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April 26, 2004
Call Me Cynical

But I don't like it.

President Bush on Monday plans to introduce an initiative to have electronic medical records for most U.S. residents within 10 years, the AP/San Francisco Chronicle reports. Bush also is expected to announce the creation of a national health information technology coordinator, a sub-Cabinet-level position to help meet the goal of computerizing medical records.

Bush has said paper records can lead to errors, inefficiency and poor communication among health care providers (Riechmann, AP/San Francisco Chronicle, 4/26). However, he will suggest that patients' participation in EMR programs be voluntary (Riechmann, AP/Washingtonpost.com, 4/25). Under his EMR plan, Bush will announce a proposal to double the annual grants to support the technology to $100 million (Hitt/Schlesinger, Wall Street Journal, 4/26).

Like the gathering of fingerprints on driver's licenses, this is just another part of an electronic database many people suspect the government would like to gather on all of us.

Face it, the government itself (under any administration, any political party) has neither the time nor the resources to create a database from scratch.

On the other hand, by putting together driver's license data, medical information, taxes, credit card, and other electronically held information, the government can effectively outsource the creation of such a database.

Industry pays to maintain it, with each industry gathering and storing the data it has a financial interest in. Grocery stores, clothing stores, bookstores, electronics stores, you name it. Any store you walk into that demands your phone number even if you're paying cash is collecting information on you in its database. Mixing and matching data from half a dozen or so privately held databases, you could create a fairly complete history of anyone.

I'm going to start pulling cash out of my checking account and using it for everything.

Okay, now that I have that out of my system....

No, I don't really think the government has a Sekrit Sinister Master Plan to build Big Brother's Database.

The thing is, they've been pretty open about it, so it's not Sekrit.

And I don't believe it's Sinister, not in intent. They just don't know what else to do. How do you govern a country this size? Their solution is to reduce the complications offered by messy, disorganized individuals to clean, tidy data that can be statistically analyzed. It's a bonus that the underlying database also offers individual-specific information.

It's not even really a Master Plan. I mean, some of the most dangerous things, from a paranoiac, 1984 perspective, are things we've asked for.

Paying bills on-line, or via credit card (rounds out your credit history and fills in your purchasing habits). "Permanent" phone numbers (that create a lifetime history of your phone use). Many "databases" of information were created with the approval of the vast majority of citizens of this country.

The real problem is the mindset that if you can just document, regulate, and oversee people closely enough, then all will be well. That's what can lead to an authoritarian regime.

As I see it…we don't entirely trust our government, which is healthy and leads to us keeping an eye on what they're up to.

And our government doesn't entirely trust us…which is wise. People, as individuals, aren't bad. I believe that. On the whole, most people are fairly well-behaved, law-abiding types.

But people en masse are a different story. We're not entirely trustworthy. One guy mad about a parking ticket is just grouchy. One hundred people mad about a slew of parking tickets along a street one afternoon can quickly become a mob.

Individuals can be intelligent, thoughtful, logical, and mindful of consequences.

Groups are impulsive, reckless, short-sighted, and fickle.

I think we all need to bear in mind that a government that changes direction every four years or so while dealing with disparate mobs of constantly aggravated citizens (who calls their congressman unless they're annoyed?), isn't facing an easy task.

At some point, the citizens of this country stopped considering themselves as part of the government and the "us versus them" mentality that has evolved was inevitable. Out of that divide, many of the country's problems have developed.

I don't have a slam-bang conclusion for this post, it's been more of a stream-of-conscious musing than anything else, but it all comes down to that. What information the government has doesn't matter. It's what they do with it. If if "they" were "us" then "they" would be unlikely to do anything with it that we wouldn't approve of.

Democracy is supposed to be participatory. You're not off the hook just because you spend thirty seconds in a voting booth every four years.

Posted by AnneZook at 02:27 PM


This raises other questions: all that information is out there, and available to government investigators with a little legal justification and legwork. Why is it different to have the information centralized and integrated? Should a warrant be required for investigators to use the data? Will meaningful profiles help prevent or solve crimes, or will our mania for preventive caution result in more of the half-witted stereotyping that already goes on?

And you're absolutely right about the importance of engagement, instead of delegation.

Posted by: Jonathan Dresner at April 26, 2004 03:51 PM

Drat. I've been brooding over your comment and I don't have a good response.

I guess the answer is that I don't mind the grocery store knowing how much brie I buy, and I don't mind the bookstore knowing I bought an introductory book on Bordeaux, and I don't mind Orbitz knowing I bought a ticket to Washington...but I don't want the government putting those facts together with my application for a passport and labelling me a surrender-monkey loving, anti-American agitator if my face shows up in the background of an anti-war march past the French Embassy. :)

Or, at the very least, I want them to have to work for it. I don't want some poorly written computer program spitting out my name along with the names of five thousand other innocent people and labelling us potential terrorists just because we coincidentally fit a pattern. If you make labelling people as terrorists easy (and without consequences, under a government with the power to hold people incommunicado for years on end), then more people will be labelled terrorists "just on the off chance." It's like...it's like "guilty until proven innocent" which pretty much strikes me as what the government's policy in Guantanamo is.

Posted by: Anne at April 28, 2004 02:45 PM