Tuesday, December 10, 2013

560 Major world authors: A society under surveillance is no longer a democracy

Mon Dec 09, 2013

So says 560 of the world's leading writers in an Open Appeal they signed: "A Stand for Democracy in the Digital Age"

[Since this is an Open Letter, and there is no copyright at the site I've copied from, the Open Appeal is posted in full. If there's a problem, someone let me know.]

In recent months, the extent of mass surveillance has become common knowledge. With a few clicks of the mouse the state can access your mobile device, your e-mail, your social networking and Internet searches. It can follow your political leanings and activities and, in partnership with Internet corporations, it collects and stores your data, and thus can predict your consumption and behaviour.

The basic pillar of democracy is the inviolable integrity of the individual. Human integrity extends beyond the physical body. In their thoughts and in their personal environments and communications, all humans have the right to remain unobserved and unmolested.

This fundamental human right has been rendered null and void through abuse of technological developments by states and corporations for mass surveillance purposes.

A person under surveillance is no longer free; a society under surveillance is no longer a democracy. To maintain any validity, our democratic rights must apply in virtual as in real space.

* Surveillance violates the private sphere and compromises freedom of thought and opinion.

* Mass surveillance treats every citizen as a potential suspect. It overturns one of our historical triumphs, the presumption of innocence.

* Surveillance makes the individual transparent, while the state and the corporation operate in secret. As we have seen, this power is being systemically abused.

* Surveillance is theft. This data is not public property: it belongs to us. When it is used to predict our behaviour, we are robbed of something else: the principle of free will crucial to democratic liberty.

WE DEMAND THE RIGHT for all people to determine, as democratic citizens, to what extent their personal data may be legally collected, stored and processed, and by whom; to obtain information on where their data is stored and how it is being used; to obtain the deletion of their data if it has been illegally collected and stored.


WE CALL ON ALL CITIZENS to stand up and defend these rights.

At what I take to be the website for this we can read the background on this group's formation:
Public Intervention: 560 authors from 83 countries have signed an appeal against mass surveillance.
There is hardly any issue more pressing than systematic mass surveillance and the dangers it poses to democracy and civil liberties.

Under the name "Writers Against Mass Surveillance", a small group of authors has formulated an international appeal, signed by more than 500 renowned authors from around the world, including five Nobel Prize Laureates. It calls for an "International Bill of Digital Rights,“ demands that the United Nations passes a binding convention to protect civil rights in the digital age and calls upon all citizens to stand up and defend these rights.

It is noted in the Huffingtonpost  account that an attempt is going on right now to weaken a U.N. Digital Rights resolution, lead by the US, with our puppies the UK and Australia coming along on the effort.

The US and UK are probably the most surveilled societies on earth at this point. In all of human history. Who needs to turn family members into rats when you can get everyone to turn themselves in just by living. Orwell looks like a piker of the imagination in his fantasy of how far this kind of thing would go.

(More below the DailyKos fleur.)

So two points to make about this:

Yes, please, we have to stay centered in our humanity above all. And that means 'privacy' today is pretty much what the humans behind 'privacy' at the nation's founding meant.

Then, there was paper and talking if you wanted to say anything. It was resolved that there would be no interference with personally-generated papers and speech among people. The object was the person's freedom to express. The object of that being to let the best ideas and courses be heard, and develop, so we can properly self-govern. Democracy, in short.

The fact that we now communicate with the additional option of electrons does not change the requirements of a real democracy. Nor of the human need, and right, to feel space to express ourselves about serious matters.

The idea that 'it's out there and whoever can get it will' ignores that we can as easily write software to instantly obliterate traces as it is to track them; or laws to forbid looking at such traces. The idea ignores that takes a deliberate act of will and commitment of material resources to keep hold of data. That can simply be forbidden.

If a business wants to make money from my existence, and my doings, then first get me to agree in principal to my participation, Then lets talk about what fees and royalties I get.

If government suspects a crime, get a warrant based on probable cause and have at it. Stop pissing away vast resources to catch little to nothing, except the free soul of the people.

Someone looks through your window to see what you're typing, someone puts a line into your phone, someone follows you on the streets, looks at your purchases, sees who you talk to, monitors your activities in public.... in real life we call that 'someone' a Stalker.

Just because there's electrons involved doesn't stop it from being Stalking.

The other thing is an experiment I have in mind.

I think we'd all have our minds boggled if the Media were to promote this Open Appeal event with any intensity at all.

Soon after President Jimmy Carter told (Spiegel I think it was) that "The United States is not a functioning Democracy" I thought a test of whether or not the much-vaunted internet, ...

...which will change everything for the last 20 years, but hasn't changed the 1%s victorious roll-over of Democracy...

could be a base from which to hound the mass-reach Corporate Media with "We want to hear more about what the President has said, and what it means, and if it's true." Until they started talking about it as a top story for a long time.

Pres. Carter's statement, not so many years ago, would have been a 'newsflash' 'stop the presses' kind of moment. They walked right by it though, as if it never happened.

So low have we fallen.

What if we, on the internet, brow-beat our media outlets until they were forced to cover the story; forced to interview Noble Prize winning authors; .... Or can they be forced?

An interesting test of our prowess, no?

Originally posted to Jim P on Mon Dec 09, 2013

Monday, December 09, 2013

The ACA: An Emergency Room Workers Perspective

By ERdoc in PA on Thu Nov 28, 2013

One of the more hackneyed and deceptive statements throughout the Affordable Care Act debate was how we have “the best healthcare delivery system in the world”.  I’ve been an ER doc for about a decade, and I know from first-hand experience that it just ain't so.

But what really stuck in the collective craw of emergency physicians was the glib response to the lack of insurance coverage for millions.  More than one politician suggested that people could always go to the Emergency Room.  Uh huh.  News flash:  Emergency Rooms are for, you know, emergencies.  When folks visit the ER for conditions not deemed to be life threatening, well-intended providers often don’t fix the problems, or even dig deep to figure them out – there just isn’t time or resources to do it. And poorly-treated, less dangerous conditions can sometimes blossom into full-blown disasters. Without insurance, and therefore without access to non-emergency providers, these situations become very expensive, and… they can kill. The ACA, bringing many patients under the umbrella of coverage, will avert the severe outcome for many.

Consider the orange squiggle the front door to my Emergency Room on this Thanksgiving day.  Push through, and let me introduce you to a few patients (of course, all names and details are altered from actual cases, but I assure you, people just like these are extremely, painfully real).

It’s 10:35 AM on this Thursday morning, but the ER is full of activity.  Nurses and physicians scurry about, patients are wheeled into rooms on gurneys, overhead announcements blare.  A colorful plastic blow-up turkey sitting on the registration desk is one of the few signs that this is a holiday. 

Let’s visit Room 22:

Sitting in the exam room is John.  He is 48 years old, a married father of two girls.  He was the breadwinner until he lost his job at a call center, and is currently looking for work.  His wife Lauren works part time as a teacher’s assistant.  They have no health insurance currently, and are trying to get on the Medicaid rolls.  John is not thrilled to be in the ER, but went at Lauren’s urging– he has been having occasional shortness of breath and nausea, especially with exertion, and it’s getting her worried.  He feels fine right now, but with their extended family visiting for the holiday, she wanted to make sure he was alright.  He resisted for a week, but finally relented. 

John doesn’t have known medical problems, and his symptoms are fairly vague: no chest pain, no physical exam findings.  The provider team obtains blood tests, an EKG, a chest x-ray – and everything comes back normal.  Since he feels fine after a few more blood tests over the next four hours, the physician on duty says that he can go home…. with the strong recommendation that he get a cardiac evaluation as an outpatient.  It could be a coronary artery blockage, the doctor tells them.  In the modern U.S. healthcare system, there is no way a guy like John gets admitted to the hospital for evaluation.  And without coverage, John can’t get to a specialist or undergo expensive outpatient cardiac testing, so he and his wife wait, and hope for the best. Once he gets back in the workforce, they reassure themselves, they will get him to a doctor.

Two weeks later, John is helping clean up the house, and his shortness of breath comes on hard, only now it is accompanied by crushing chest pain.  Lauren calls 911, and an ambulance rushes John back to the ER.  He is diagnosed with a heart attack, and undergoes immediate (and expensive) cardiac catheterization to open up a clogged artery.  Turns out, the shortness of breath and nausea were subtle signs of coronary blockages, extremely common in the U.S. population – but when he visited the ER on Thanksgiving, the blockages had not yet caused a myocardial infarction (MI), the technical term for a heart attack, so his tests were normal. Although John’s heart sustained damage from the ensuing MI, he is luckier than thousands of Americans who share his story – in many such patients, the MI triggers cardiac arrest, a condition that is lethal in over 80% of victims.  And John wanted to do the right thing: with expanded coverage under ACA, John would have seen a specialist as recommended.  His coronary blockage would have been diagnosed, and medication would have been started to help prevent the ensuing attack. Taking these cases in aggregate, the ACA would very literally save lives.

OK, one more example – let us visit Room 31.

Emily is a 28 year old waitress.  Hard working and ambitious, she is saving up for graduate school.  She is currently uninsured, because for her the choice is either buy health insurance or save for her future education.  She is visiting the ER today with irritating abdominal pain that just won’t go away. In fact, this is her third ER visit in two months.  In two other ERs, Emily underwent blood and urine tests that came up empty. Given her age and mild symptoms (no fever or vomiting, for example), neither an ultrasound nor a CT scan was justified.  The recommendation to follow up in a clinic was of course useless to Emily.

Repeat visits to different ERs are a common and costly problem. With our fragmented healthcare system comes another nasty inefficiency: precious few ERs enjoy linked health care records.  Since the process of contacting medical records departments at other hospitals (usually closed on weekends and holidays, anyway) is time consuming, most ER providers don’t bother to do this for well-appearing patients – so they repeat the same battery of tests that were performed a week prior at another ER, if only they could have checked.

Today, Emily again receives blood and urine tests, all negative.  She is frustrated, but the providers don’t have any answers.  She asks for an x-ray or CT scan or something, anything, to figure it out.  My ER colleagues explain to her in sympathetic voices that it’s not medically indicated, but a primary care provider could maybe set her up for additional testing.  Emily shakes her head in frustration, signs her walking papers, and goes home.

Emily finally makes it to the free city health clinic, where an abdominal ultrasound is ordered.  However, it takes a month in the queue before she actually gets one performed since the free clinics are completely overwhelmed with such patients.  When completed, she receives bad news – she has abnormal growths in her abdomen, and a biopsy is recommended.  That takes an additional month of waiting, and Emily is eventually diagnosed with metastatic cervical cancer.  Her life is now in jeopardy.  With ACA coverage, Emily would have gladly visited a gynecologist regularly, and a Pap smear may have caught her condition much earlier, perhaps even before the cancer had spread.  A Pap smear costs pennies compared to the costs of treating metastatic cancer, and it represents an excellent example of the power of preventative care: cheap, effective, and often life-saving.  ERs don’t do Pap smears. 

As I join my wife’s family for Thanksgiving dinner this year, I will look upon a large assembly of educated and gainfully-employed cousins, aunts and uncles.  They are lucky, and they know it. How many similar dinners will be taking place where the gathered company is less fortunate?  How many uninsured people at American tables are silently weathering abdominal pains, chest discomfort, or headaches, worried about what these symptoms might mean but not sure what to do without the resources to seek appropriate care?

Despite its many flaws, the ACA will have a very real impact for many people, on this very day as we enjoy family and friends at the dinner table.  It sure won’t make our healthcare system “the best in the world”, or even close to it.  But if John and Emily can get the care they need, they and their families will have a better future, and will have many more Thanksgivings to celebrate in years to come.  DailyKos