Tag Archives: Technology

We Need a Centralized Medical System Too

Is there a central database for medical records in the U.S.? - Quora

The coronavirus pandemic has laid bare two fundamental flaws in the American healthcare system.

Number one: There’s a reason that other rich countries treat healthcare as a taxpayer-financed social program. Employer-based health insurance was stupid pre-COVID-19 because our economy was already steadily transitioning from traditional full-time W-2 jobs to self-employment, freelance and gig work. The virus has exposed the insanity of this arrangement. Millions of people have been fired over the last two months; now they find themselves uninsured during a global health emergency. The unemployed theoretically face fines for the crime of no longer being able to afford to buy private healthcare.

The second inherent flaw in the U.S. approach is that it’s for profit. Greed creates an inherent incentive against paying for preventative and emergency care. Even people who are desperately ill with chronic conditions see 24% of legitimate claims denied.

When your insurance company issues a denial, they don’t merely pocket that payment. They also add to future profits. Even if you’re insured, the hassle of knowing that you might get hit by a surprise bill for uncovered/out-of-network charges makes you more likely to stay home rather than to risk seeing a doctor or filling a prescription and going broke. “Visits to primary care providers made by adults under the age of 65…dropped by nearly 25% from 2008 to 2016” due to routine denials by insurers, reports NPR.

Denials also create a societal effect: news stories about patients with insurance receiving bills for thousands of dollars after being treated for COVID-19, even just to be tested, prompt people to stay away from hospitals and try to ride out the disease at home. Some of those people die.

There’s another, third structural problem exposed by the pandemic—but it’s not receiving attention from public policy experts or the media. I’m talking about America’s lack of a centralized healthcare system.

A centralized healthcare system has nothing to do with who pays the doctor. A centralized system can be fully socialized, government-subsidized or fully for-profit. In such a scheme all patient records are stored in a central online database accessible to physicians, pharmacists and other caregivers regardless of where you are when you need care. If you fall ill while you’re on a trip away from home, the admitting nurse at a walk-in clinic or hospital has instantaneous access to your complete medical history.

The current system is primitive. Data is not transferable between doctors or medical systems without a patient’s directive, which inexplicably is often required by the obsolete technology of sending a fax. That assumes the sick person is sharp enough to remember which of his previous doctors did what when. And that’s it’s not a weekend or national holiday or a Wednesday, when some doctors like to golf.

Unless a patient happens to be wearing a medical alert bracelet, there is currently no way to determine whether an unconscious victim is allergic to a drug, has a chronic illness or that there’s a treatment regimen proven to be more effective for them. Even if the patient is alert and conscious, a new doctor may ignore her request for a specific medication in favor of cookie-cutter one-size-fits-all treatment.

A few months ago I developed the classic symptoms of what we now know to be COVID-19. I live in New York. I succumbed while on business in LA. Trying in vain to fight off a relentless dry cough, difficulty breathing and day after day of brutal aches and fever, I visited a CVS walk-in clinic. I have a long history of respiratory illnesses: asthma, bronchitis, pneumonia, swine flu. I requested a third- or fourth-generation antibiotic since I knew from experience that I would inevitably decline with anything less. “We do not treat viral infections with antibiotics,” the nurse, a charmless Pete Buttigieg type, pompously declaimed. I pointed out that viral lung infections usually have a bacterial component that should be treated with antibiotics.

This would not have been a issue back home in New York, where both my general practitioner and my pulmonologist know my medical history. Either doctor would have prescribed a strong antibiotic and a codeine-based cough syrup.

Because I happened to be in LA, I left CVS empty-handed.

I declined.

It got to the point that I couldn’t walk 100 feet without pausing to catch my breath.  I felt like I was going to die.

I called my doctor back in New York. She called in a prescription to the same CVS. It helped arrest my decline. But I wasn’t getting better.

I visited a different walk-in clinic, in West Hollywood. It was a better experience. They tested me for flu (negative), X-rayed me (diagnosis was early stage- pneumonia) and put me on a nebulizer. I began a slow recovery.

A centralized system would have been more efficient. The CVS nurse would have seen my history of non-response to treatment devoid of strong antibiotics. He also might have taken note of my pulmonologist’s effective use of a nebulizer to treat previous bouts of bronchitis and pneumonia. I might have been prescribed the proper medication and treatment as much as a week sooner.

COVID-19 almost certainly would have been detected in the United States sooner if we had a centralized medical system. “One example of a persistent challenge in the early detection of health security threats is the lack of national, web-based databases that link suspected cases of illness with laboratory confirmation. This leaves countries vulnerable, as they cannot accurately and quickly identify the presence of pathogens to minimize the spread of disease,” according to the U.S. Centers for Disease Control. Algorithms can automatically scan massive volumes of information for signs of novel infectious diseases, help identify potential problems and focus responses where they are needed most.

How many people’s lives could have been saved if lockdown procedures had begun earlier? If public health officials had seen the coronavirus coming back in December—or November—they might have been able to protect vulnerable populations and avoid a devastating economic shutdown.

There are substantial privacy considerations. No one wants a hacker to find out that they had an STD or an employer to learn about documented evidence of substance abuse. Keeping a centralized healthcare system secure would have to be a top priority. On the other hand, there is no inherent shame in any kind of illness. In a nightmare scenario in which medical records were to somehow become public, no one would have anything to hide or any reason to look down on anyone else.

We can’t pretend to be a first world country until we join the rest of the world by abolishing corporate for-profit healthcare and decouple insurance benefits from employment. But reform without centralization would be incomplete.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of the biography “Bernie,” updated and expanded for 2020. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

California Cops Can Kill You Simply Because They “Feel” Like It

California has just passed a law that was originally intended to reduce the likelihood of police shootings of civilians. But it still allows policemen to assess whether or not to kill you based on their “feelings,” whatever that means.

Everyone is Talking About Blockchain But No One Does Anything About Knowing What It Actually Is

If you read or talk tech you hear about blockchain everywhere, even in the context of fields of endeavor it wouldn’t seem to relate to. Cool. But what’s blockchain?

SYNDICATED COLUMN: Ban Drones

Image result for sky full of drones           Ban drones.

Why not?

We have succumbed, in recent years, to technological passivity, the assumption that there’s nothing we can (or should) do about what an older generation used to call “progress.” But that’s not true.

War goes on, yet most of the world’s nations came together to ban landmines. Mines, humanity decided, were a horror we could no longer live with because their murderous potential remained long after the frontlines moved elsewhere, even after hostilities ceased, and mostly hurt civilians. Similarly, chemical weapons were banned after mustard gas scarred the World War I generation.

Here in the United States, societal consensus supports bans of hollow-point bullets that explode inside the body (they’re currently banned by the military), high-capacity magazines for guns, the bump stocks that came to our attention after the mass shooting at a country music festival in Las Vegas, and semi-automatic assault rifles.

Weapons aren’t the only tech to which society simply responds: “Hell no. Just. No.” Human cloning has prompted calls for bans by those who believe we shouldn’t plow ahead without better understanding the potential downsides. Alcohol and cigarettes are banned for children. Lots of drugs are banned. Banning products is a well-established societal and political prerogative.

Drones should be banned too: military drones as well as recreational ones. We already have a substantial body of evidence that they are dangerous. Potential advantages, on the other side, seem relatively modest. They’re cool. I’ve played with them.

No one has sat down to consider, in a careful measured way, the pros and cons of unmanned aerial vehicles. Where, as our skies are about to turn into the Wild West, are the Congressional hearings and expert opinions?

If you stop to think about it, selling drones to any yahoo with $400 is a recipe for chaos. Launched from the roof of a Manhattan apartment building, a pervert’s drone can peep through windows. A terrorist, or merely a doofus, can fly one into the blades of a low-flying helicopter or into the engine or windshield of a plane approaching the airport. And they will. It’s only a matter of time.

The terrorism potential became evident in 2015 when a guy accidentally flew his Phantom drone onto the White House lawn. Loading one with explosives is easy. Or a gun—a father and son affixed a pistol to a drone and fired it remotely in the woods of Connecticut.

I’m even less sanguine about corporate and institutional applications. Whether it’s Uber and NASA’s announcement that they plan to launch flying taxis in Los Angeles or Amazon’s imminent fleet of delivery drones, I’m not sure I want to live long enough to hear buzzing drones where birds are supposed to sing, or see some dude’s dinner pass overhead. Maybe a sane compromise is possible, like limiting the gadgets to flight paths above major roadways. Why can’t we figure that out now, before the inevitable technological growing pains (aka deaths and injuries and overall crapitude)?

While it’s easy to imagine how drones can improve our lives—they have already found missing hikers in the wilderness, for example—it is impossible to overstate how creepy it would be to put them into the hands of law enforcement. Obama attorney general Eric Holder said in 2013, and no legal expert challenged him, that the feds have the right to launch military drone strikes against American citizens on U.S. soil. California cops used one to track a rogue LAPD officer a few years ago. Local law enforcement drones could catch speeders, scan for expired vehicle registration and inspection stickers (stationary devices already do) and use thermal imaging devices to conduct warrantless searches. And there will come a day, not in the distant future, when the same Cleveland police department that shot 12-year-old Tamir Rice to death for the crime of playing while black will type commands into an iPad that controls an armed drone that blows up more innocent civilians.

This is serious, major dystopian horror-show crap. Can’t we stop it before it starts?

Overseas, and thus far from the decreasingly vigilant eyes of our increasingly establishmentarian journalists, the Trump Administration is expanding the military drone assassination program Obama expanded after inheriting it from Bush. Formerly focused on killing young men and whoever happens to be nearby in South Asian zones like Pakistan, where studies show that 98% of the thousands of victims were innocent, the drone killers are ramping up in new places like Africa.

“The number of American strikes against Islamist militants last year tripled in Yemen and doubled in Somalia from the figure a year before,” reports The New York Times. “Last month, an armed drone flown from a second base in Niger killed a Qaeda leader in southern Libya for the first time, signaling a possible expansion of strikes there.”

Like the innately disconcerting notion of letting local-yokel cops run wild with facial-recognition-enabled autopiloted self-guided missile drones, it is impossible to overstate how self-defeating America’s drone program has been to U.S. interests. Unlike here, where the nearly daily attacks barely rate a mention in the news, people in other countries and especially in the Muslim world are well aware of the fact that the vast majority of victims are innocent civilians, including many women and children. (Even the “guilty” men who die aren’t threats to the U.S., but rather to the corrupt local governments we supply with arms.) Local populations in cities where drones patrol the skies are jittery and resentful. Many have PTSD.

True, drones eliminate harm to American soldiers. But we operate them in macho cultures that prize honor and courage. Our unwillingness to risk our sons and daughters in ground combat makes us look not just like aggressors, but cowards worthy only of contempt. In a war for hearts and minds, drones are propaganda suicide.
We’ve begun a new arms race. When a foreign country or non-state actor attacks us with drones, who will listen when we complain?

Even in the short run, drone killings don’t work. “Eliminating jihadi military leaders through drone operations could temporarily disorganize insurgent groups,” Jean-Hervé Jezequel, deputy director of the International Crisis Group told the Times. “But eventually the void could also lead to the rise of new and younger leaders who are likely to engage into more violent and spectacular operations to assert their leadership.”

A drone ban doesn’t have to be forever. But it should last long enough for us to figure out, as Donald Trump used to say on the campaign trail, what the hell is going on.

(Ted Rall (Twitter: @tedrall), the editorial cartoonist and columnist, is the author of “Francis: The People’s Pope.” You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

From an Addiction to Weed to an Addition to Devices

Studies show that the use of smartphones and tablets exploded at the same time that drug use declined among American teens. Correlation or causation?

SYNDICATED COLUMN: The NSA Loses in Court, but the Police State Rolls On

http://henrymakow.com/upload_images/policestate.jpg

Edward Snowden has been vindicated.

This week marks the first time that a court – a real court, not a sick joke of a kangaroo tribunal like the FISA court, which approves every government request and never hears from opponents – has ruled on the legality of one of the NSA’s spying programs against the American people.

Verdict: privacy 1, police state 0.

Yet the police state goes on. Which is what happens in, you know, a police state. The pigs always win.

A unanimous three-judge ruling by the US Court of Appeals for the Second Circuit, in New York, states unequivocally that the Obama Administration’s interpretation of the USA Patriot Act is fatally flawed. Specifically, it says, Congress never intended for Section 215 to authorize the bulk interception and storage of telephony metadata of domestic phone calls: the calling number, the number called, the length of the call, the locations of both parties, and so on. In fact, the court noted, Congress never knew what the NSA was up to before Snowden spilled the beans.

On the surface, this is good news.

It will soon have been two years since Snowden leaked the NSA’s documents detailing numerous government efforts to sweep up every bit and byte of electronic communications that they possibly can — turning the United States into the Orwellian nightmare of 1984, where nothing is secret and everything can and will be used against you. Many Americans are already afraid to tell pollsters their opinions for fear of NSA eavesdropping.

One can only imagine how chilling the election of a neo-fascist right-winger (I’m talking to you, Ted Cruz and Scott Walker) as president would be. Not that I’m ready for Hillary “privacy for me, not for thee” Clinton to know all my secrets.

Until now, most action on the reform front has taken place abroad, especially in Europe, where concern about privacy online has led individuals as well as businesses to snub American Internet and technology companies, costing Silicon Valley billions of dollars, and accelerated construction of a European alternative to the American dominated “cloud.”

Here in the United States, the NSA continued with business as usual. As far as we know, the vast majority of the programs revealed by Snowden are still operational; there are no doubt many frightening new ones launched since 2013. Members of Congress were preparing to renew the disgusting Patriot Act this summer. One bright spot was the so-called USA Freedom Act, which purports to roll back bulk metadata collection, but privacy advocates say the legislation had been so watered down, and so tolerant of the NSA’s most excessive abuses, that it was just barely more than symbolic.

Like the Freedom Act, this ruling is largely symbolic.

The problem is, it’s not the last word. The federal government will certainly appeal to the U.S. Supreme Court, which could take years before hearing the case. Even in the short run, the court didn’t slap the NSA with an injunction to halt its illegal collection of Americans’ metadata.

What’s particularly distressing is the fact that the court’s complaint is about the interpretation of the Patriot Act rather than its constitutionality. The Obama Administration’s interpretation of Section 215 “cannot bear the weight the government asks us to assign to it, and that it does not authorize the telephone metadata program,” said the court ruling. However: “We do so comfortably in the full understanding that if Congress chooses to authorize such a far-reaching and unprecedented program, it has every opportunity to do so, and to do so unambiguously.”

Well, ain’t that peachy.

As a rule, courts are reluctant to annul laws passed by the legislative branch of government on the grounds of unconstitutionality. In the case of NSA spying on us, however, the harm to American democracy and society is so extravagant, and the failure of the system of checks and balances to rein in the abuses so spectacular, that the patriotic and legal duty of every judge is to do whatever he can or she can to put an end to this bastard once and for all.

It’s a sad testimony to the cowardice, willful blindness and lack of urgency of the political classes that the New York court kicked the can down the road, rather than declare the NSA’s metadata collection program a clear violation of the Fourth Amendment’s right to be free from unreasonable search and seizure.

(Ted Rall, syndicated writer and the cartoonist for The Los Angeles Times, is the author of the new critically-acclaimed book “After We Kill You, We Will Welcome You Back As Honored Guests: Unembedded in Afghanistan.” Subscribe to Ted Rall at Beacon.)

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