally, evading.

So those who are being spied upon are actually paying the bills for all spying activities, including fees for services to data providers and taxes to support government processing of such unprecedented amounts of data, but in all fairness we must note that our progressive and open government is trying to save us some money by utilizing the latest open-source technologies for its cutting edge Boundless Informant software (yep, it’s in Wikipedia already). The agency engaged in the electronic surveillance of your Facebook likes and dislikes, the National Security Agency (NSA), is a military agency headed by a uniformed soldier, and its job amongst other things is to supply information to “war planners and war fighters.” The war being planned and fought here is presumably the never ending war on terror (with zombies just around the corner), and it seems that the preferred strategy is to replace the possibility of terrorist (or zombie) induced terror, with the benevolent terror of being watched and tracked by your friendly military, for your own good and the good of the nation.

Another branch of our great government is also very much concerned with our well-being and is also waging all sorts of little wars to protect us from the terrors of unhealthy lifestyles, such as being sick or preferring to be left alone, and as is the case with the war on terror, the wars on lifestyles require lots of electronic information. Sadly, the information needed by the Department of Health and Human Services (HHS) to successfully prosecute its wars, and keep us safe, is not readily available in electronic format, and although the current NSA data providers did try to collect health data in the past, and some are still trying today, most medical information is either on paper or scattered all over the place in electronic formats unsuitable for processing in the zettabyte data centers of the military. Fortunately, the gentle and caring government who is watching over all of us came up with a great solution.

The government decided to finance the purchasing of computers for medical records holders who agree to collect health data in a format more conducive to large scale processing. To make sure that medical data is useful, the distinguished President’s Council of Advisors on Science and Technology (PCAST) advised that medical records should be broken down into specific elements with proper metadata attached to each one, to better resemble the electronic data available from Google, Microsoft and other Internet data providers. But even with all these improvements, the collection of medical data is proving extremely difficult.

First, there are hundreds of thousands of medical records holders, which is a huge logistic problem. Imagine the nightmare of collecting data from hundreds of thousands of mom and pop phone companies or search engines or social media outlets, each with a few thousand users, and each with a slightly different data format. This problem seems to be resolving itself though, as medical records holders are consolidating into larger and larger health chains and as a handful of medical software vendors are gaining huge market shares within these chains.

Second, health data was not traditionally generated by the public and having only a few intermediaries empowered to generate electronic data creates a serious bottleneck in collectible content generation. This too is being slowly resolved as people are increasingly encouraged to attach themselves to various tracking devices and as the movement to allow patients to create data in their medical records is gaining momentum. One cannot understate the importance of increasing the velocity of health data to customary Internet levels and beyond. Think about the value of correlating metadata from Verizon phone calls with real time changes in blood pressure, heart rate and perhaps even perspiration, or think about the improvements to the “51 percent confidence in a target’s ‘foreignness’” that could be achieved by simply knowing what targets eat every day. Oh, and let’s not forget that Section 215 of the Patriot Act authorizes the collection of medical records amongst other things.

The third set of problems facing the war on not being safe, are that potential health data providers are accustomed to antiquated oaths and legislation concepts that supposedly prohibit them from becoming government data suppliers, and consumers who have no problem with other electronic data collection, seem a bit skittish when it comes to their medical information. So the government is mounting an all-out effort to liberate medical data from the privacy ball-and-chains imposed by Hippocratic oaths and HIPAA laws.

Every government approved medical data collection software must allow consumers to dislodge their information from health care providers’ data stores and send it to roam free and uninhibited on the Internet, preferably over “secure” email, which has been shown to improve consumers’ physical, mental and financial health and well-being. To spur consumers into action, the government is conducting a beautiful marketing campaign aimed at fostering “trusted exchange” of clinical information. Our government’s trustworthiness should be evident from our Director of National Intelligence, James Clapper, whose “too cute by half” responses to Congress are “the most truthful, or least untruthful,” by his own admission. There surely is no other government in this whole wide world with spy managers so chummy, candid and forthcoming. Like a breath of fresh air.

So when the government tells us that we can opt-in or opt-out or opt halfway in and halfway out of trusted exchange of our medical records, we should trust that it is indeed so. Vaguely being aware that information stored in a computer database, connected to the Internet, can be copied, backed up or extracted in many ways, regardless of frontend opting preferences, should not in any way give you pause or elicit suspicions that your information may be shipped over to the government zettabyte collection.

Besides, as Mr. Clapper eloquently stated, this is really a trifle matter of semantics: “When someone says ‘collection’ to me, that has a specific meaning, which may have a different meaning to him.” The soldier in charge of the NSA, General Keith Alexander, tried to clarify in a Senate Appropriations Committee hearing, that there is a subtle difference between amassing data and actually looking at it. President Clinton, for example, had similar nuanced definitions for smoking pot and having sex.

Speaking of the wisdom of great American leaders, President Obama is reminding us that “We’re going to have to make some choices as a society,” because, “You can’t have 100 percent security and also then have 100 percent privacy and zero inconvenience,” and you definitely can’t have 100 percent health without making some hard choices. One cannot fault our president for forgetting, seeing how busy he is running our Nnation, but we made our choices in 2008 and again in 2012, when we chose a president who said that the previous administration “puts forward a false choice between the liberties we cherish and the security we provide.”

As a society, we don’t want to communicate by ravens instead of email and cell phones, we don’t want to throw our Birkenstocks at computer screens, we don’t want a black market for doctors who are not on the grid, and we are rather tired of having to make false choice after false choice. Perhaps it’s time for our president to make some personal choices as well.

Margalit Gur-Arie is founder, BizMed. She blogs at On Healthcare Technology.

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