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That’s a key claim in President Obama’s health care plan — actually, it was a key claim of John McCain’s plan as well. It doesn’t take any acute powers of observation as a patient to notice the places where data has to be re-entered by a new doctor or hospital, or where important data isn’t available and the patient is asked to report it instead. (I was once asked about the results of a cardiac stress test I had had three years before, of which I had only the vaguest memory.) It’s reasonable to hope that computerized medical records could do for delivery of medical care what, say, computerized parcel records have done for parcel delivery.

But it’s also easy to dream of a perfect world that is unlikely to be reached or to look like the dream once we get there. And that is the bottom line on a good Wall Street Journal column by noted physicians Jerome Groopman and Pamela Hartzband, Obama’s $80 Billion Exaggeration. The $80 billion number, they report, comes from a four-year-old RAND Corporation study with a lot of wishful thinking and not a lot of data. The doctors raise a privacy concern, too — not that the data will be mishandled and leaked, but that the entire enterprise is in part designed as a monitoring program by the federal government.

Some have speculated that the patient data collected by the Obama administration in national electronic health records will be mined for research purposes to assess the cost effectiveness of different treatments. This analysis will then be used to dictate which drugs and devices doctors can provide to their patients in federally funded programs like Medicare. Private insurers often follow the lead of the government in such payments. If this is part of the administration’s agenda, then it needs to be frankly stated as such. And Americans should decide whether they want to participate in such a national experiment only after learning about the nature of the analysis of their records and who will apply the results to their health care.

The suggestion that the government will want to chew on the data to try to figure out what works is unsurprising. But it surely hasn’t been highlighted, and it raises some fundamental questions. What is the data in my medical record going to be used for, how long will the data be kept, and can I be sure it won’t be repurposed?

Twitter is the the new hip tool with which you can blast all your friends with quick updates on what you are doing. The messages must be short and only text, but type a few characters and hit the button and there they go, onto the screens of a hundred of your closest friends. The standard use is to invite people into your daily life: What are you doing RIGHT NOW?

Different folks may have different views about the social thrill of learning that their friends are eating donuts in Walla Walla or are enjoying the view of the Grand Canyon (except they aren’t watching at all since they are thumb-typing instead). But sometimes you really, really shouldn’t twitter, no matter how excited you are to share with a few special friends the wonderful news about what’s happening to you.

Like for example if you are a US Congressman on a top-secret diplomatic tour of Baghdad. No, bad idea to twitter then. You see, when you twitter, what you say isn’t secret. In fact, do I really need to explain that the reason for twittering is to tell lots of things to lots of people, which then pretty much inevitably become not secrets? You can read the rest of the story, including the tweets of Congressman Pete Hoekstra (R-MI),¬†here. He even announced the time he would be entering the Green Zone. A big help to the soldiers charged with keeping this genius safe on his trip.

I wouldn’t want to suggest that the Republicans are having more trouble than the Dems, but it’s less than a 1 in 4 chance that both Congressmen involved in spilling the beans via Twitter today are members of the GOP. Jeff Frederick of Virginia announced in an elated tweet that State Senator Ralph Northam was switching from Democrat to Republican. Except that, oops, the tweet fell into Democratic hands, and Northam’s colleagues waterboarded him until he changed his mind about changing parties. (OK, that last part about the waterboarding was just a metaphor, but the rest is true.)

Guys, tweets are public. Don’t get carried away by the metaphor that because it’s so easy and quiet it’s a neat way to share secrets. You aren’t whispering into the ear of a trusted confidante, you are screaming it from the mountaintop! Or to put it more succinctly: Grow up.

Thanks to MIT student Xiao Xiao and to Hal Abelson for these pointers.

Well, not the moose itself, but the author of the book about it, will be speaking at Harvard this coming Tuesday at 5pm, in Austin Hall. As I blogged earlier, David Post’s book is a wonderful rendition of the ways in which the dilemmas that faced the founding fathers about how to empower the people without having everything decided by mob rule are being revisited because of the Internet. Should be a great talk.

A standard philosophical posture taken on privacy issues is that choice is what counts. If you have a choice between sharing information and not sharing it, the burden of responsibility shifts to you from the entity (usually a corporation) that collects the information. If you don’t like the way your information is being shared, you have only yourself to blame.

Hogwash. It all depends on the default: Do they share UNLESS you tell them not to, or do they share ONLY IF you explicitly tell them it’s OK? Almost no one ever changes the default — because, practically speaking, almost no one ever reads the fine print in which the default is stated. So most people have to depend on the ethics and good taste of the company, and that is rarely enough.

Though these are old saws — read the part of Blown to Bits where we discuss Sears Holding Company — rarely does one ever see a case quite as egregious as what David Weinberger describes about Verizon. Not only is the opt-out barely whispered, it is almost impossible to find and to make functional, even if you follow Verizon’s instructions exactly. A short, quick, funny, and infuriating read. And maybe I’m wrong about this being rarely seen — maybe it’s just that few of us have the patience to do what David did to chase it down.

Cable television networks are beginning to experiment with targeted advertising. Cablevision is trying out an indirect method. They buy data about their customers from Experian, which aggregates data about individuals for use in credit checking, etc. Once Cablevision knows that there’s no one over 30 at your address, or that you’re a single woman of 45, it can avoid showing you the “I’ve fallen and I can’t get up” ads. As Marc Rotenberg of EPIC agrees, there isn’t really any privacy breach here, yet. But the article continues,

[A competing technology] uses data from remote controls to follow what a person is watching, then matches that with ratings information and program guides to infer that person’s gender and age. It can use census data or data sources like Experian for further refining. Then, it shows an appropriate commercial.… Eventually … the company will be able to identify who is watching based not just on what they are viewing, but also how they watch it: whether they channel change frequently or not at all, or immediately turn to CNN or to Bravo. That will help it show the right ads in households where multiple people watch television.

Watching me watching you, as the song says.

Debit cards are just like cash, right?

So a guy goes into a convenience store in West Virginia, gets a soft drink and waits until the store is empty except for the cashier. Then he tells the cashier he has a gun, and demands that the cashier turn over the money in the cash register.

Then a customer comes in, interrupting the robber’s plan. The cashier tells the hold-up genius to pay for his drink. The guy turns over his debit card, the cashier swipes it and hands the slip to the “gunman” to sign. Being no dope, he protects his identity by signing “John Doe.”

The guy is under arrest. He says it was just a joke.

A few months ago, a physician who attended one of my talks started a correspondence with me about sites in which patients critique doctors. Anonymously, sometimes ungently. And sometimes by making statements that are false and injurious to the doctor’s reputation. That’s the definition of libel. What, I was asked, can be done?

There are, of course, many sites where anonymous garbage gets posted — think rottenneighbor.com or dontdatehimgirl.com. But a site such as¬†RateMDs.com¬†– the libel is discrediting a laboriously earned professional credential, in a way that could cost physicians their livelihood.

This is a classic case of the problems of anonymous speech. It should generally not be believed, unless there is some evident reason to think that the speakers could be imprisoned if their identities were known. Otherwise, with no skin in the game, why wouldn’t the speakers identify themselves, except to shield themselves from libel charges? It would seem that their confidence in their speech is very low if they hide themselves.

And yet anonymity has always been protected. Whistleblowers may have all kinds of reasons to want to get the truth out without spending their lives defending what they say. Ben Franklin wrote pseudonymously, even when he was just writing his almanac and had no political ax to grind. And so on. Courts generally are protective of online anonymous speech, and won’t force web site operators to reveal the names of their posters. Laws banning anonymity — though they do get proposed every now and then — would almost certainly be unconstitutional.

Now comes a free-market solution. Medical Justice provides waiver forms that doctors can ask their patients to sign. Sign the form and you agree not to malign the doctor on any web sites. Don’t sign the form and you can perhaps expect to be told that you might prefer to see another doctor. At least the doctor will be armed with a signed release from you if he or she tries to get a site to remove something unkind you’ve said.

Now this is a free-market solution, only if there is real competition in the doctor business. In a rural town with only one doctor, there may not be. In that case, the choice would be waiving your right to criticize the doctor, no matter how incompetent or unmannerly he or she proved to be, and forgoing treatment.

I tend to go with those, like the patient advocate quoted in this story, who find this practice noxious. Though you shouldn’t believe anonymous speech, this way of handling the problem blocks speech indiscriminately, the true along with the false and libelous. One can imagine all kinds of professionals asking clients to waive their rights to speak up. Even though only anonymous speech is at stake, the price seems too high.

But the doctors who use these forms are within their legal rights. So how to fight back? With more speech. RateMDs.com is planning to create a “Wall of Shame,” listing doctors who make their patients sign waivers. Whatever you think of the criticism, or libel, of doctors on that site, that’s a fine approach to fight the doctors’ attempt to gag their patients.

Some teenagers are being charged under child pornography laws — extremely serious charges — because they passed around a cell-phone nude photo of another teenager. (Quite the rage, apparently.) What if Mom and Dad bought the perpetrator the phone? Are they in trouble too?

No one can say for sure, of course, but in civil court you can sue for anything and see if any money shakes out. Here’s an interesting discussion of the possibilities.

As an academic exercise this is a wonderful example of the dilemmas that come from giving everyone a free printing press, capable of producing a million copies at no cost. And, of course, the weird fluctuations in the meaning of “privacy” in the digital age. Parents need to talk to their children about cell phones — but that is not easy if they can’t talk to their kids about anything else!

This is the sole case of copyright infringement by downloading that had actually gone to trial, prior to the case of Joel Tenenbaum in which Professor Charles Nesson is active. The Thomas case, which we discuss on page 198, is being re-tried after the judge threw out the first decision. Today Thomas’s expert, Prof. Yongdae Kim of the University of Minnesota, filed his report, which includes a strong attack on the evidence against Thomas and also on the report of the opposing expert. The site “RIAA v. the People” has a good summary, and a hotlink to Kim’s full report. For me the killer sentence is this:

MediaSentry claims to have much experience in identifying individual committing copyright infringement. However, they insist that their methods are proprietary and thus cannot be subject to scrutiny by an impartial third party. No academic studies exist of their internal investigative techniques, methods, software, data collection practices, or even employee training in retaining collected data in a way that would allow for it to be used as evidence at a trial.

MediaSentry is the private police force of the RIAA, of which Nesson also complains. How on earth can one defend oneself against a private investigator who makes a claim about what you did but says that its methodology for gathering the evidence is proprietary and even the judge can’t review it?

On Saturday I spoke at a Harvard Club event in Baltimore. In the audience was Ruth Glick, a romance and suspense novelist whose pen name is Rebecca York. She blogged my talk here. The hilarious part is that she says the cell phone causes her problems as a novelist: she has to keep coming up with excuses for why people can’t get in touch with each other! Makes sense — suspense requires a degree of isolation, and that is no longer a phenomenon of daily life, all the scary Verizon ads about dead spots notwithstanding.