This knife is a switchblade apparently...

Customs and Border Protection has moved to ban import of all knives with springs, or knives that can be opened with one hand. This is ridiculous, as these are no more dangerous than any other knife. All it will do is make these knives more expensive, and hurt knife manufacturers, which will destroy jobs (because jobs are all that matter these days, I had to work that in somehow). I’ve handled quite a few knives that have assisted opening, and I find them much easier to handle than knives that have no assist. Get ready to see new US knife sales hit an all time low as the better knives are traded underground. Just my 2 cents.

(d) MINIMUM TYPE-SIZE AND FONT REQUIREMENT FOR CREDIT CARD APPLICATIONS AND DISCLOSURES.-

All written information, provisions, and terms in or on any application, solicitation, contract, or agreement for any credit card account under an open end consumer credit plan, and all written information included in or on any disclosure required under this chapter with respect to any such account, shall appear-

(1) in not less than 12-point type; and
(2) in any font other than a font which the Board has designated, in regulations under this section, as a font that inhibits readability.

Interesting – I wonder how much extra paper that would waste every year, and how many more trees would be required to make it happen. Is readability really a problem? If one is blind, he/she can probably find help to read the terms (yes, they can). Funny enough, nothing this guy’s ever sponsored or co-sponsored has passed – so he’s zero for 44 as of today.

TR: What about the public-health benefits? Systems that house large quantities of patient data could enable new types of research studies.

KB: Absolutely, that’s something I get really excited about. It will totally break open our knowledge base. For example, I have been diagnosed with low-pressure glaucoma, which is fairly unusual. No one knows what causes it. I would love to be able to search the system for anyone with this form of glaucoma and start to look for similarities.

I’d love to be able to do that too, except it would potentially violate the privacy rights of all of those individuals if they hadn’t agreed to specifically let you see their records. If they were to elect to share their information to help others find similarities as she suggested, that would be fine, but we should not assume everyone will do that, and we would have to have a process for this election upon diagnosis.

The first issue to cover is whether the Internet will be used as the medium of record transfer, if point-to-point connections will be established using the phone system or another network, or if an entirely new network will be created to facilitate these transfers, like the financial network. This article assumes the first option, especially since citizens will supposedly have access to the information online.  A separate network would be a much better solution, but would cost much more to deploy.

Why does it matter?

What are the non-privacy-related implications of Internet-accessible health records vs. them being on paper in a drawer? Most of them have to do with hacking, bribery and blackmail. Let’s say someone pays the Database Administrator of the health system $1,000 to change your health records to indicate you saw the doctor about gonorrhea (or they simply use a stolen doctor’s account, or they’re a hacker, etc. etc.). Now, they give you a call, letting you know that they’ll tell your wife unless you pay $10,000. Blackmail is a huge possibility. This is possible now, but only by those who work with patient information physically.

One effect of the centralized hackable database of health records would be the illegal issuance of prescriptions for drugs like Valium, Oxycontin, etc. for a fee. All that would have to happen is a falsified entry into the database, and you can go down to the store and pick up your bottle. I don’t necessarily oppose loosening rules on prescription drugs, but creating a new electronic black market for health record falsification could prove dangerous. After considering this possibility further, it would be possible to remove prescriptions from the system as well, possibly endangering lives.

So we should just use paper?  Come on!

Now, I’m not necessarily against digitizing health records. If each citizen, on the initialization of their record, was given a private key, and all the records were encrypted with the matched public key, and kept in a large central database, that would be fine. Yet, there are problems with this too since in an emergency, the health records wouldn’t be accessible unless the patient was conscious and able to type their passphrase. Therefore, there would have to be an override of some sort, which would destroy the security of the system. This override could be a “health safety deposit box” provided to patients optionally by a private corporation, which would contain their passphrase for emergency use, and would be authorized for query by the living will of the patient. This is the only possible way I can see for centralized health records to be implemented securely, but it seems to be unworkable at the moment.

So what about decentralization, which is what we currently have with paper and with the SAFEHealth system. If the records were kept by the doctor, and encrypted with both his and the patient’s public keys (for patient confidentiality), that would be secure. Of course, assuming the medium of transfer is the Internet, the decryption and changes would have to be done on a standalone computer to prevent the cleartext from being retrievable from the Internet, and any transfer to another office would involve re-encrypting the files with the other doctor’s public key, transferring of the result to an Internet-enabled machine, and the reverse process on the other end to read the records. Because this is painful and time-consuming, doctors and administrative assistants (I like ’secretaries’ better, but whatever) would obviously skirt the security here. And human involvement to decrypt would still be needed in emergencies. I’ve just sent an email to SAFEHealth asking for more information about their system:

Hello,
I’m interested in learning more about how your system works at a deeply technical level. Could you please point me to an explanation of exactly how records are stored, accessed, encrypted, decrypted, which keys are used, who generates those keys, and what network protocols are used to access the information? Thanks.

The only workable solution seems to be the patient signing away the rights of the government to make his/her health records potentially public information. We’ve seen various scandals involving medical industry employees already, like Octomom. Many people would sign this, especially if they went to different doctors all the time. Many people don’t care about their medical records being public, so they’d do it for convenience. But at a process for removal from the system at any time should be available for all patients. A system like this might complicate seeking diagnosis for things like alcoholism, opiate addiction, and mental health for fear that one’s employer might find out about the condition. Any patient should be able to elect to use paper instead, and be responsible for the transfer of his/her medical records to medical professionals for treatment.

But it’s for your own good!

A dangerous assumption is that we must force the patient to allow doctors access to their medical records for his/her own good. The fourth amendment exists to prevent this very thing from happening. It could also be argued that random searches of homes would discover meth labs and would save children, but it is unacceptable in this country because of our natural right to privacy. One way to assure access in case of emergency for those who have privacy concerns is by using a living will to allow access to the paper records assuming they’re filed somewhere accessible. Private companies could provide medical record storage facilities for profit, and could be called in case of emergency need of the records (or as I described before, the passphrase to unlock the records).

If one thinks this article is scathing to the whole idea of digital health records, he/she should have a look at this one.  While some of the same concerns and many more are brought up, different fears are addressed.  The corruption of government employees would also be a danger (which I touched on with the DBA bribe example earlier), but some of the later examples (the police officer having access) are a little unfounded and paranoid.

Microsoft and Google both have products for storing large amounts of health information.  When stories like this are appearing all the time, that really concerns me.  I’ll finish up with a good quote from this article.

“Ironically, HIPAA creates felony penalties if a doctor or hospital abuses the data, but there’s absolutely no penalties for a Microsoft or a Google because they’re not covered by the law,” Brailer said. “It’s nothing that they’re doing wrong. It just shows you the state of mind of Congress when that rule was written 10 years ago, because they never ever envisioned there would be online services managing health information.

“I think that’s a very high priority, because one consequence of the President-elect ramping up people’s attention to this is that people will come back to a lot of their fundamental worries about the protection of their health information,” Brailer said.

I look forward to comments and suggestions for this post.  This is definitely a hot-button issue at the moment, and any constructive criticism will be appreciated, and probably responded to.

Update 4/10/2009

So, Lawrence Garber, Principal Investigator for SAFE Health, and I have had a great email thread going on the security details of their system.  It sounds pretty good, but there are still concerns.  Apparently, they use HTTPS over a VPN, which isn’t a bad solution for network traffic security.  Yet, the last response I received from him indicated the following:

There’s no need or requirement to encrypt the data on the server because it’s within our physically, password-protected, and firewall secured datacenter. However passwords and credentials are encrypted.

So, again, we’re back to the unhackable datacenter with unencrypted data idea, which, from personal experience, isn’t a good idea.

EAST Anglia’s largest independent retailer has announced it is withdrawing knives from sale in all its outlets with immediate effect.  The East of England Co-operative Society said it will withdraw knives from sale in its 135 supermarkets and food stores and five petrol forecourt shops.  It hopes the decision will reduce the risk of knives “falling into the wrong hands” in the communities its stores serve.

American

We are free from enslavement by the government, and each other (well, unless we screw up, in which case the government can enslave us in prison).  We embrace free enterprise, and demonize central planning in business and industry.  We are free to speak and to own weapons (mostly – see Free Speech Zones and the soon-to-be-brought-back-permanently Assault Weapons Ban).  We have freedom of movement within our borders, and many other individual rights that I will not reiterate here.

Un-American

It would be un-American to allow people to enslave other people for any reason.  This includes creating any individual right to any service provided by another individual.  The only exception to this seems to be the right to a fair trial, which binds a judge and possibly a jury to try an individual, yet the right to have others dictate one’s fate isn’t a right that allows the individual to hold power over others, but rather the opposite.  This seems to be necessary for a free society.  It is un-American to prohibit free speech, free movement between territories of the United States, and thanks to Heller, ownership of weapons by law-abiding citizens.  It is un-American to legislate social norms, which prohibit freedom of expression, or to prohibit any free speech that does not direct to incite and is not likely to incite imminent lawless action, search or seize private property without a warrant based on probable cause, etc. etc. Bill of Rights verbatim.

Validity

Yet, is being un-American part of being American?  How paradoxical would that be?  Congress can amend the Constitution, and the proposition of such an action is not un-American.  Does the Declaration of Independence not give us all the right to dissent against a government destructive to Life, Liberty, and the Pursuit of Happiness?

That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness.

So, if this statement is “American,” the un-American equivalent would be to never question your government, no matter how destructive it becomes.  The interesting thing is that questioning the actions of the government (eg. war) seems to be one of the things that is popularly called un-American, or un-patriotic.

A patriot is someone who thinks, feels or voices expressions of patriotism, support for their country.

There is a difference between supporting your country and supporting your government.  Supporting your country has to do with creating the maximum opportunity and protection (including protection of individual rights) for your fellow American, whoever he/she happens to be.  Supporting your government is simply going along with whatever your leaders have chosen to do, even if that happens to be harming other Americans, which is called patriotism, but is more like fanatical nationalism.  Those who are truly un-patriotic express a desire for failure of other Americans, or the infringement of their rights.  Those who are truly un-American reject the existence of unalienable rights to Life, Liberty, and the Pursuit of Happiness, but may be pro-government and nationalist at the same time.  This all depends on the current policies of those in power.  Think about that next time you hear these pejoratives.

WASHINGTON — Rep. Ron Paul vehemently denounced the $410 billion catch-all spending bill approved last week by the House of Representatives.

But although the libertarian-leaning Republican from Lake Jackson cast a vote against the massive spending measure, his fingerprints were on some of the earmarks that helped inflate its cost.

…

His earmarks included repair projects to the Galveston Seawall damaged by Hurricane Ike and the Gulf Intracoastal Waterway.

This makes perfect sense to me. It’s not hypocritical at all, as this article seems to paint it. He’s always done this, and there are good reasons behind it.

1. The federal government taxes his constituents.  They want their money back.
2. He adds earmarks to bills promising funding to the states, then votes against them.
3. Result: His district gets money, and he votes on principle.

It’s like if there’s this big pot of soup that everyone’s about to eat, and Ron Paul tells everyone it has too much bacon, but no one listens.  Then, he lets everyone watch him dump a whole bunch of bacon into the soup, proving it has too much bacon.  He then watches everyone continue to eat the soup, while he refuses to eat it on account that it will give him heart disease.  He added bacon to the soup, so he must be partially at fault if everyone dies of cardiac arrest, right?  No.

To clarify:

1. The soup is the bill
2. The bacon is a load of earmarks
3. Eating the soup is equivalent to voting in favor of the bill

The existence of free speech zones is based on U.S. court decisions stipulating that the government may regulate the time, place, and manner—but not content—of expression.

The same legislation could be passed here! Something should be done to fix this obviously flawed interpretation. The government can legally force you to exercise your right only in the tundra of Alaska at midnight on Christmas. This is obviously not what the founders intended.

Old Version (11/6/2008)

“When you choose to serve – whether it’s your nation, your community or simply your neighborhood – you are connected to that fundamental American ideal that we want life, liberty and the pursuit of happiness not just for ourselves, but for all Americans. That’s why it’s called the American dream.”

The Obama Administration will call on Americans to serve in order to meet the nation’s challenges. President-Elect Obama will expand national service programs like AmeriCorps and Peace Corps and will create a new Classroom Corps to help teachers in underserved schools, as well as a new Health Corps, Clean Energy Corps, and Veterans Corps. Obama will call on citizens of all ages to serve America, by developing a plan to require 50 hours of community service in middle school and high school and 100 hours of community service in college every year. Obama will encourage retiring Americans to serve by improving programs available for individuals over age 55, while at the same time promoting youth programs such as Youth Build and Head Start.

New Version (11/7/2008)

“When you choose to serve – whether it’s your nation, your community or simply your neighborhood – you are connected to that fundamental American ideal that we want life, liberty and the pursuit of happiness not just for ourselves, but for all Americans. That’s why it’s called the American dream.”

The Obama Administration will call on Americans to serve in order to meet the nation’s challenges. President-Elect Obama will expand national service programs like AmeriCorps and Peace Corps and will create a new Classroom Corps to help teachers in underserved schools, as well as a new Health Corps, Clean Energy Corps, and Veterans Corps. Obama will call on citizens of all ages to serve America, by setting a goal that all middle school and high school students do 50 hours of community service a year and by developing a plan so that all college students who conduct 100 hours of community service receive a universal and fully refundable tax credit ensuring that the first $4,000 of their college education is completely free. Obama will encourage retiring Americans to serve by improving programs available for individuals over age 55, while at the same time promoting youth programs such as Youth Build and Head Start.

Interesting…

So, it seems that this form of conscription is acceptable to the American people. I wonder how this will be enforced if it is adopted. The very interesting thing is that we are expecting forced labor from our children before our prison population. If this happens, I will expect to see chain gangs on the side of the road as well, though this will of course not happen since it’s “demeaning” when prisoners pick up garbage and dig ditches. By changing the language from require to setting a goal, he will win more people over as it doesn’t sound like forced labor, but that’s still basically what it sounds like to me. At least he got rid of the 100 hour per year community service in college in the newer version, which removes the possibility of making income to pay for school for that time.

He also cites that the average college graduate has $19,000 in debt, which apparently he thinks is a bad thing. That is a very manageable amount of debt, especially for someone who will almost definitely make $30,000+ their first year of work after college. The payments on that debt will likely be fairly small, and if the person has good spending habits, they should be able to pay it off in just a few years. The interest, which for figuring I’ll guess is 8%, is only about $1600 a year, so assuming they can put in an extra $4000 per year towards the principal, which most people with a degree can, you’re looking at paying it off in less than 5 years. Having the equivalent of debt that comes from buying a new car is nothing to be worried about. In fact, if these college graduates did the exact opposite of what most of them do and actually buy a used car after college, they will be able to focus their earnings on the debt they already have. If anything, Obama should be pumping money into initiatives that persuade people to avoid unnecessary debt.

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