Google Health Open Platform Is Great — Or Awful

JackPowers writes "The Google Health APIs enable portable, standardized, open architecture, extensible personal health records, which is nice but boring if they're just used to manage the paperwork of the doctor/patient relationship. But once the data is set free, all kinds of Web 1.0, Web 2.0 and Web 3.0 apps are possible. This article looks ahead 10 years at Best Case Scenarios. A follow-up article lists the Worst Case Scenarios."

Comments

Google is not to be trusted

[BadAnalogyGuy]

No private company should be so entrenched in society that it would be impossible to survive without the service they provide. If I can't get a job without a Google Health "badge", then something somewhere has gone horribly wrong.

This is already a big problem with credit companies becoming so pervasive. It's also bad enough that private companies are leading the American military around by the nose. But that pales in comparison to the actual, direct, and personal limits imposed by something like the system the article is talking about.

Re:Google is not to be trusted

[JCSoRocks]

That's the very point the OP was making. The credit companies are already ridiculous. Not, "yay credit companies! it's totally ok that they can ruin your life!"

Re:Google is not to be trusted

[Lumpy]

It is already very wrong. many places pull your credit report for hiring. They throw away everyone below 680.

Honestly this practice should be outlawed and companies that do so need to be fined heavily.

also the fact taht your credit report is probably the MOST INNACURATE information you have on you and companies make decisions based on this horribly inaccurate data.

Re:Google is not to be trusted

[qbzzt]

No private company should be so entrenched in society that it would be impossible to survive without the service they provide.

Define impossible. My father in law doesn't have a credit rating. He lives in a rural area where most deals are done in cash. But he has to work harder and has a lower standard of living because of his choices.

You have a right to compete in the job market. But you don't have a right for a job.

Re:Google is not to be trusted

[Hijacked Public]

Healthcare companies can already ruin your life, literally and figuratively. If one of their people incorrectly transcribes 1 character of your personal info your insurance company will deny the $35,000 invoice they send and it will fall entirely on you to sory out. That same transcription error can result in your new doctor not getting your medical records from your old doctor, who probably doesn't have a complete set anyway because to get them you'd have to put in a request from every single medical provider you've ever visited.

It doesn't have to be this way. I'm usually a big free market believer, but I'm also a vet who has been through the VA healthcare system (unfortunately named VistA). Here is a good piece that mentions the VA's system and how it is being used by an FOSS project to get some of this under control.

I don't particularly like Google, but I like the US healthcare system even less.

Re:Google is not to be trusted

[hamvil]

You have a right to compete in the job market. But you don't have a right for a job. Well this is what sets Europe apart from US.

Re:Google is not to be trusted

[cryptodan]

If a company sees you as a liability risk through your credit then they should do anything to prevent you from working there. I only wished more companies did this. If i ran a company you better believe that a credit check from all 3 credit reporting agencies would be done along with a criminal background check and a piss test for drug/alcohol use.

Re:Google is not to be trusted

[niceone]

Yes, especially as in 10 years time it will probably still be Google Health beta.

Re:Google is not to be trusted

[Julie188]

"But once the data is set free, all kinds of Web 1.0, Web 2.0 and Web 3.0 apps are possible." Newsflash ... it's not a bright idea to load up any of these online cloud databases with your personal medical records ... I mean, why the heck would I want to blab to Google (and hence, eventually the world) that I'm a herpes-infested schizophrenic ... no, you're not ... yes, I am ... no way! ... I told you to stop bothering me while I'm typing ...

Re:Google is not to be trusted

[timeOday]

The UK is working on a massive centralized database of health records called NPfIT. Aside from all the typical delays and cost overruns of deploying a massive new IT system, there is widespread concern about privacy among citizens. It will be very interesting (and easy) for Americans to sit back and watch how it pans out. I have an in-law who was fired from a nice hospital job for unauthorized access of patient records (she was showing a friend hoping to get hired on how they file things), which showed me both that 1) privacy concerns are real, and 2) institutions take the matter seriously, at least in some cases.

Re:Google is not to be trusted

[Stooshie]

... In some areas, having bad credit will prevent you from getting a job. What's the difference ...

You can do something about bad credit. Most health problems are outwith your control (cancer, car accident, genetic problems ...)

Re:Google is not to be trusted

[GeckoX]

Nothing like being guilty until proven innocent is there?

A criminal background check, ok, not a big deal for the most part and can save a company a lot of potential headaches and/or liability.

A credit check though? What good does that do for a company? Actually, wouldn't most companies prefer employees with less than good credit ratings as they would likely be less able to leave the job?

Piss test too you say. And why can't this be left to law enforcement? Pretty serious invasion of privacy, and if there's not a damned good reason for it how can it possibly be justified?

Actually, companies doing these things could be opening themselves up for lawsuits. A lot of places have laws in place to disallow discriminatory hiring practices, which these in most cases would be. There would have to be a darned good reason for discriminating based on credit rating for the job to use that as a reason not to hire someone.

Anyways, there are probably more reasons than just this as to why you _don't_ own your own company. But should you ever make the leap, could you just post a notice on /. so we all know _not_ to bother applying? Mmkay, thanks.

Re:Google is not to be trusted

[Stooshie]

Alcohol use! OK, drinking(or being drunk) at work is not allowed. But they can't stop you drinking in your own time as long as you don't turn up drunk.

Re:Google is not to be trusted

[icebrain]

It depends... if that person is going to be handling a company credit card or something, or otherwise have some autonomy with company funds, I can see a credit check being reasonable.

Re:Google is not to be trusted

[cryptodan]

The reason I would do a credit check to decrease the liability that a person would potentially sell trade secrets or other proprietary information for money to settle credit card and other outstanding debts.

The reason for a piss test would be to weed out the people who would potentially come into work under the influence of drugs or alcohol which could cost a company a lot of money if an employee got hurt on the job and then would cost the company more money in possible litigation and workmans comp claims.

All this would be easily mitigated with a piss test, credit check, and criminal history since they can all be easily tied together with a rope.

Re:Google is not to be trusted

[value_added]

No private company should be so entrenched in society that it would be impossible to survive without the service they provide.

An insightful comment if ever I read one, but I'm afraid you're a few generations late. As a society we gave up believing in government, institutions of power or authority, religeon, civic responsibility and most all notions of tradition, and adopted instead a belief in individuality and self-fullfilment. That doesn't leave us with much, does it?

If the current trend continues and free market idealogues get to rule the day, we should expect to have everything from infrastructure to institutions ruled and run entirely by corporations (to the extent they don't already), and we'll all be working for Taco Bell or for The Brawndo Corporation.

The situation can also be viewed political terms. A good portion of the electorate really does believe that government is evil, that government can't possibly do anything as efficiently or as cheaply as business, and that taxes infringe on their God given rights, but they're only too happy to let the Walmarts of the world take over provided they can maintain the illusion they've kept a few extra dollars in their own pockets.

The people who complain about undue corporate influence on government probably don't notice that they've succumbed to those same influences in their own lives, but they might notice when there's nothing left to sell off, somebody else holds all the cards and those free-market choices they've been promised come up short.

Google, I think, is doing what any business does, and that's fulfulling an unmet need and making or trying to make a profit in doing so. The question is why we're not doing it ourselves?

Re:Google is not to be trusted

[Dog-Cow]

(unfortunately named VistA) I can see why the state of the VA health system would worry you so much. Anyone who considers it "unfortunate" that a health system happens to share the name of a bad MS OS is in need of deep psychological help. Really, you shouldn't be allowed near a computer for your own good.

Re:Google is not to be trusted

[cryptodan]

Exactly, and thats what I would like to prevent.

Re:Google is not to be trusted

[Nursie]

Why piss test?

What fucking business is it of yours if I drink at the weekend?

Re:Google is not to be trusted

[edrobinson]

This has nothing to do with transcription errors. They will happen no matter what as long as people are involved.

I believe that massive healthcare databases could solve myriad problems particularly that of providing all doctors access to your complete medical record.

This whole privacy thing is a sham and things like HIPAA are solutions looking for problems.

Re:Google is not to be trusted

[cryptodan]

I dont care if you drink on the weekends, as I would probably do it as well. The piss tests would be completely random and company wide.

Re:Google is not to be trusted

[db32]

You have some false logic in your security description. When you talk about how it would be easier to steal data from the office server rather than from Google you are grossly misunderstanding the threat. What are the odds that someone is going to even target that private practice? How much do you think they would even get if they do get in? I would even go so far as to say that the average individual worthy of specific targeting typically gets healthcare from slightly larger and more advanced organizations. Now on the other hand, you have one of these online providers that will host more individual records by many orders of magnitude. So the payoff for a success is already considerably higher. Couple that with being targeted by a number of threats many orders of magnitude greater than that small provider.

Now on top of that...I think these services are monumentally stupid because of some of the very reasons you mention. That many people with all their medical data all in one place. That is a datamining heaven. Corporations will want that "Sorry, you have too much of a medical history, we don't want to hire you because you will cost us too much". Insurance companies will want that "Oh, you have a family history of 4 major expense problems...your premium will be tripled for this and will be subject to early termination." Of course there is the tremendous amount of political value "Prolifer Sally is on her 3rd abortion." Then the really really really fun one everyones favorite reoccuring government program! Eugenics! What better way to track down all of the undesirables that you would like to exterminate. To hell with getting IBM to help you with a census like the Nazi's, we have DNA testing these days!

All of this with no real protection to stop any of these companies from selling out to the highest bidder. Or has it has been lately with the Bush Administration and the telcos search engines...just rolling over for whatever nonsense the government asks for in its quest for the "War on (Drugs|Terror|Poverty|Other)".

Re:Google is not to be trusted

[Stooshie]

People already know if someone's drunk. If you can't tell (ie can't smell any drink and behaviour unchanged) then it is probably so little as to leave work unaffected.

Re:Google is not to be trusted

[UncleTogie]

It depends... if that person is going to be handling a company credit card or something, or otherwise have some autonomy with company funds, I can see a credit check being reasonable.

Your credit has NO bearing on your moral structure. My score's shot due to a divorce, but while the opportunities to steal may've presented themselves, one fact remains: It's not MY money. I have the keys and alarm codes to many of our clients. Never was a problem, even during a homeless stint. Criminal background checks would be more appropriate here, IMHO, rather than trying to glean one's moral fortitude from their spending histories...

Re:Google is not to be trusted

[Anonymous Coward]

You got a divorce, therefore your ability of choosing is already taken into consideration...

Re:Google is not to be trusted

[Crazyswedishguy]

Most big investment banks on Wall Street make you take a drug test (urine) before you start working there.

Is a drug test something bad? I personally don't think so. For every employee your hire, it costs money before you hire him/her (marketing, interview time), after you hire him (training) and also when you fire him. Someone who is doing drugs is probably more likely to become addicted and ruin his life through drugs. Therefore, you should be more careful when hiring that person, as the money spent on training him might be wasted in 6 months.

But to be honest, many of the people I know in banking do cocaine on a regular basis. It doesn't stay in your system as long and makes you less likely to get caught, but it's also probably a more harmful drug than marijuana (there's more addiction among other things).

Fyi, I'm not a banker, and I've never done coke.

Re:Google is not to be trusted

[UncleTogie]

You got a divorce, therefore your ability of choosing is already taken into consideration...

*She* got the divorce. *I* got the bill. Falling for/trusting a liar doesn't mean I'm untrustworthy.

Re:Google is not to be trusted

[Brad Eleven]

credit companies... can ruin your life

And with very little responsibility in the matter. They continue to succeed in placing the onus of accuracy on the consumer's back. Note that you are not the credit company's customer; you are the consumer. The identity of a given credit firm's customer is left as an exercise to the reader.

And then there's the matter of how they treat the sensitive information that they demand up front and without compromise.

Re:Google is not to be trusted

[Anonymous Coward]

I think that the key distinction to make here isn't free market vs. government, or public vs. private, it's a competitive environment vs. monopoly power. I think government has its place, so do any of the institutions we've created, but the distiction between the problems of a 'private' monopoly and government is weak. At least government is ostensibly answerable to the people.

Re:Google is not to be trusted

[Mr. Slippery]

The reason for a piss test would be to weed out the people who would potentially come into work under the influence of drugs or alcohol

Except that a piss tell tells you no such thing. A positive result tells that either 1) it's a false positive (very likely) or 2) that someone used cannabis sometime in the past month or other drugs within the past few days. It tells you nothing about present impairment.

People subject to drug testing who want to use drugs often use LSD, which is just about impossible to detect via urine testing; so you're encouraging people to drop and spend a whole day tripping, rather than relaxing with a bong hit Saturday night. Brilliant.

If the only way you can tell if I'm using drugs is to test my urine, then my (hypothetical) drug use is not affecting my work and is none of your business. If you want to prevent people from coming to work impaired, then institute an impairment testing policy.

Employers who perform chemical drug screens demonstrate their own ignorance and incompetence; I will not even consider working for them.

Re:Google is not to be trusted

[eh2o]

There are many serious problems with drug testing.

1- A proper drug test requires access to the medical records of the patient--otherwise there is no way to discriminate between controlled substances used legally (by prescription) vs illegally.

2- Urine testing reveals a large amount of additional medical information about the patient's condition beyond just drug use. It's more like looking at a bank statement than a credit report--you see it all. That information is private. And, only a handful of states regulate drug testing, putting that information at risk of exploitation.

3- Drug testing has a non-trivial false positive rate, which may be as high as 5%. As the prevalence of the condition decreases, so also must the false positive rate otherwise the test is not economical. When the false positive rate exceeds the prevalence times the correct positive rate, the test will identify more non-drug users than it will drug users.

4- Severity; drug testing does not easily distinguish between occasional and habitual use.

Finally, there are more effective methods for determining individual fitness for performance of a task, which focus on the ability to do the actual task. For example NASA uses computer-based hand-eye coordination tests (e.g. video games) for testing pilots' fitness to perform. This test is better than a drug test because it catches more ordinary conditions like fatigue and distraction, and it can be administered quickly and easily when needed, e.g. every time they are about to fly a mission.

Testing can, and should be used, for people in performance-critical positions--however, *drug* testing is both unreliable and insufficient, in addition to being a serious invasion of medical privacy.

Re:Google is not to be trusted

[Anonymous Coward]

hmmm, I'm curious what you mean by 'ourselves'... as in we should all be wharehousing our personal data personally? Sound's like a good idea, but... How do I convince the McD Corp to send the data, every time I use my 'frequent buyer' card, from their NCR cash registers to my personal server? What economic incentive do they have to look after my good health? (obviously a rhetorical question)

Re:Google is not to be trusted

[Anonymous Coward]

All I can say here is I hope to ${deity} you never end up actually running a business. Your employee turnover will be so high because of your proposed policy that you'll never make any money.

Re:Google is not to be trusted

[vertinox]

An insightful comment if ever I read one, but I'm afraid you're a few generations late. As a society we gave up believing in government, institutions of power or authority, religeon, civic responsibility and most all notions of tradition, and adopted instead a belief in individuality and self-fullfilment.

Umm... You do realize that private businesses have never caused a war (on their own at least) that resulted in deaths of thousands and in worst case millions of persons.

Relying on government or religious organizations 100% results in situations where a handful of people having the power to do very evil things without anyone else being able to do anything about it. You know... Crusades, inquisitions, gulags, concentration camps and every other bad thing either religious or governmental organization has pushed on their fellow man throughout history.

This has made people very cynical for good reason. You should never trust any power of authority because it is thought that 1 out of every 100 persons could be a sociopath (meaning they feel no altruism) and that means that your chances of getting someone who has an agenda that is not good for the rest of population is high.

That said, corporations wielding the same power as governments doesn't appeal to me either. However, its currently the government that makes them so powerful. If they so choose they could break up Microsoft, the cell phone monopolies, oil companies, and almost infinite list of mega corporations that have GDP larger than Poland.

The corporations use congress and the presidency to pass legislation that benefits them and only them at the expense of rest of mankind. Simply giving the current government more power to do what it wants will only result in more powerful corporations.

Of course that would require more changes than society is willing to handle (reformed congress into a parliament system with porporational representation and lobbying reform) so arguing about it is a moot point.

Re:Google is not to be trusted

[Lumpy]

Why stop there?

Healthcare costs are high, you gotta do something about that to protect your year end bonus...

Smoker? sorry we dont hire smokers.
Drink beer? We dont hire drinkers.
Had a speeding ticket? you are a liability.

As an employer I have the right to discriminate any way I want to within the law, and thankfully today I can even do iligal discrimination legally by using different excuses.

BTW: most MINORITIES have low credit scores, it's a great way to keep from hiring those pesky minorities. (and typically is used as such at companies that used credit scores for hiring.)

Re:Google is not to be trusted

[TheLink]

"You do realize that private businesses have never caused a war (on their own at least) that resulted in deaths of thousands and in worst case millions of persons."

Yeah, they just get governments to start wars for them. Look up United Fruit Company.

Governments that stay in power maintain a monopoly on violence.

If there weren't pesky (or powerful enough) governments around, what do you really think companies like that would do? Look up the East India Company.

Many large companies would be really happy if there were no powers higher than them that could say "Hey our citizens don't like that Anglo Persian Oil Company is taking more than 80% of net profits from our country's oil".

Once there's more than a few hundred people you cannot escape from a government. Whether it's a democratically elected one, or or one where a Company is the Government, or a Dictatorship you'll end up with a government one way or another.

Re:Google is not to be trusted

[ReedYoung]

If a company sees you as a liability risk through your credit then they should do anything to prevent you from working there. Wow! "anything"? Merely because "a company sees you as a liability risk through your credit"?? And if an employee sees a company "as a liability risk"?

I only wished more companies did this. If i ran a company you better believe that a credit check from all 3 credit reporting agencies would be done along with a criminal background check and a piss test for drug/alcohol use. It seems like you're considering only the perspectives of the employee and the employer, meaning the boss, president or owner of the company. But you have not commented on the employees in HR who will have all that personal information available to them about their peers, some of whom they will undoubtedly dislike. Various abuses of access to personal data can be prosecuted as slander, libel, wire fraud and identity theft, to name a few. If employers could be held liable as accomplices to such crimes, when committed by their employees who they have granted access to other employees' private information, would you pursue that information so aggressively?

Re:Google is not to be trusted

[cryptodan]

My HR Department will undergo even more strenuous background checks and will be held extremely accountable. If any data is leaked or used in criminal behavior, then they would be fired instantly on the stop and escorted out of the building by security and charges would be filed depending on the stuff that happened. Id also make sure that they wouldn't be marketable to other companies.

Re:Google is not to be trusted

[ReedYoung]

OK, when you own a company I guess you can run it that way, for as long as it's profitable. I hope you find that the strategy you plan is more expensive than employing competent people and staying out of their personal lives.

Awful?

[sm62704]

Considering that the site's about peoples' insides, shouldn't that be "offal"?

web 3.0?

[Anonymous Coward]

what's that?

btw..first

Re:web 3.0?

[sm62704]

The same as web 2.0, which is the same as web 1.0 was. It's yuppie buzztalk for the clueless by people who miss the dotcom bubble.

Web 1.0 was "It's a series of tubes."

Web 2.0 is "It's a cloud."

Web 3.0 will be "It's pixie dust and fairie magic".

Re:web 3.0?

[TooMuchToDo]

Heh, whatever sells them servers and routers I guess.

Looking ahead 10 years

[Anonymous Coward]

You don't think we'll be on Web 17.0?

Great, Web *3.0*

[LighterShadeOfBlack]

Just what we need, more bullshit for buzzword fetishists.

Re:Great, Web *3.0*

[grassy_knoll]

Seriously.

What, everyone gets bingo too fast on their Web 2.0 bingo cards so the next version of bingo cards needs new entries and thus is Web 3.0?

Re:Great, Web *3.0*

[Otter]

I'm just relieved to hear that Web 4.0 is more than 10 years away...

Re:Great, Web *3.0*

[JCSoRocks]

If I hear some MBA start saying this I'll either stab myself in the eye with a pen or just one-up him and tell him that Web 3.0 is garbage and we should really be working toward the Web 5.0 initiative. Either way, should be a good time.

Re:Great, Web *3.0*

[Ed Avis]

I think it jumped the shark with 2.0.

Re:Great, Web *3.0*

[JackPowers]

I was being arch.

Re:Great, Web *3.0*

[dhj]

Web 3.0? F that. iWeb 2009 Enterprise Edition is just around the corner. It will make Web 2.0 and Web 3.0 look like buzzwords from the 1990s. The the major feature enhancements of iWeb 2009 Enterprise Edition are:

A synergistic development model.
Grassroots support.
Enterprise level uptime and support (obviously).

This technology promises to create a paradigm shift in the way we think about web services.

Re:Great, Web *3.0*

[ShogunTux]

Meh, I'm holding out for Web 3.11 for Workgroups. I hear it's going to rock.

Re:Great, Web *3.0*

[lamona]

Plus, I hear it'll come with a card game installed so that you can practice using the mouse. I bet it'll take thousands of hours to get those mouse movements right!

Re:Great, Web *3.0*

[MobileC]

The the major feature enhancements of iWeb 2009 Enterprise Edition are:

A synergistic development model.
Grassroots support.
Enterprise level uptime and support (obviously).

This technology promises to create a paradigm shift in the way we think about web services. And the worst bit is that I understood that and it made sense :(

agreed with the worst case.

[DragonTHC]

This is one of the most (potentially abused) systems I can forsee. I really don't think losing our privacy where medical records are concerned is going to help society. this just stinks. google should be ashamed.

Re:agreed with the worst case.

[ColdWetDog]

This is one of the most (potentially abused) systems I can forsee. I really don't think losing our privacy where medical records are concerned is going to help society. this just stinks. google should be ashamed.

Unless this is mandated by somebody or other, you're free to post or not post whatever you want on Google health.

That's fine, but it does severely limit the usefulness of the product. As a physician, I'm not going to be inclined to spend much time looking at a highly edited version of somebody's medical history. There is a reason we ask for records from doctors or hospitals. It's far too easy to simply edit out the uncomfortable bits of your life. That of course, is perfectly within your rights, but my job is too look at the whole history, not bits and pieces.

I don't see this as taking off much in the professional sector - it may be popular in the direct-to-consumer advertising space (which is why I cynically suspect it exists), but it's too limited to be much use professionally. Not useless, but very limited.

The truly scary part is that the "10 worst" scenarios are much more likely to come true that the "10 best".

Re:agreed with the worst case.

[Anonymous Coward]

Unless this is mandated by somebody or other, you're free to post or not post whatever you want on Google health.

I don't see why on earth would anybody put wllingly personal health data into a limited responsibility corporation's database.

I don't even get it!

I suspect Google has other goals in its mind, maybe for example selling global health management systems to governments...?

Re:agreed with the worst case.

[Hijacked Public]

If you are indeed a physician, where are you? I ask because here in the US there is absolutely no wau any physician I've ever met would take the time to read my entire medical history, because there is no way an insurance company would pay them to do it.

I've seen large parts of mine and most of seems worthless to me. Lots of redundancy, lots of unreadable scratching. Medications and treatments that didn't work but contain no follow up that would communicate that.

And I'm not very old and I've been in relatively good health my entire life.

Re:agreed with the worst case.

[cryptodan]

Its all optional, you are not forced to enter your health care information.

Re:agreed with the worst case.

[ColdWetDog]

If you are indeed a physician, where are you? I ask because here in the US there is absolutely no wau any physician I've ever met would take the time to read my entire medical history, because there is no way an insurance company would pay them to do it.

I'm in Alaska, come up and visit. Bring your harpoon....

"Taking the time to read your entire medical history" may or may not be particularly relevant. If you are young and healthy without significant ongoing issues, it may be perfectly unnecessary. I likely don't care about the details of your tonsilectomy at age 6 (I might, however, if you had a significant anesthetic reaction).

But you bring up a good point that's generally obfuscated in these debates: You may not want every detail of a person's medical history at any given time. Sometimes you do. Having to wade through tons of extraneous detail makes it easy to miss important tidbits. Getting a 200 page printout from a 6 day hospitalization with everything including the janitor's notes doesn't help me much. Putting that in machine readable format helps me maybe a bit. What we don't have is an underlying, consistent framework for electronic medical records that's used by everyone and has the capability to organize a huge amount of information into a generally usable format.

There are baby steps out there, but it's a huge chicken and egg problem for the field. I personally see the digitalization of medical records happening *very* slowly - over the next 20 years or so. And that's a feature, not a bug folks. There are absolutely huge societal issues to be dealt with before we give some uber-governmental department the holy grail of databases. I'd rather have the current fragmented system then allow every government and corporate entity start data mining for whatever purpose of the week they feel important (or profitable).

Re:agreed with the worst case.

[charlesj68]

I'm in Alaska, come up and visit. Bring your harpoon.... I tried. TSA was not amused.

Re:agreed with the worst case.

[Hijacked Public]

Alaska is great. I usually make a trip or 2 there every year to hunt.

I can see how the fragmentation helps protect the data, but I'm not sure whether the benefits outweigh the risks. I'd like it if an ambulance crew could pull my records up in some protable terminal and see "Allergic to Sulfa" in a prominent position.

As it is, if I forget or can't communicate that or whatever else, it would probably never be known because the last time I was given sulfa I was about 6 years old and I lived in Angola (Africa). I imagine the records from that hospital visit are long gone, I know the hospital is.

Certainly I wouldn't want my records to be available to the public in trade for that, but we are communicating most of this stuff via fax machines as it is. A motivated party could probably get hold of it anyway. Only recently has the US put any teeth into laws to keep it private, especially for anyone who might be peripherally involved, like most employers outside the healthcare industry.

But if you take the time to go over medical records, even just to sift the important from the trivial, I applaud you. My experience indicates that that doesn't happen often.

Re:agreed with the worst case.

[sm62704]

As a physician, I'm not going to be inclined to spend much time looking at a highly edited version of somebody's medical history

And considering HIPPA, you would be in deep doo doo if you posted anyone's info (you know that, of course, but others here may not)

What I would like for MY doctor to do would be to give me a CD of my medical records when I visit him. I'm 56, most of my medical records simply no longer exist. Like everyone else, doctors retire and records get lost.

But I don't want it on Google. I want it in my hand so if my doctor retires, dies, or his office is destroyed by a fire or flood or tornado I can still have the records to present to a new guy.

Re:agreed with the worst case.

[Anonymous Coward]

ColdWetDog is totally on the money. Both Google and Microsoft's offerings suffer from the same failures that most of the other PHRs suffer from- they rely on the honesty of the patient. I'm in managed care and we've already taken a stand against them. We do offer a PHR, but it's strictly as a reminder type service for the patients- we don't use it for anything even remotely related to care based guidance, and I can't think of a single physician that has ever requested to even see, much less use the data.

The facts are simple- people mislead, forget, and outright lie. The various and scattered medical records we use now aren't perfect by any stretch, but they're far better than anything we'll ever see from most patients.

On a related note, don't think that EMRs will bring about the pax medica either- they suffer from all of the same centralization risks as PHRs, all the same error risks (unintentional or otherwise), and all the same fraud risks as well. It's just less likely when you take the patient's direct action/responsibility from the picture.

Re:agreed with the worst case.

[ColdWetDog]

I'd like it if an ambulance crew could pull my records up in some protable terminal and see "Allergic to Sulfa" in a prominent position.

No ambulance in the world is going to give you an antibiotic. They're going to wait until they get to the ER and let the doc decide. Even if I, for some reason, decide that I'm giving you a drug you subsequently decide to have an anaphylactic reaction to it, well, that's why I have steroids and endotracheal tubes. If you're that sick we ask you the AMPLE history (Allergies, Medications, Past (Medical History), Last Meal, Event. If we can't get it out of you, well, then your likely sick enough to be run through some rather standardized stabilization protocols until we figure out just what you manage to do to yourself. Usually, it's readily apparent. If it's really complicated, it's likely that you are stable enough for the docs and staff to work through the problem bit by bit.

Yes, rapid access to medical information can be important and very occasionally life saving (but likely not). But Google Health isn't going to work for this. If you are unfortunate to have a serious medical condition, a small laminated paper with your doctor's name, brief past history, medication and allergies and maybe an old EKG shrunk down would do wonders. Stick in in your wallet. We always check that looking for cash, checks and your insurance card....

Re:agreed with the worst case.

[DragonWriter]

I personally see the digitalization of medical records happening *very* slowly - over the next 20 years or so. And that's a feature, not a bug folks. There are absolutely huge societal issues to be dealt with before we give some uber-governmental department the holy grail of databases.

Having a standard format and infrastructure for requesting and exchanging digital records doesn't mean having a single entity (government or otherwise) with access to all the data.

Re:agreed with the worst case.

[Anonymous Coward]

"What I would like for MY doctor to do would be to give me a CD of my medical records when I visit him. I'm 56, most of my medical records simply no longer exist. Like everyone else, doctors retire and records get lost."

"But I don't want it on Google. I want it in my hand so if my doctor retires, dies, or his office is destroyed by a fire or flood or tornado I can still have the records to present to a new guy."

You seem to believe that your data will be safer on your CD than it would be with Google. Unless you handle critical data for a living, I doubt it. What about when *your house* gets destroyed by a fire or flood or tornado, or if your CD gets scratched and you are like most folks and didn't make enough backups, or it simply gets misplaced among 1000 other "important things" at your house? What about if you have an auto accident or other emergency, and you don't have your CD with you? Even if you are in the miniscule fraction of the population that knows how to backup and secure data to professional standards, almost everyone else would be better off letting Google (or some other group of professionals) store it.

Plus (speaking as a physician now), just having your own CD doesn't address the issue of data organization. Right now, there is no consensus whatever about file formats for medical records. The electronic medical record products I've seen all seem to store everything in their own SQL database, without any consistent way to move data from one practice setting to another. Usually, "outside records" either get kept in paper form, or get scanned from paper into the database as images of the paper records, not as live, structured data. Right now, we usually encounter CDs when we need to look at CT scans or other images. The problem is that all of the images come with their own proprietary viewer on the disc, they all have different user interfaces, and they only run on Windows. It would be vastly better to have all of these studies in a single, web-accessible repository. I don't think the "CD in hand" comes anywhere close to making sure one's medical data are available to one's care providers.

I think there is a very strong need for a universally accessible electronic medical record. Whether Google is the right organization to do it is a separate question. It would seem more appropriate for a government agency to do this.

Re:agreed with the worst case.

[Kahan]

Regardless of the agents (public or private) behind it, a better health care IT infrastructure is rather desperately needed - at least in Canada. If my partner's experience as an ER nurse is any indication, there is a fair amount of duplication and waste, and a not-insignificant contribution to the ER mortality rate, caused by the lack of a central electronic repository of patient data. Maybe this will help: http://www.infoway-inforoute.ca/en/home/home.aspx We'll see.

Re:agreed with the worst case.

[sm62704]

You seem to believe that your data will be safer on your CD than it would be with Google

Using the internet for offsite backup is stupid. The data would be safer from loss, but would NOT be secure. They passed the laws making medical records secret for good reason. I do not trust Google or any other corporation with my medical records. I only trust the doctors and hospitals and insurance companies with them because I have to; I have no choice.

If I have the CD in my hand I can put it in a bank vault. Not much chance of fire or tornado destroying it there.

you are like most folks and didn't make enough backups

I'm a nerd. Nerds aren't like most folks.

What about if you have an auto accident or other emergency, and you don't have your CD with you?

The CD's only needed if I get a new doctor. He gets a copy.

Right now, there is no consensus whatever about file formats for medical records

That's YOUR problem. I'm paying you, and paying you some damn big money, to treat my illnesses and injuries and to keep, maintain, and most of all be able to read those records. If there's no consensus as to how those data are organized, then that's a failing of your profession.

I suggest plain text for anything not an image, and TIF for images.

The problem is that all of the images come with their own proprietary viewer on the disc, they all have different user interfaces, and they only run on Windows.

You just made me lose a lot of faith in your profession, doc.

It would seem more appropriate for a government agency to do this.

Until we get government funded universal health care the government has no business looking at my PRIVATE health records.

Meaningless buzzwords run amok

[DragonWriter]

Web 1.0, Web 2.0 and Web 3.0 apps are possible

Web 3.0? That's just silly.

Re:Meaningless buzzwords run amok

[sm62704]

So was web 2.0.

Re:Meaningless buzzwords run amok

[Anonymous Coward]

Silly, but still possible.

Web 4.0 apps are even possible, too! I think the only thing holding us back is that 3.0 comes first.

Who knows?

[aceofspades1217]

This sure does open up a world of possibilities...for better or for worse.

You gotta hand it to google though they never stop trying!

I <3 Gmail and google email hosting for domains.

Oh Hell

[Target Practice]

Web 3.0? What is that supposed to be? A LAMP application hooked up to a cage of weasels?

Re:Oh Hell

[TheRealFixer]

Correct. Except, the cage is also on rails.

Re:Oh Hell

[Qzukk]

A LAMP application hooked up to a cage of weasels?

Given the subject of the story, maybe we can call it GASLAMP? (GAS=Google AJAX Something...)

Re:Oh Hell

[hamvil]

Web 3.0? What is that supposed to be? A LAMP application hooked up to a cage of weasels? I do not know what Web 3.0 will be, but Web 4.0 will be read on clay tablets.

Re:Oh Hell

[Yvanhoe]

It's supposed to be Semantic Web. One buzzword to fund all our AI research, and in the darkness, bind them.

Re:Oh Hell

[Bogtha]

Don't forget that it has to use the Wisdom of Clowns.

Re:Oh Hell

[Anonymous Coward]

Ice weasels?

The ideas are cool

[Oxy the moron]

But that doesn't mean they're good. Diet monitoring? Try this, or any other free web service that does it *without* needing your medical history. Fitness Monitoring? Doesn't Wii Fit do this? How about a simple spreadsheet? Travel? Is it that hard to look at The Weather Channel before you leave?

Honestly, this just sounds like candy-coating a terrible idea so that people will buy into it. None of the ideas on that page are lacking a non-Google implementation assuming you're not too lazy to do some footwork.

Then again, if you are too lazy, maybe whatever ill effects you receive from using Google's service are deserved...

Re:The ideas are cool

[Anonymous Coward]

I understand your point about using simple techniques to achieve the same monitoring results. I find though that a well designed, data-packed tool like Polar
provide a great way to track personal improvement over time. If google can consume output from devices like this, I would consider using google services. I've used this device for 4 years and built up a significant dataset on my fitness performance. Reviewing this with a professional may provide ways to improve my workouts.

This will help

[Anonymous Coward]

Facebook Fred adds an application that displays his STD test status as a badge on his social media profile pages. At some colleges, the fad is banned because some badges are counterfeit. Third-party testing firms spring up to deliver authenticated results, often to mobile phones. Thus a new division of Verisign is spawned: Virusign.

Great - or awful?

[Rob T Firefly]

Well then, I'm happy - or sad for them.

Re:Great - or awful?

[Oxy the moron]

Ideally they would have been for good or for awesome.

Re:Great - or awful?

[skeeto]

With apologies to Colbert,

Google Health Open Platform: great platform, or greatest platform?

worst case scenario?

[Red Flayer]

From the worst case scenarios:

PUBLIC HEALTH

Anonymized Google Health data is mined by Pleasantville public health officials to chart wellness patterns and develop health policy. Government commissions use the stats as the basis for regulating smoking, trans-fats, sugar and alcohol. Households with strong wellness metrics are eligible for tax rebates.

Sounds like a good idea to me. People with unhealthy lifestyles cost communities and bigger units (states, federal govt) a lot of money in emergency services, medicare costs, etc. I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles. Plus, there is then an obvious economic incentive to become healthier.

Seems like a win-win to me.

Re:worst case scenario?

[AndersOSU]

You missed the part where they dispatch the T-888 to the guy who ate the hamburger.

Re:worst case scenario?

[Anonymous Coward]

The thing about health is -- it's not always your damn fault if you fall ill. You'll understand when you get cancer, even if you had had a "healthy lifestyle" beforehand. You just can't control everything that has an impact on your health.

Re:worst case scenario?

[Anonymous Coward]

A tax incentive for a not engaging in a behavior could be viewed as a tax on a behavior. Of course tobacco and alcohol are already heavily taxed and much of that money goes to the general fund so the unhealthy lifestyles are actually subsidizing the healthy lifestyles now.

Re:worst case scenario?

[NewbieProgrammerMan]

I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles. Plus, there is then an obvious economic incentive to become healthier. Maybe I'm just naive, but it seems to me that the *only* way to prevent healthy people from having to subsidize unhealthy people is to (1) allow health care providers to refuse to treat unhealthy people, AND (2) make everybody pay for their own health care. Anything less than that will involve some hidden subsidization via taxes, etc. (Please note I'm not saying I think it should work that way, just that subsidization is always going to be part of health care).

Also, sometimes bad health has nothing to do with having an unhealthy lifestyle. It seems to me that "giving an obvious economic incentive to become healthier" will also have the unintended consequence of economically punishing people who got an unlucky roll of the genetic dice.

Re:worst case scenario?

[xaxa]

And from the best case scenarios:

SCHOOL RECORDS
The Turner Twins' immunization records are forwarded to their school each September. Throughout the year, their schoolmates' anonymized records are linked to the school to keep track of ear infections, strep throat, lice and sports injuries. Schools publish aggregate wellness data to attract new students, and education watchdogs lobby for funding based on overall student health indices. School funding based on how often the children get ill? No, thanks.

INSURANCE
Trader Ted shops for insurance by selectively releasing his Google Health record on-line. He pays for regular care through a Health Savings Account, but health insurance companies bid for his catastrophic coverage based on his authenticated medical history, diet and exercise records. No mention of what happens to someone with a disease though.

Re:worst case scenario?

[Hijacked Public]

I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles You should drop your health insurance then. Or at least get into an HDHP.

Or go to work for a drug company, or a healthcare provider. They see an economic incentive in keeping people in poor health.

Re:worst case scenario?

[grassy_knoll]

What's next? Only approved food may be sold? Perhaps any non-vegan food is subject to confiscation and the owners subject to arrest?

Maybe we can ban alcohol nationally, since that worked so well last time.

Oh, I know. Mandatory exercise. Not running fast enough? Well, attack dogs are cheaper that what you're costing medicare, so enough with your rights.

The idea the economics of health care must trump individual rights leads to complete regulation and control of everyone's lives as a "cost saving measure". It's totalitarianism.

But I suspect you know that, since your sig line seems to indicate you're trolling.. if so, well done.

Re:worst case scenario?

[non]

i'm afraid its not that simple. your comment seems to have overlooked some of the other factors that contribute to health, such as; lead, asbestos, and other types of industrial pollution.

this system that you consider a 'win-win' is actually a more tightly controlled authoritarian system than the one in which you currently live. the only practical advantage here would be for the HMOs and insurance companies. they would be better able to price coverage.

i don't think it would require a great deal of imagination to imagine how that could evolve into outright eugenics. based on the purest of libertarian and capitalist principles, but nevertheless eugenics.

Re:worst case scenario?

[sm62704]

People with unhealthy lifestyles cost communities and bigger units (states, federal govt) a lot of money in emergency services, medicare costs, etc.

Yeah? Give me (actually, give my friends who have no health care) taxpayer-supported medical care like the civilized world has and we'll talk. Now, when you said "emergency services" I thought smokers, and wondered about how various fires start. Google helped little. But one page (listed at the bottom of Google's first search page) suggests that we put a high tax on candles, children, geezers, and furnaces, the last of which outstrips smoking during winter months as the leading cause of fires.

I fail to see how trans-fats and sugar have anything to do with emergency services in the US. You're going to go to the hospital in an ambulance and die (unless you don't make it to the ambulance). Fat smokers just do it faster than fit nonsmokers.

I know that personal experience is discounted here at slashdot, but my teetotalling nonsmoking grandmother and her son (my uncle) illustrate the illogical nonrationality of saying smokers (and fat people) cost taxpayers money.

Grandma was born in 1903, a few months before the Wright Brothers flew their winged, powered bicycle. She neither smoked nor drank. From age 65 to age 99 she collected Social Security and went to the doctor at least monthly, paid for by Medicare.

Uncle Bill, her son, had lost a lung to tuberculosis, worked in a garbage incinerator in St Louis, drank heavily, and smoked four packs of Kools every day through his one lung. He died at age 64 without ever seeing a doctor on the Medicare dime, or collecting a penny in Social Security.

Uncle Bill didn't cost the taxpayer anything. Grandma did.

Everybody gets sick and dies. Smokers just do it earlier, and by doing so SAVE the taxpayer lots of money.

Logically, smokers should get a discount on their taxes.

Re:worst case scenario?

[InvisblePinkUnicorn]

"Seems like a win-win to me."

As long as you are on the enforcement end, and not on the end being forced to give up all of your rights as a rational being, everything will always look win-win.

Re:worst case scenario?

[strech]

Sounds like a good idea to me. People with unhealthy lifestyles cost communities and bigger units (states, federal govt) a lot of money in emergency services, medicare costs, etc. I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles.

This seems facially reasonable, but is related to why I will never support government funded healthcare :

It allows the government (and by extension, a majority vote) to dictate what you do with your life by making it incredibly hard to live otherwise. For example, the British Conservative party wants to bar people with "Unhealthy Lifestyles" from getting NHS care. You know, the care they pay for. Furthermore, this never has any sane relation to the cost of the activity - In the UK, smoking costs 1.7 billion and raises 8 billion in excise taxes, another $2 billion in VAT. I find it unlikely that the same isn't true in the US. Plus, obesity is at least partly biological - apparently you want to punish people for things they have no control over.

Health has a great deal to do with dumb luck and actions we have no control over, even for "lifestyle diseases" that are more common with obesity, alcohol, or smoking. And getting one bad card in health can prevent you from living a healthy lifestyle. There's the surveillance implications - government is watching what you eat, how you live. There are some things that simply aren't the government's business, even if they might theoretically make emergency services more expensive. Front end taxes (on cigarettes, alcohol) are fine, if probably too high since they're an easy political sell; lifestyle monitoring is not. The government is here to serve us, not the other way around.

Re:worst case scenario?

[strech]

As a note of clarification, government subsidized healthcare (in which our tax dollars fund health care for groups of people that wouldn't otherwise be able to afford it) is a good idea - it's vulnerable to the same kind of meddling, but not to the same extent, and it targets a group of people that really need the help.

Re:worst case scenario?

[Anonymous Coward]

I think it is a good idea too. It would be better than taking 'random' sampling for their medical research.

Even better is if I would only see advertisements for the conditions I have. I don't need to be bombarded by drug ads I have no use for.

Re:worst case scenario?

[InvisblePinkUnicorn]

Another overlooked factor: heredity and genetic mutation.

Re:worst case scenario?

[Red Flayer]

You miss the point. The point is that when making everyday decisions about lifestyle, people get to externalize some of the cost. If we make them bear the cost, they will be less likely to make decisions that are more expensive for society as a whole.

Just like corpoate pollution -- when the cost is externalized (because someone else bears the brunt of ecological damage and cleanup), it makes sense for companies to pollute. When they need to bear the cost of pollution (or at least account for the cost, via fines or what-have-you) then there is incentive to pollute less.

The point is that any kind of rational decision-making based upon economic ideas is skewed heavily by whether the decision-maker, or the public at large, or someone else entirely, bears the costs of the decision.

Re:worst case scenario?

[Red Flayer]

Sorry to double-reply, I hit submit before I was finished.

I don't think any of the things you mentioned should be banned. I do believe, however, that allowing people to externalize the costs of their behavior (whether they are smokers, polluters, poachers, or anything else) means that people take actions that are highly inefficient and detrimental from a societal point of view. If we want people to make decisions that benefit themselves, while not unduly causing harm or costing others, we need to make sure that the decision-maker bears the costs.

Ex. (though hamstrung in the US) Polluters face fines if they pollute illegally. This, in theory, should tip the decision-making process in favor of not pollutiing. If you do not fine polluters, or make them bear the cost of recovery, then they will always pollute. Note, however, that bad publicity is one cost they should factor into the decision.

Sure, not all actors within a system are rational -- but we can make an impact on behaviors harmful to society by making people pay for the harm they do to others, instead of having the public at large pay.

Re:worst case scenario?

[Red Flayer]

As long as you are on the enforcement end, and not on the end being forced to give up all of your rights as a rational being, everything will always look win-win.

Who said anything about being forced to give up rights?

How about this -- if you smoke, you pay a cigarette tax that is put into a fund to be used only for medical care. That way, you don't trample on my right to be secure in my property, when I get taxed more to pay for your care when you are suffering from lung cancer, heart disease, or any of the other illnesses smoking causes.

Re:worst case scenario?

[grassy_knoll]

On your comment:

You miss the point. The point is that when making everyday decisions about lifestyle, people get to externalize some of the cost. If we make them bear the cost, they will be less likely to make decisions that are more expensive for society as a whole.

and mine

The idea the economics of health care must trump individual rights leads to complete regulation and control of everyone's lives as a "cost saving measure". It's totalitarianism.

We seem to agree that the phenomenon exists, although we seem to disagree that the phenomenon is desirable.

For a centralized monitoring of the citizenry as a health cost savings measure to be effective, those doing the monitoring and enforcing must be always right and free from personal bias.

I know of no humans who are always right and always free from personal bias.

Therefore, I view the idea of monitoring and punishing the citizenry for what they eat, how much they do or do not exercise, et. al. with a healthy dose of skepticism.

Re:worst case scenario?

[InvisblePinkUnicorn]

"Who said anything about being forced to give up rights?"

The original poster in reference to the article's worst case scenario.

"How about this -- if you smoke, you pay a cigarette tax that is put into a fund to be used only for medical care. That way, you don't trample on my right to be secure in my property, when I get taxed more to pay for your care when you are suffering from lung cancer, heart disease, or any of the other illnesses smoking causes."

Your first sentence contradicts your second. You propose taxing others so that your right to property is not violated through taxation. That right is universal. Forcing someone - anyone - to give up some amount of their productivity is an immoral violation of their rights as a rational being.

Re:worst case scenario?

[frogzilla]

Apparently it is living longer that costs more to society. Prevention No Cure for Increasing Health Expenditure

Re:worst case scenario?

[Red Flayer]

That is valid. However, we are rapidly facing a situation where the burden of health care is, quite simply, going to hobble our economy. The answer, I think, is very complex, and must include incentives for healthy behavior (as opposed to punishment for unhealthy behavior -- two sides of the same coin), a tiered healthcare system, and the assignment of cost to the people who make the costly decisions.

If our healthcare system does not work economically, we are screwed. I do not want people, six generations from now, paying for my decisions. And yet that is exactly what we have now. Without factoring in the economics, we cannot make a system that is equitable and affordable.

Re:worst case scenario?

[Red Flayer]

The original poster in reference to the article's worst case scenario.

I was the original poster. And I did not mention giving up rights.

You propose taxing others so that your right to property is not violated through taxation. That right is universal. Forcing someone - anyone - to give up some amount of their productivity is an immoral violation of their rights as a rational being.

Are you deliberately misunderstanding? When a smoker smokes, they are costing me money because we have a public safety net that subsidizes their treatment for illnesses caused by smoking. Rather than have *me* and *you* and everyone else pay for it, why don't they have to pay for it? And on the plus side, the tax is a disincentive to smoke, and therefore we would see a reduction in smoking and a corresponding reduction on the drain it has on the economy. Everyone wins, except for the idiots who continue to smoke despite all the negative effects (health, wallet, etc).

Re:worst case scenario?

[grassy_knoll]

Seems like what we'll end up with then is no government paid for health care system. Given demographics, we just may not be able to afford it.

We could also see something like what the NHS is trying in the UK, preventing people with "bad lifestyles" from receiving treatment.

Seems like that would be self defeating. It would create a class of people who are forced, via taxes, to pay into a system that doesn't benefit them. That doesn't bode well for long term stability or viability.

Re:worst case scenario?

[InvisblePinkUnicorn]

"I was the original poster. And I did not mention giving up rights."

You said the quoted situation sounded like a good idea. The quoted situation involved the regulation of what people can and cannot choose to do to their own bodies. Are you saying this does not violate their natural liberty?

"When a smoker smokes, they are costing me money because we have a public safety net that subsidizes their treatment for illnesses caused by smoking. Rather than have *me* and *you* and everyone else pay for it, why don't they have to pay for it?"

You are proposing replacing one rights violation with another. Rights are universal and should never be violated by anyone.

Re:worst case scenario?

[Red Flayer]

You said the quoted situation sounded like a good idea. The quoted situation involved the regulation of what people can and cannot choose to do to their own bodies. Are you saying this does not violate their natural liberty?

I expanded on the original quote from TFA. What makes sense is that people should need to pay the cost for their decisions, rather than getting to externalize it to the general population.

You are proposing replacing one rights violation with another. Rights are universal and should never be violated by anyone.

No, I am proposing removing one rights violation and replacing it with something that doesn't violate rights. How does making people responsible for the effetcs of their actions violate their rights? They can still exercise their rights... but they need to make sure that exercise of their rights does not impinge on others' rights. Isn't that how the system works? All I am suggesting is that some of the less obvious ways peoples' rights are infringed upon by others are accounted for.

Re:worst case scenario?

[Red Flayer]

Or a tiered system. Universal access to care to a certain threshold, then private insurance will need to take care of the rest. It'll suck when people die when we have the means to save them, but it's a harsh fact that one person's value to society can be tiny compared to the cost of extending that person's life.

Harsh, yes. Cruel, maybe. Necessary, I think so.

Re:worst case scenario?

[strech]

When a smoker smokes, they are costing me money because we have a public safety net that subsidizes their treatment for illnesses caused by smoking. Rather than have *me* and *you* and everyone else pay for it, why don't they have to pay for it?

First of all, some people who use the public safety net won't "deserve" it. It's not all cute orphans and single mothers whose husband/boyfriend dumped her. There's a public safety net anyway. Second, cigarettes are already taxed extra for public health reasons. I haven't seen the US numbers, but in the UK smokers subsidize the healthy people at this point. This isn't what you suggested was a good thing; you suggested government health monitoring of "healthy lifestyles".

We pay "unfair" taxes all the time; I'm not on Medicare or Medicaid but I do pay for it. Same for unemployment pay, welfare, lots of other things. "Unhealthy Lifestyles" that can't be compensated for with a simple product tax (cigarettes, alcohol) aren't inefficient to the point they justify this kind of government intrusion. Assuming we can even identify them properly without punishing innocent people in the first place, that is - we're still not sure about all the biology behind obesity, and even when we figure it out that's another level of intrusion.

Re:worst case scenario?

[strech]

I expanded on the original quote from TFA. What makes sense is that people should need to pay the cost for their decisions, rather than getting to externalize it to the general population.

But externalization of some costs is a good idea. (Roads for example). Both for reasons of efficiency (you can't make everything a toll road) and fairness (a good road structure ultimately benefits everyone). And any sort of tax incentive for a "healthy lifestyle" will prevent certain things from being externalized that should be. An example that's been mentioned elsewhere on this page is drug side effects - some epilepsy drugs slow metabolism, and thus promote obesity. This seems like the kind of cost that should be externalized, but "healthy lifestyle" incentives will prevent this.

Re:worst case scenario?

[InvisblePinkUnicorn]

"No, I am proposing removing one rights violation and replacing it with something that doesn't violate rights."

Your proposed replacement violates the individual smoker's right to their property, just as the original regulation violated your right to your property. They are both violations of the same right.

"How does making people responsible for the effetcs of their actions violate their rights?"

Forcing someone to give up a portion of their productivity to the government, or anyone else, is a violation of their right to property. Agreed? It is no different regardless of what the government deems to be a proper allocation of responsibility. The government is violating your rights now, and under your proposal, they would be violating the rights of smokers. I'm sure you're more inclined to be alright with that because you think that smokers should be forced to pay the government for state-sponsored healthcare, but it is still a violation of their rights, and we must support them (and everyone else) in their rights because rights are universal. Mocking someone else's rights makes a mockery of your own rights.

Bottom line: Who is forcibly taking a portion of your productivity (in the form of money) away from you - smokers, or the government?

Re:worst case scenario?

[Red Flayer]

I am not a libertarian, so we're not going to agree on this.

I believe that taxation with consent is justified. I believe that social safety networks are justified, necessary, and profitable to the country at large.

Given these items, I believe it is unjustified for people who willingly take action that has costs the public, not to have to contribute towards those costs.

Those who speed should pay fines. Those who drive drunk should pay fines. Those who pollute should pay for remediation. Those who kill should pay restitution. See where I'm going here?

Your point makes sense only if considered in the abstract; given that we do indeed have a social safety network funded via taxes, it *is* depriving me of my property when someone smokes their entire life without contributing more than me to their healthcare.

Re:worst case scenario?

[InvisblePinkUnicorn]

"I am not a libertarian"

Good, because if you were, we would definitely not be able to agree on anything.

"I believe that taxation with consent is justified."

Agreed, as long as that consent is on a per-individual basis, as rights are individual rights. I am fine with voluntary taxation. Just as you voluntarily get insurance to protect against emergencies, you would also voluntarily give to the government to help uphold your rights and the rights of everyone else.

"I believe that social safety networks are justified, necessary..."

I am not sure what you mean by "social safety nets". If the funding necessary for such safety nets to exist is acquired voluntarily, I have no problem with that. What you do with your productivity (ie money) is up to you. The moment you start having the government take this money by force from everyone regardless of their individual opinions on the matter, then you are violating their right to property.

"Those who speed should pay fines. Those who drive drunk should pay fines. Those who pollute should pay for remediation. Those who kill should pay restitution. See where I'm going here?"

Of course, I agree with all of this. However the first two situations would only be justified if roads were privately-owned. The private owner would determine what constitutes violating what they deem acceptable on their property (speeding, drunk driving, etc), and if someone violates those rules, they could take that person to court and get restitution. As far as pollution, that would only be true if the pollution spread outside one's property, which of course is almost always the case, so I agree with you on that as well.

"given that we do indeed have a social safety network funded via taxes, it *is* depriving me of my property when someone smokes their entire life without contributing more than me to their healthcare."

Do you see how you are being wishy-washy with property rights? You are saying getting taxed is fine, but you don't want your taxes to pay for a smoker because you say it violates your property rights, but you would rather have them get taxed more, except that you also claim that does not violate their property rights.

This is how we have gotten to our current situation where, for example in the US, Democrats are for "liberty", and Republicans are for "free market", except both groups are fine with deciding to violate all rights in certain cases where they deem something to be an unacceptable use of someone's private property. For them, rights are convenient except when they are not - then you can just ignore them. For me, rights are universal and should never be violated.

All government should start with upholding the rights of the citizenry, and then go from there. The present government has it the other way around. They know people like their rights, so they uphold those rights when it is politically profitable, and they ignore those rights when doing otherwise would be unprofitable.

Re:worst case scenario?

[Red Flayer]

Do you see how you are being wishy-washy with property rights? You are saying getting taxed is fine, but you don't want your taxes to pay for a smoker because you say it violates your property rights, but you would rather have them get taxed more, except that you also claim that does not violate their property rights.

I'm not being wishy-washy with property rights, if you followed the logic of tmy last post I think you might understand my position better.

It has already been determined that the right to property is not an absolute. Like it or not, that is the state of affairs.

It has already been determined that all income earners in the US will contribute to programs such as social security, medicare, welfare, etc (the social safety net).

My problem is that those who contribute more to the cost of these programs are not expected to contribute more to the funding of these programs. I believe that contribution to these programs should be based on risk factors as well as income. That is, smokers, overweight people, etc, should pay more in medicare taxes, etc, rather than have healthy people unduly punished for the unhealthy actions of others. This is in line with my belief that no state should contribute more to the federal government than they receive from the federal government (+/- a small margin of error). If you're concerned about income redistribution, just take a look at how much NJ, for example, gets back from the federal government for every dollar given to the federal government. Note that this percentage always gets higher when there are conservatives in power. Not sure if this rant is getting completely OT, but it seems that one of your main concerns is income redistribution...

Re:worst case scenario?

[InvisblePinkUnicorn]

"It has already been determined that the right to property is not an absolute."

According to what? You can't legislate rights out of existence.

"Like it or not, that is the state of affairs."

That does not make it right. Your argument is basically that a majority disagree that you have certain rights, and therefore you don't have those rights. The government doesn't grant natural rights. They are charged with upholding those rights, and granting any additional right along the way.

"It has already been determined that all income earners in the US will contribute to programs such as social security, medicare, welfare, etc (the social safety net)."

Yes, bills and legislation have made that the current situation. That doesn't make it justified or morally sound. The moment you tell someone else what they can and can't do with their productivity, you are violating their rights as a human being. The whole point of my discussing it here is to help make another situation possible. Saying, "this is the status quo" is not a valid rebuttal to an argument against the status quo.

As for your smoking situation, I understand fully what you are trying to say, but you are deliberately ignoring property rights when it is convenient for you to do so. One need not look further than your initial analysis of your property rights in relation to the healthcare subsidization to see this is true.

"Note that this percentage always gets higher when there are conservatives in power."

There is quite a difference between labelling yourself a "liberal" or a "conservative" when it is politically profitable, and actually holding true the principles that are supposed to typify a liberal or a conservative. That is also how it is possible to have a Libertarian Party made up of liberals, conservatives, anarchists, etc, and who just nominated for their presidential candidate someone who has a long history of opposition to gay marriage and drug legalization (Bob Barr - he actually introduced the Defense of Marriage Act, and later said he opposed it when it was politically advantageous).

"Income redistribution"

You can call it whatever you like, it is still a violation of my and my family's and friends' and neighbors' rights as human beings.

Re:worst case scenario?

[jrady]

Sounds like a good idea to me. People with unhealthy lifestyles cost communities and bigger units (states, federal govt) a lot of money in emergency services, medicare costs, etc. I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles. Plus, there is then an obvious economic incentive to become healthier.

Seems like a win-win to me. Sounds like a bloody nightmare to me!

What about people with "unhealthy" hereditary conditions? like asthma?
Are you friggin kiddin?
or take ulcers: bacteria cause it that are everywhere, but food, stress and smoke are blamed for it,in the minds of the unknowing...

besides: there are a few things that a government CAN do better than a business. And the US healthcare, run by businesses is a clear example of that.
THE most expensive health care in the world, with a quality of health care for the public that is surpassed by burkina faso and bangladesh.

Re:worst case scenario?

[ReedYoung]

Why should the answer be "very complex?"

The answer, I think, is very complex, and must include incentives for healthy behavior (as opposed to punishment for unhealthy behavior -- two sides of the same coin), a tiered healthcare system, and the assignment of cost to the people who make the costly decisions. It's as simple as this: pay your own way. I appreciate that several of your comments boil down to that point. I'm just wondering why you choose to describe this subject as "complex," which I'm most accustomed to seeing in arguments for "interdependence," as a wedge for full-blown collectivism.

Of course it is awful

[iXiXi]

Has anyone ever seen Logan's Run? I am just waiting for my little RFID 'crystal' to be implanted so that I may authenticate to the Big Brother system. This is just one more step in the erosion of our privacy. When Homeland Security and CDC folks determine that they need access to your google health records, how quickly they will institute health care reform disease prevention legislation to force you to do things with your body against your better judgment. "Your gov't and your health care provider have determined that you must conform to this medical procedure to ensure that you are not posing a risk to the financial and physiological wellness of the nation." "If you do not comply, your children will be taken by social services for not having risky vaccinations and you will be criminally charged."

In Other News

[had3l]

Scientists are baffled by the realization that most things that matter are either Good - Or Bad.

Weasels

[grassy_knoll]

Finally, a use for the marketing department! They can power the LAMP application!

At least until PETA complains it's cruel to the application...

[badum-ching]

Wake me when KDE4 is actually usable

[Anonymous Coward]

Is 4.1 supposed to be the actual usable release, or have they shifted it to 4.2 now?

Their best case is terrible.

[Anonymous Coward]

I don't want any of that -- ever.

Huh?

[Anonymous Coward]

What are they talking about? Even the "best case" scenarios sounded worst-case to me.

Bleah

[Indigo]

I don't want MY health data "set free"...

E-Records and good thing but...

[WamBam]

As someone who deals with paper medical records all day, I welcome standardized electronic medical records. Not only would e-records be portable, they would also allow for greater continuity of care between healthcare providers. Obviously, security is an issue and I'd like to see more measures taken to ensure that our medical records are protected. As for the possibility of these records raising insurance premiums I think the best way around this is to create a national healthcare plan. I would think that in countries where there is national healthcare services, electronic medical records would be of great benefit since it's inevitable that such a large beaucratic undertaking would need centralized patient information. I would take issue with basing rates on people with healthier lifestyles. There are many in this country that aren't living healther lifestyles due to socio-economic factors. People that live in in poorer areas don't always have access to proper healthcare, are often not educated in the ways of maintaining health and don't have access to nutritional foods.

Re:E-Records and good thing but...

[0xG]

"Obviously, security is an issue and I'd like to see more measures taken to ensure that our medical records are protected." The best policies in the world, and even better practices, mean SH*T in view of the USA PATRIOT act. No Thanks...

Re:E-Records and good thing but...

[jrady]

the only way to prevent data mining by the usual suspects (Insurances, employers, banks) is to keep stuff in singly copy dead-tree archives spread across my doctors. anything lesser is an open barn door to Orwellian wet dreams ...

think it through a little more

[Quadraginta]

You think? Hmmm. How about someone in government realizes that AIDS costs the public treasury a huge amount of money, so they start penalizing a gay lifestyle? Or being unmarried, which shortens up your life? Or amusing yourself rock-climbing or bicycle racing, which are more dangerous than going to the gym and riding a stationary bicycle to nowhere?

More plausibly, how about someone in government thinks that lifestyle X is bad for you, and starts handing out tax penalties and rebates accordingly -- but he's wrong. Not like we've ever had any health fads that turned out to be nonsense, right? And no government bureaucrat would dream of making decisions when he doesn't really have enough information to make a good one, right?

Re:think it through a little more

[grassy_knoll]

On this:

More plausibly, how about someone in government thinks that lifestyle X is bad for you, and starts handing out tax penalties and rebates accordingly -- but he's wrong.

I think you nailed the problem with totalitarianism.

For an example, take the bureaucrat working for an elected official. The bureaucrat comes out with some boneheaded rule about each citizen must not eat meat as it's very unhealthy.

Once symptoms of B12 deficiency start showing up, there's at least a chance the elected official will respond to public outcry, lest the next election not go so well.

On the other hand, if there are no elections then whatever inane policy is out there can be maintained forever. Obviously it's not that the policy is wrong ( since that would require the government to admit it made a mistake ) but that the people aren't implementing it correctly. Like collectivism in the former soviet union:

Despite the expectations, collectivization led to a catastrophic drop in farming productivity, which did not regain the NEP level until 1940. The upheaval associated with collectivization was particularly severe in Ukraine, and the heavily Ukrainian adjoining Volga regions, a fact which has led many Ukrainian scholars to argue that there was a deliberate policy of starving the Ukrainians (see Holodomor for more information). The number of people who died in the famines is estimated at between three and ten million in Ukraine alone, not counting the adjoining regions. The best estimate is that in the whole USSR there were 5â"6 million excess deaths.

Re:think it through a little more

[Red Flayer]

You think? Hmmm. How about someone in government realizes that AIDS costs the public treasury a huge amount of money, so they start penalizing a gay lifestyle?

Overruled, unconstitutional. How about instead we do not punish everyone for the actions of an inconsiderate few who decide that having unprotected sex or using septic needles is ok? I do believe in the need and utility for a public safety net... but I cannot condone allowing people to have no negative repercussions for behavior that costs society as a whole.

Or being unmarried, which shortens up your life?

And, interestingly enough, reduces your burden on society.

Or amusing yourself rock-climbing or bicycle racing, which are more dangerous than going to the gym and riding a stationary bicycle to nowhere?

Yes, that's right. I should not have to bear the cost of some jackass adrenaline junkie who takes ridiculous risks. Let him get insurance, and if he doesn't want to, too bad. There is no reason the public at large should be penalized for his poor decision-making.

More plausibly, how about someone in government thinks that lifestyle X is bad for you, and starts handing out tax penalties and rebates accordingly -- but he's wrong. Not like we've ever had any health fads that turned out to be nonsense, right? And no government bureaucrat would dream of making decisions when he doesn't really have enough information to make a good one, right?

Now you're talking about poor implementations, not whether it's a bad idea in theory. Please note that (a) a decision like that is not made by an individual (b) safeguards would be built in and (c) it's not about lifestyles, it's about specific decisions.

Is it considered spam...

[Kookus]

When you start getting more emails for Viagra after you've been diagnosed by your doctor for having ED?

but you're an amateur

[Quadraginta]

You're thinking that it takes a physician the same time to read through your history and pluck out the important stuff that it would take you, a complete amateur with nearly zero understanding of how medicine works.

That's as logical as thinking that it would take Linus Torvalds as long to understand a kernel patch as J. Random User who's never coded a line in his life. Or that your car mechanic needs to carefully listen to every sound your jalopy makes to know whether it needs a valve job. Or that the conductor of the Los Angeles Philharmonic would have to get out a tuning fork and go carefully around to listen to each of his 150 musicians to know whether the orchestra is playing in tune.

Re:but you're an amateur

[Anonymous Coward]

Did you seriously just use the word "jalopy"?

Points.

While I agree with your contrast of expert vs. retard, I'd like to point out that I have been given incorrect and harmful advice by the U.S. healthcare system. It's my body. I'll do my own research and come to my own conclusions, thankyouvermuch.

No doctor will ever give a shit about my body as much I do.

If Things Get Serious...?

[D Ninja]

From the "Good Things" article...

Ready to take their relationship to the next level, lovers Romeo and Juliet share STD status reports through their Google Health accounts. If things get serious, they'll open up their entire files to each other and compare genetic data when contemplating children. This doesn't seem like such a great thing to me. Here's the scenario I see...

Romeo and Juliet share STD data. They are both clean (or so the record says). Great. They can now enjoy sex with each other.

Then, over time, they decide that this relationship is really a great thing and they want to start looking into marriage. They get married. Everybody is happy.

Now that they're married (because nobody would be stupid enough to share this type of data BEFORE marriage...would they?), they share their genetic information with each other as they are talking about children. But, what's this?! Juliet sees that Romeo has a high propensity for Down Syndrome (or any other "disease" - take your pick). Well, this isn't good.

So, instead, Juliet decides to get a divorce and go on her merry way.

The End

Re:If Things Get Serious...?

[JackPowers]

I wonder if this gets into pre-nuptual agreements. The marriage contract is dependent on certain test metrics, or the size of the post-nup settlement is pro-rated against the ending health record.

Re:If Things Get Serious...?

[SnapShot]

This probably sounds perfectly reasonable to some. According to the "marriage is for heterosexuals only" crowd, the only purpose for marriage is to raise healthy, well-adjusted children. If you can't raise healthy children then that would be an appropriate reason to seek a different partnership.

This is not a position I agree with. My marriage is a partnership that transcends our desire to procreate. But, there are some who want to define marriage so specifically.

Re:If Things Get Serious...?

[Anonymous Coward]

Okay, that's a scenario, yes, but... where's the down side? What, precisely, is the objectionable act?

Your problem is with the choice Juliet made. You hold that, because a choice you disagree with could be made, that none should have the choice or any information that could be used to grant that choice.

I'm not sure I'm on board with you, here.

And you haven't even proven Juliet's choice is wrong. Maybe she really, really, really doesn't want retard babies. Lord knows I don't.

Re:If Things Get Serious...?

[DragonWriter]

Now that they're married (because nobody would be stupid enough to share this type of data BEFORE marriage...would they?), they share their genetic information with each other as they are talking about children. But, what's this?! Juliet sees that Romeo has a high propensity for Down Syndrome (or any other "disease" - take your pick). Well, this isn't good.

So, instead, Juliet decides to get a divorce and go on her merry way.

Is this really bad, compared to alternatives like someone like Juliet that can't cope with even the possibility (much less the reality) of a child born with a genetic defect not knowing about the probability but leaving after such a child is born, or when she turns up pregnant with such a child and she and Romeo can't agree on what to do. Or has the child and stays around -- but is abusive or neglectful because she can't deal with the child.

Re:If Things Get Serious...?

[5KVGhost]

You should realize that people already get genetic testing prior to getting married and/or prior to having children. This is not a new scenario. For example, those marrying in Jewish communities may check for Tay Sachs, blacks might check for sickle-cell disease, and couples with a family history of certain rare genetic disorders can check specifically for those.

These aren't relatively minor issues like a club-foot or cleft palate; these are genetic disorders that often fatal or crippling. And I think it's perfectly understandable that a couple would want to know about them before having a baby. It's certainly better for everyone (IMHO) than getting pregnant, discovering the problem later on an ultrasound, and then having an abortion. Which is, in fact, what many women who discover they have Downs babies have chosen to do.

Re:If Things Get Serious...?

[Red Flayer]

But, what's this?! Juliet sees that Romeo has a high propensity for Down Syndrome (or any other "disease" - take your pick). Well, this isn't good.

So, instead, Juliet decides to get a divorce and go on her merry way.

Why do you hate Darwin?

Seriously, what's wrong with a little unnatural selection? Let the 'purestrain' people breed with eachother, and the rest of us can interbreed. How else are we going to get speciation within a 100 generations so that we can have sustainable populations of dwarves, gnomes, elves, and trolls?

Because really, that's what we should be aiming for.

**please check the settings on your sarcasometer if your blood vessels are straining to burst free from your neck and forehead after reading this post**

Re:If Things Get Serious...?

[goodmanj]

But, what's this?! Juliet sees that Romeo has a high propensity for Down Syndrome (or any other "disease" - take your pick). Well, this isn't good.


That's a tragedy for Romeo, but I much prefer it to the tragedy of bringing a kid with, say, cystic fibrosis or Tay-Sachs disease into the world. Or Down syndrome, though that's more closely tied to the age of the mother than to genetics.

The thing about the major genetic diseases I've mentioned is that in most cases, they're recessive, which means that a variety of simple solutions (ranging from divorce to sperm donation) can result in happy families and no risk of disease.

Your tragic tale isn't so tragic: genetic diseases are examples of where good medical information can be a good, not an evil.

Re:If Things Get Serious...?

[Huntred]

Now that they're married (because nobody would be stupid enough to share this type of data BEFORE marriage...would they?), If Romeo and Juliet cannot trust each other enough to share their respective genetic histories with each other before they get married and have children, they should probably not do either.

If Juliet bails on her marriage with Romeo because of some sort of previously-unknown-to-her genetic issue that could affect the lives of children, Romeo is better off without her.

If Romeo decided to willfully withhold this information to try to "trap" Juliet, then Juliet is better off without him.

Re:If Things Get Serious...?

[D Ninja]

The thing about the major genetic diseases I've mentioned is that in most cases, they're recessive, which means that a variety of simple solutions (ranging from divorce to sperm donation) can result in happy families and no risk of disease. Divorce results in happy families?

A number of posts pointed out that people are already getting genetic testing and that parents may not be able to handle having their kid have problems when they come into this world.

My questions is...why can't they? Are we so weak and do we expect everything to be so "perfect" (whatever the heck that is) that we can't handle a little bit of difficulty in our lives.

I'm not trying to troll here, and heaven knows that I would not wish one of these problems onto any child or any family, but there are *many* families out there with children who have these issues (and much more). Yet, despite that, they can come closer together and can be a strong and happier family for it. Will things be easy? Nope. Nobody ever said life would be easy or fun or happy. Will it be rewarding and create those important, close bonds and create a loving, caring family. Absolutely.

I seriously wonder what it is that people truly find important anymore.

In other news

[Daimanta]

Tomorrow it will rain - or not.

Mental health?

[SnapShot]

It's interesting that none of the "best case" scenarios deal positively with mental health but many of the "worst case" scenarios are based on a persons mental health records being revealed to the outside world. Are mental health diseases still so stigmatized that there could be no good to come from this?

better get ready then

[Quadraginta]

When national health care arrives, as it will shortly, if the elections this November turn out the way they look like they will, then the government is going to be your health-care provider. There will be no need for passing actual legislation to force you to conform to any particular medical procedure. That can just be decided by the President, who, as head of the Executive Branch, is in ultimate charge of all national government agencies.

Re:better get ready then

[iXiXi]

Unfortunately, you are correct. We need to rattle our chains !

re: health insurance

[Anonymous Coward]

it's already bad enough that we allow the internet to expose our personal lives so much so that an employer can google your name and possibly dig up dirt on your social behavior (i.e. myspace, facebook, etc.). Now, insurance companies can keep track of your dietary habits and find yet another reason to deny you their service and jack up your insurance rates. Knowledge is power ... but it's always a dangerous tool when possessed by the wrong person(s).

Careful of the slippery slope

[hellfire]

You are thinking about health records in the sense that someone smokes a pack a day and shouldn't get the same paybacks on their care as other people. I applaud that, in terms of smoking, but in terms of everything else, you are dead wrong.

Some people are overweight because they eat too much and don't exercise enough. Others are overweight because they (truthfully) have a glandular problem. Some, like my sister, are the result of the epileptic drugs she takes which lower her metabolism. Should these later classes be penalized?

Also, penalties don't often work in situations like this. Make something look like an incentive, however, and it will work.

A federal law should be passed that information in these records and records like them cannot be used to create laws regulating state or federal health care systems.

Oblig. Demolition Man quotes

[cparker15]

John Spartan: Get me a Marlboro.
Alfredo Garcia: Yes, of course... [pause] What's a Marlboro?
John Spartan: A cigarette. Any cigarette.
Lenina Huxley: Um, smoking is not good for you, and it has been deemed that anything not good for you is bad, hence illegal. Alcohol, caffeine, contact sports, meat...
John Spartan: Are you shitting me?
Computer: John Spartan, you are fined one credit for violation of the verbal moralities code.
John Spartan: What the hell is that?
Computer: You are fined one credit...
Lenina Huxley: Bad language... chocolate, gasoline, uneducational toys, and anything spicy. Abortion is also illegal but so is pregnancy if you don't have a license.

=====

John Spartan: Do you have the salt?
Lenina Huxley: Salt is not good for you, hence, it is illegal.

Re:Oblig. Demolition Man quotes

[gpuk]

Excellent!

worst idea ever.

[lawn.ninja]

I wish I could say more, but... This is the worst idea ever. It is also one of the biggest money pits. No hospital I've ever worked for would let control of that data go. We just had a long drawn out battle with one of our vendors about that. 2 years later they still don't have access to our data.

Good not that different from Bad

[Anonymous Coward]

Is it just me, or do teh best and worst cases seem almost identical?

Take the sex examples:

Best Possible Thing - Romeo and Juliet share STD information after getting to know each other, before having sex.

Worst Possible Thing - Lonesone Larry freely decides to share his STD information with prospective dates.

There isn't that much difference. And while we might think Larry's decision is stupid, he might have a good reason for it.

The same goes for some of the other issues.

good vs bad.

[fish_in_the_c]

There are some interesting precidence here but I think the article did a very poor job of comming up with worst case senerios.

Grandma Mini
How about the Chinese , or Russian , or German or American ( what have you ) have legalized euthanasia. Grandma mini's medical records indicate that she has become far too much of a drain on the nationalized medical system and that the taxes she and all of her immediate family pay into the government are causing a drain on society. Since obviously grandma mini can no longer expect a high quality of life the state puts subtle and not so subtle pressure on the family to
let Grandma mini "die with dignity" even though it is the last thing in the world Grandma wants and goes directly against her religious beliefs. She is cut off from state funded medical aid , not able to find a doctor and unless her family takes steps to ensure her graceful departure they will be required to pay back the whole of grandma mini's medical expensive for the last 60 years.

( Think it can't happen check out the Chinese population limitation laws. They are already there.)

Highly convenient.

[MBC1977]

Personally, I think this is well overdue. A common health record system that all hospitals and patients is highly beneficial. I think any digtial system has the potential to be abused, so perhaps a third-party organization could oversee this, but truthfully I don't see that happening, as everyone wants to kill it before it can be effective.

While a private company developing technology like this could seem questionable; what I'd like to know is why has the medical industry NOT took the initative to create such a system themselves?

Making money off your data

[PinchDuck]

is Google's business plan. You are nuts if you put your medical record on their databases. No freaking way I will do this.

They're smarter than the average bear.

[argent]

what I'd like to know is why has the medical industry NOT took the initative to create such a system themselves?

Perhaps because they don't want patients to start lying to their doctors because they're afraid of their insurance company going all Scrooge on them?

Solution to already solved problem.

[C10H14N2]

We already have HL7. Providers have the ability to exchange and consolidate your medical records directly and to provide electronic copies for the patient to physically retain to personally bring by sneakernet between their providers without the need for a proxy. The vast majority of people don't have that many medical providers, nor do they change them very often. It is neither necessary nor desirable to have a company like Google aggregate the records. Its only strength is in being the *only* repository, which is its greatest weakness as a single point of failure. If there are multiple companies like Google providing the service, how is that terribly different than polling the providers directly? Central clearinghouses might be useful, a la the credit reporting agencies. When someone has records on you, they publish that fact without publishing the actual records. So, in an emergency situation, a provider could ask the question "where does this person have records" and then proceed to retrieve them with proper clinical discretion on both ends.

Re:Solution to already solved problem.

[TubeSteak]

Central clearinghouses might be useful, a la the credit reporting agencies. When someone has records on you, they publish that fact without publishing the actual records. If you don't see this as a flaw in your plan, I don't know what to tell you.

A lot of people go get mental health care and pay out of their own pocket so that it isn't 'in the system'. The same goes for various other types of treatments.

Centralizing that information takes away control from us as individuals.

I'm unhealthy right now!

[lamona]

And it's rather obvious that anyone reading this thread and posting replies is, de facto, engaging in an unhealthy activity RIGHT NOW! Sitting! Typing! Mousing! Avoiding real work!

We should all just fling ourselves out the windows. If we have windows. And if they open. And as long as no one is walking below. And that we'd be quickly bio-degradable upon landing.

OK, next post.

Already there.

[C10H14N2]

http://www.hl7.org/ Major medical records systems are pretty universally HL7 compliant. That means medical providers can uniformly interchange your charts without the help of Google. It has been around for a decade.

Instead of flaming use intelligence....

[aceofspades1217]

I don't see anything wrong with this. They are just trying something and seeing if it will work. They aren't saying hey "give us all your medical records". If you are concerned with your privacy or you have an STD that you are trying to hide...no one is pointing a gun at your head and saying give me all your medical records.

Maybe in the future hugely busy New York doctors could use it to keep track of their patients and become more paperless.

I could definitely see a nutritionist using this. I mean there is obvious benefits to this.

I myself being part owner of a Sports Nutrition Store already do web based nutrition planning for our customers. You sign into a web-based app and you can choose your meal plan for the day and pick from a list of foods.

Obviously if google could do something like this it would be quite successful. I already use google apps to host our corporate email (justsaymax.com).

Thumb print access to records?

[madcat2c]

I see at some point thumb print access to records, even at a cafeteria checkout. Imagine putting your thumb on a scanner to pay for your food, and then a warning pops up that says "Opps that slice of pie has sugar in it and you cant have sugar because of your condition, go back and get a yellow slice it has splenda in it".

You could make it chastise you at a supermarket checkout, perhaps in your mother voice, "Do you really need the big bag of cookies? Go get the 100 calorie pack right now mister". A sample if Jillian's voice form the biggest loser would do it for me.

I think a slower more deliberate development of this kind of database will provide much more useful. As long as these records are secure and modular, you can build cheap internet access to them that might just return warning flags instead of actual specific medical data, thus solving the privacy and usefulness arguments.

If you go on a cruise or stay at a hotel, you scan your thumb and the staff know you need a sharps container in your room, or you have a history of motion sickness, or that you have an allergy to Dial soap so make sure none is in the room.

You haven't thought this through completely.

[C10H14N2]

See: http://www.hhs.gov/ocr/hipaa

Centralizing that information takes away control from us as individuals.

I specifically stated that your medical records themselves would not be centralized and that your consent to release would be required and would further fall under the clinical discretion of each of your medical providers.

The only thing I was suggesting is that for emergency purposes, it would be possible to quickly locate records sources that you have explicitly authorized. Whether or not any particular situation meets your consent requirements to actually release the records is a totally different story, which was the whole point you so cleverly failed to understand.

A lot of people go get mental health care and pay out of their own pocket so that it isn't 'in the system'.

Your method of payment has absolutely nothing whatsoever to do with your medical records and how they may -- or even MUST, with or without your consent (See: http://www.cdc.gov/ncphi/disss/nndss/PHS/infdis.htm ) -- be legally be released.

Sure, you can choose to go to witch doctors who keep no records to "stay off the grid." So what? Since the whole point of my post was "consent," what's your point? "I'm a super-secret rebel and I don't leave a paper trail?" Well, good for you, but what does that have to do with a single word of what I said?

Re:You haven't thought this through completely.

[TubeSteak]

Since the whole point of my post was "consent," what's your point? "I'm a super-secret rebel and I don't leave a paper trail?" Well, good for you, but what does that have to do with a single word of what I said? You said: When someone has records on you, they publish that fact without publishing the actual records.

Your system advertises the existence of my medical records
This is a problem, even if the records themselves are not disclosed.

Good one for linking to a list of infectious diseases that require mandatory reporting.
That's why I specifically brought up mental health.

Right now, I can pay for all kinds of medical care out of pocket and not have to tell anyone else about it. With a copy of my medical records, I could check into a psych hospital for a week and not have to tell my general practitioner, insurance company, my boss or anyone else about it.

If I don't want anyone else to know that I'm going to a psychiatrist or psychologist or have some other non-mandatory reporting issue, how do I keep those institutions from advertising that they have the medical records of TubeSteak (669689)?

By making this "well its for emergencies" system, you take away my ability to choose who I disclose my health issues to.
Perhaps now my point is clearer?

Re:You haven't thought this through completely.

[C10H14N2]

If I don't want anyone else to know that I'm going to a psychiatrist or psychologist

I'm pretty sure you either a) already are or b) should do so immediately.

USB Drives

[Randseed]

No, seriously, USB drives or something equivalent. Get an 8GB USB drive and walk around with all your medical information on it. Make a standardized protocol for it. Then when you go to the doctor, you plug it in and sync it. With digital signatures, you could sign each entry (including, for example, an index of the entries with SHA-1 hashes of each entry) so that it's hard to mess with.

Just make it secure.

[Anonymous Coward]

This debate could be avoided if access required a thumb-print or eye-scan so the "patient" must be present.

This would have the added benefit of being able to obtain medical records of a John Doe patient. (blood type, drug allergies, chronic diseases...)

Any third party access could be controlled on an individual basis for a set time period after a verified secure logon (prints, voice-match, eye scan...)

Hmmmm... I guess that would mean the government would already have your fingerprints even if you had never committed a crime... some lost "privacy" there I guess, but with the added benefit of solving criminal investigations quicker.

I normally would disagree with this kind of nonsense but as long as it is secure, I might be willing to make the sacrifice for the benefit of medical emergency situations.