Wednesday, October 28, 2015

Today by Michael Lucy

The recording angel
A new health information system should remind us of the pitfalls of big data

Thirty years ago, the Hawke government proposed a single national identification system, to be called the Australia Card, that would bring together government records for each citizen in one place. The idea was to cut down tax avoidance and reduce health and welfare fraud. The legislation was blocked by the senate, and Hawke called a double-dissolution election in July of 1987, which Labor won.

The card had not received a lot of coverage in the run-up to the election, but afterward a campaign against it began, centred around privacy concerns. (The campaign started with a meeting at radio host Alan Jones’ house, and grew into what is now the Australian Privacy Foundation.) Public support for the card dropped from 55% in August to 39% in September; an editorial in the Australian said “there has never been such a cry of opposition form the nation over one topic”. Hawke soon abandoned the proposal.

In following years the government quietly expanded the role of the Tax File Number to achieve some of the tax enforcement goals and dropped the rest of the plan. The idea of a single record for each person in Australia is still a tempting one to governments, for obvious reasons. Having all the information gathered neatly in the view of one all-seeing eye makes administration simpler, for one thing; for another, it shrinks the realm of life outside the government’s purview. It would also bring together what each person contributes to government revenue (tax) and what they receive in government expenditure (health and welfare).

John Howard revived the idea, this time as a counter-terrorism measure, after the 2005 London bombings. In 2006, Joe Hockey (then the health minister) announced plans to come at the problem from the other side: health and welfare. The Medicare card would be supplanted by something called the Access Card, which would be required as identification for all government benefits, including Medicare. The idea was unpopular, and the Rudd government ditched it after the 2007 election.

This seems relevant today after the announcement by health minister Sussan Ley of a new trial of the My Health Record electronic health record system, which allows patients to keep all their medical information in one place and take it around to various doctors as they like. If all goes well, the scheme is projected to save $2.5 billion over the next ten years.

The trial will cover about 1 million people in Queensland and NSW, and $485 million has been set aside in the 2015-16 budget for development of the system. This scheme was initially tried out in 2012 by the Labor government (as the Personally Controlled Electronic Health Record), but was criticised because people had to opt in to the scheme. The new trial will be on an opt-out basis: if you live in one of the trial areas you will be included unless you deliberately choose not to be.

“Why can’t we allow someone’s doctor to use an app developed on the free market to monitor their patient’s blood pressure at home?” asked Ley in her announcement. “We can, and allowing consumers open-source access to their health data is the way to do it,” was her answer.

This time around the push for centralised data collection comes with Turnbullian rhetoric of the agile free market, but the unanswered questions are as troubling as ever. Who will be able to read the data? How long before health insurers make access to the information a condition of coverage? How confident are we that the database can’t be hacked? Which government agencies will have access, and under what conditions? What are the safeguards, basically? And do the benefits outweigh the risks?

As the recent introduction of compulsory metadata retention should remind us, we are in the midst of the transition to a world dominated by big data: soon (perhaps as soon as now) all our actions will be recorded somewhere. And once they are recorded, it only makes sense to put them together into databases that can be mined for useful information. (I say “it only makes sense” because this is literally the logic: if a thing is technically possible and might turn a profit, it will happen.) The government, for instance, is implementing a vast facial-recognition system with the almost comically dystopian name of “the capability” that will store and cross-reference tens of millions of photos, and may well crawl your Facebook page to check your latest haircut. Companies like Telstra are taking elaborately detailed customer profiles to “potentially creepy” levels.

The data is out there, and it can’t be taken back. There doesn’t seem to be a lot of opposition to governments and companies using it as they see fit. Thirty years ago, public concern over privacy was enough to change the course of a government; now the idea of privacy is becoming difficult even to explain, let alone defend. This is perhaps the second great revelation to come from the leaks of Edward Snowden and co: not only are we under constant surveillance, but for the most part we don’t care.


Today’s links

  • Tony Abbott last night gave a speech in London about the importance of turning away refugees. It included a specific rejection of Jesus’ famous injunction to “love thy neighbour as thyself”, and Catholic priests are not impressed.
  • The PM says a GST rise is in his sights.
  • Full-time workers are increasingly working more than the official 38 hours per week.
  • South Australian senator Nick Xenophon’s new political party may be causing some anxiety in Canberra.
  • The United Nations has called on Australia and Nauru to sort out the case of Abyan, the pregnant Somali refugee, urgently.

Michael Lucy

Michael Lucy is a writer based in Melbourne.



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