Government Innovation: Life (Part 1 of 3)

Life. I’m not talking about Oprah’s version of the BBC and David Attenborough’s Planet Earth. I’m talking about what is perhaps the most fundamental of rights granted to any person by positive law, natural law, social contract or any other system we could use to quantify rules and rights.

Our right to live is the cornerstone of ensuring a prosperous and sustainable society. Animal hierarchies decide and categorize social interactions to lessen violence and death and our laws seek to do the same. Life, however, has not always been a given right in human civilization and has not even extended to all people for the entire history of this country.  People from various political persuasions would argue that today, in the United States, our right to live is threatened by either the death penalty, poor healthcare, violence terrorism and war, abortion, poverty, poor nutrition and the list goes on.

And we expect our government, even the most libertarian among us, to protect our lives. We generally expect police/fire/emergency management services, a military and the most basic regulations to ensure that we don’t die as easily as some wouldn’t mind us to.

Personally, I would consider that protection of life extending to healthcare, including diet and nutrition, certain consumer regulations, like seat belts and pharmaceutical regulation, and the ability for us to live in a society where violence and death are not accepted forms of social dynamics.

So, we have arguably the most powerful military in the world. We have over one million police officers employed throughout the country. We have an unbelievably responsive 9-1-1 system that sends emergency personnel to your doorstep in minutes in most of the country - without asking how much money you have or insurance information or whether you paid your taxes or even voted (Except in South Fulton, TN). Not bad.

But the biggest gap that is readily visible is the health of our country. This lack of attention being paid to health is causing epidemic obesity and diabetes rates, steadily climbing rates of sexually transmitted diseases, emerging strains of antibiotic resistant bacteria and exploding rates of conditions, from cardiac issues, strokes, cancer, and of course, traumatic injuries.

And we don’t even provide the infrastructure to encourage people towards preventative care and personal responsibility.

Some argue the market will handle this. However, the facts are simple: We spend more per-capita and get less than other developed countries because we are allowing the private sector to cash in on our lagging health by discouraging cost-saving preventative measures.

We are putting the onus on the emergency medical system to pick up this slack, which ends up being astronomically more expensive and time consuming than if we had approached these problems from a proactive perspective. 

But by using technology, without even tackling the larger issues that are wrapped up in the all too ubiquitous mindless political posturing of our time, the government can take major steps towards improving this system and helping us improve our health and reduce the strain on our economy and healthcare system.

Allowing consumers total control over their healthcare information, as the VA is beginning to do with their ‘blue button,’ where people can download all of their medical history from the VA website, and then take that information, do with it what they will, is a great way to put a little control back in our hands. 

Modernizing patient care by switching to electronic charting, where medical records are kept on computers, will prevent errors from being made, save medical staff time and will save us money. Electronic records are cheaper, easier, transportable, downloadable and secure. We need to re-imagine the government’s role in e-charting as a springboard for developers to create the innovations that we can use to modernize our healthcare system. Should we tell the government to create this system? Not necessarily. But should we tell our government to ensure that data is accessible so that 3rd parties can create new innovations? Absolutely.

Even by expanding broadband internet, public libraries and educational resources to more people, we can help ensure people have all of the information to make the right decisions. Of course wrapped up in a larger discussion of a failing education system that doesn't teach people how to (a) find information and (b) make their own decisions, the idea that people should be able to realize what is healthy is critical. By releasing government data for reconsumption and sharing, we can allow third party innovators create meaningful web-based informational resources on personal health, how to choose the best healthcare providers and more.

None of these issues will solve the problem. They are but the tip of the iceberg of apolitical technology-based solutions that save money, improve efficiency and make the government more transparent and accountable.

Todd Park, the Chief Technology Officer for the U.S. Department of Health and Human Services said it best with an interview with NPR, "I think everyone, I would presume, is in favor of better informed consumers. Everyone's in favor of healthy Americans, everyone's in favor of more functional marketplaces. I mean it's not a political thing, it's an American thing."

Furthermore, healthcare is but one of a dozen fields that we can improve the government’s life-saving directive by using open technology. What are some ways you think government can better protect our lives using technology?

Healthcare Reform - Defining Socialism, Communist and Fascism

In light of the furious debate around healthcare reform, and some people advocating the definition of healthcare reform (that sets a minimum standard for government regulation to spur competition in private markets to improve access to a private service) as either socialist, communist or fascist is misleading at best. I would like to provide some context to what these terms actually mean. Granted, these are not perfect definitions, as each term has libraries of literature written about them and I am not nearly educated enough on history to provide that deep of an analysis. However, I hope these will suffice as at least a very basic understanding and context for what each of these terms means.

Socialism - An economic theory or system where wage labor and private ownership of the means of production and distribution of goods/services are replaced by total public ownership and operation. In a socialist economic system, the means of production and the forces both driving production of goods and providing of services is entirely owned publicly, for example through direct government control and ownership. This is different than government regulation, which seeks to provide standards in private markets operated and controlled by privately owned entities. Some (Karl Marx for example) define this at least partly as a system which advocates the maximization of use-value as opposed to exchange-value. Some also believe socialism is a transitional phase onward to communism. In application, socialist nations tend not be able to harness the rapidly innovative forces that exist in the free market. | See: Venezuela, Bolivia, China.

Communism - Theoretically, communism is a classless, stateless way for a society to be organized free of oppression and private markets, commodities or property ownership. In practice, communist principals have been attempted to be implemented by authoritarian states like the Soviet Union and China. Some theorists believe that communism is the final stage of societal evolution, however, in practice, the application of this theory has lead to massive corruption, oppression and a stronger institution of class structure and hindering the advancement of free market structures in producing innovative goods/services. | See: China, Cuba, North Korea.

Fascism - An authoritarian state that promulgates the advancement of a singular collective nation-identity, often based on either economic status or race, above all else. A centralized state structure that absolutely oppresses dissent, (often violently) democratic civic involvement and seeks to control information and economic and political activities with violent force and propaganda. | See: Nazi Germany, Iron Guard (Romania).

Healthcare reform falls in none of those categories. To debate this issue and ensure that we are implementing the most effective public policy is a necessary piece to the workings of our democracy. However, using terms like the above to try and re-classify something to make it sound like something it is not for political gains is an embarrassment to the democratic process of our free market of ideas.

Instead of battling over political ideology, and using any means necessary to preserve or advance one ideology over another by creating what might be repeated best in a soundbite, we must engage in a truly open, free, educated and rigorous debate on the issues that face our society. Only then we will be able to truly work towards solutions that, rather than benefit a political ideology or platform, will be for the benefit of each and every citizen within our democracy.

(1) Newman, Michael. (2005) Socialism: A Very Short Introduction, Oxford University Press, ISBN 0-19-280431-6

(2) Oxford English Dictionary

(3) Merriam-Webster Dictionary

(4) "Communism". Columbia Encyclopedia. 2008.

(5) Lyons, Matthew N.. "What is Fascism? Some General Ideological Features". PublicEye.org. Political Research Associates. http://www.publiceye.org/eyes/whatfasc.html.

Objectivity, News and Healthcare

After the healthcare summit last week, these were the leading headlines on the three major news websites:

FOX: GOP comes out swinging.
CNN: Spirited but civil debate at healthcare summit.
MSNBC: Tempers flair at Obama's healthcare summit.

Each of those titles is really very different. It isn't even that one is 'liberal' and one 'conservative' necessarily or that two are stark opposites of each other. Each network just reached an entirely different conclusion as to how to summarize the summit in a one line title.

In a way, this isn't all bad, as for all news to report the same thing seriously risks discourse and debate being lost in our culture. Having a culture with a singularity around any field of knowledge is a serious impediment to progress and democracy. However, many people do watch one of those networks (or any news source, for that matter) as objective fact. But asking networks to be 100% objective is probably an impossible task as even TV anchors unconsciously give subtle clues to their own personal feelings in their posture, tone of voice and hand gestures. So the problem is not really the lack of subjectivity, but rather that these networks and news services claim to be objective (Fair & Balanced, anyone?) and therefore many people watch them expecting an objective analysis and don't place what they hear in a larger context.

There is nothing wrong with getting news from any of these sources. However, everything must be placed within the proper context of who is doing the reporting. This is another way that context is incredibly important in our society in terms of understanding information that it is presented with. To hear a soundbite and know whether it came from MSNBC or Fox News helps people understand better what they are hearing.

I can only keep my fingers crossed that one day Fox's 'Fair & Balanced' would change to 'Leading Conservative Provider of News.' Does anyone really believe after looking into the issue that Fox is fair and balanced? I hope not. And admitting a political inclination is not a bad thing at all. It's honest. Internet news sources seem to get quickly pinned as liberal or conservative and thus readers can try to place what they read in the proper political and cultural context, and we need to encourage networks to be honest and help people place what is reported on in a better frame of mind.

The Costs of Waiting

When thinking about investing money in infrastructure (whether physical, political, educational, etc) like healthcare it's important to frame the context in which this debate is being held. Let's be honest: our current system will change, probably quite often until some sort of equilibrium is reached, and then it will just change again. The idea of changing something we have now should never, ever be controversial.

Unfortunately, a counterproductive practice people tend to exhibit, that has been more recently explored in the field of behavioral economics, is peoples' misperception that waiting costs nothing.

I find the phrase 'status quo' interesting, because, in reality, it doesn't exist. Nothing is ever not changing in some way. The changes may be small or may seem unrelated, but they are not. And in terms of healthcare, the costs are enormous as emergency rooms become more overcrowded and more American families are faced with the horror of not having the ability to ensure the safety and health of their loved ones.

I am not even advocating a particular solution, and in fact, none of the solutions we have are perfect, and they never will be, but as science moves forward exploring and learning, so must we in public policy. And part of that is realizing that waiting has costs just as much as bad policy does, maybe even more. Not everyone will get exactly what they want out of this debate, but let's think about how we can best move this policy forward and help cover more of those 47 million uninsured Americans.

President Obama Wins Nobel Peace Prize

Internet media especially is in a frenzy today as everyone looks to get in their word edgewise on Obama's, what turned out to be controversial, winning of a Nobel Peace Prize. The award came at a time when Obama is facing crucial decisions regarding troop levels in Afghanistan.

Many Obama supporters hail this as a landmark occasion where the international community has finally recognized Obama's ideas and vision for a more peaceful and diplomatic world where working with other nations and cultures is seen as a priority rather than a drag on international relations.

Conservatives, and a fair amount of Obama supporters, on the other hand, feel that this award was issued far too early, at best, and cannot possibly be based off of his record because nominations were due for the award almost immediately after he took office.

Others even may say this award comes at an awkward time, as a NASA rocket was just launched into the moon. (Though for peaceful purposes. For now. You're on watch Moon.)

Although both sides have a good point, it seems to have brought to light two very important points:

First, Obama has not yet delivered on his campaign promises of bringing peace, withdrawing troops and shutting down Guantanamo Bay. Granted, he has not been in office a very long time, and to make such large changes considering the past eight years requires a lot of political capital that he may not have yet. But unless he can constructively shape this healthcare debate, he may have trouble gaining that much-needed capital.

Second, conservatives and the Republican Party seem that they would rather see Obama fail than see our country succeed. That definitely doesn't apply to everyone who considers themselves right of center, but 'mainstream' American conservatism has definitely picked out Obama as a target, for whatever reasons, and celebrate his failures, like when Chicago lost out for the Olympic bid. What happened to the standing beside your President in tough times, a mantra oft-repeated during the Bush years?

My take on it? Regardless of whether or not he should have been awarded the prize now, I am confident that by the time Obama leaves office he will have demonstrated that he does indeed deserve a Nobel Peace Prize.