Blocked State Innovation

I’ve complained that regulation usually slows innovation. For example, huge driverless cars gains seem needlessly delayed by excess regulation (Tyler agrees). The problem, however, is not government per se, but the citizens to whom government defers. Politics is not about policy; voters are far more interested in showing off symbolic stances than in giving citizens more of what they want.

But to be fair, citizens hinder not only private innovation, but also government innovation. Long ago when people were imagining a future of cheap computing and communication, they imagined dramatic gains from government databases and citizen monitoring. But then some warned of how such data and monitoring could support tyranny, and ever since most voters have been so eager to signal their disapproval of such Big Brother domination that they are unwilling to consider the most promising government innovations in data and monitoring.

For example, me a year ago:

Overall my students oppose change, moderately favoring whatever is the status quo. So I was quite surprised to see … 85% of my students said yes to: Should all medical practice data be published, aside from data identifying patients?

I assigned this paper topic again this year and, combining the two years, 76% of 76 students favored the change, which correlated 0.29 with student ability to identify relevant pro/con arguments. Again, I don’t grade students on their position, I don’t say what I support, and students usually oppose change. (For example, they overwhelmingly opposed stricter public-place policies on hand washing after sneezing or using restrooms.)

Last year, commenters’ main complaint was that it is impossible guarantee privacy. And this is true. In principle, any piece of info you publish about someone could be the last little clue someone else needs to uncover a great secret about them. It all depends on what other info people reveal, and to whom. The only safe policy is to never publish anything about anyone. And since info supposedly only visible to government employees are often leaked via bribes, the only really safe policy is to never collect any info.

But note that this same argument applies to every piece of info the government reveals about anyone, including date of birth, addresses, who/when they marry or divorce, professional licenses, lawsuits, bankruptcies, tax liens, criminal records, etc. The reason few complain about privacy leaks due to such revelations is that most folks have adapted their other info behavior to expecting this info to be made public.

Similarly, if we gave sufficient advanced warning on a new regime of revealing all med info (minus directly identifying info), most people could adapt their other info behavior to preserve the privacy they want. Don’t let friends drive you to the doc if you don’t want them to know who is your doc. Of course some would mistakenly reveal themselves, and illegal bribery would reveal more. But that can be a price worth paying if there is much to be gained.

Alas, while even my undergrads can see that revealing all med info could easily meet a cost benefit test, voter distaste for anything smacking of Big Brother will probably long block this innovation. This even though recent legal changes go a long way to actually enabling future dictators:

Our Presidents can now, on their own: order assassinations, including American citizens; operate secret military tribunals; engage in torture; enforce indefinite imprisonment without due process; order searches and seizures without proper warrants. (more)

Citizens don’t make a careful tradeoff between social value and preventing future dictators. Instead, thoughtless voters enable Big Brother while symbolically opposing him, and block useful government innovation in the process.

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  • http://codeandculture.wordpress.com Gabriel Rossman

    There’s a bit of a “who/whom” question in that your students are much younger than the typical voter. The median 20 year-olds has basically no health problems and so the “con” side isn’t personally salient.

  • http://twanvl.nl Twan van Laarhoven

    And since info supposedly only visible to government employees are often leaked via bribes

    Really? Do you have any evidence or statistics on this? My (obviously biased) knowledge based on news reports suggests that many leaks are due to negligence, such as accidentally selling old usb drives with sensitive information.

  • ad

    voters are far more interested in showing off symbolic stances than in giving citizens more of what they want.

    What do you expect? The vast majority of voters have only the vaguest idea which policies will give citizens more of what they want.

    So they tend to vote for whatever looks like a good idea at the time. What else can they do?

  • Constant

    I’ve complained that regulation usually slows innovation. For example, huge driverless cars gains seem needlessly delayed by excess regulation (Tyler agrees). The problem, however, is not government per se, but the citizens to whom government defers. Politics is not about policy; voters are far more interested in showing off symbolic stances than in giving citizens more of what they want.

    The problem is not the citizens. The citizens can’t reasonably be blamed for being rational (and they are – since they are rationally ignorant and rationally status-seeking). Nor is it reasonable to expect them to change, since the necessary change would be against their own interests, since it would involve an irrationally large investment of time educating themselves.

    It is pointless to blame a causal factor unless it is reasonable to expect better of the causal factor. For instance, small children are forgiven many errors and wrongs that older children are not, and the latter are forgiven for errors and wrongs that adults are not – because it is reasonable to expect better from one group but not another, reasonable to expect the practice of laying blame to be beneficial overall (e.g. by adding an incentive to do better).

    It is unreasonable to expect the public to get better at this stuff, because it is not in their individual self-interest to make the effort. It is much more reasonable to expect there to be a better system than our current system, since there is such a large space of possible systems and so few systems have so far been tried.

    But aside from all this, it is surely mistaken to suppose that the voting public has much real input into the content of regulation. Regulation is largely cooked up by people who never get elected. Your point that people are resistant to change applies not only to the average voter, but also to the average bureaucrat.

  • Peter Gerdes

    I think the word ALL is causing problems here. Given that you take data identifying patients to have the narrow meaning of data that directly identifies patients this suggests publishing the entire file consisting of all appointments by individual X except names is presumably to be published if I take you literally and we can link across providers with the notes listing other medications currently taken. Correlate births with facebook announcements, appointments with any public information on travel or moves. Link families by shared illnesses and linked appointment times. At the real extreme a psych medical record would include any major life changes like job loss, divorce, etc.. And we haven’t even started to get clever and use traffic data with late arrivals, socioeconomic class, or vaccination times against the standard age schedule for their use.

    Now that we’ve finished that logical exercisce it should be clear that releasing literally all data with names blanked out leaves no practical option to prevent everyone from learning your entire medical history. So it should come as no surprise that given such a broad unshaped proposal with easily imaginable worst cases clearly within the literal meaning of the statement people tend to react negatively.

    Alright maybe you simply meant summary info for each practice. This is really no good either as people become patients at discrete times and will have to change doctors as they move. So suppose you one day glimpse an asthma inhaler or see them use an injector to stop a potentially fatal allergy to a bee sting. Dig up their life history of moves and at each move check for other maladies that a practice in the new local which increases it’s count of asthma/bee allergy sufferers are also likely to add. So if you find out Joe has asthma and Joe has moved 6 times in his adult life and every time he comes to a new community a GP increases both his asthma patient and erectile disfunction patient counts in a correlated fashion. Light chit chat to reveal minor medical issues of wives or children will make analysis more exact.

    I think the valid reason people are afraid of the greater release of ‘anonymized’ medical data is that they wish to keep some medical information private while by necessity (sometimes requires public use of medication), accident or simple desire not to be totally paranoid be able to share seemingly harmless info like ‘Do you have a doc in town you like and would recommend’ or ‘My doc prescribed me that once didn’t do me any good either so try asking for X.” However, what they can and cannot share without revealing their secrets is a total cipher to them depending on subtle correlations and statistical likelihoods they haven’t the faintest idea about not to mention more powerful data mining techniques not yet invented.

  • Peter Gerdes

    I’d be curious to see the reactions to concrete definite proposals without this hidden mine style uncertainty about future revelation. Like if you instead had asked whether hospital aquired disease numbers or percentage of X procedures adjusted for socioeconomic class that result in successful patient treatment at a given hospital. These don’t seem to hide unknown lurking dangers the citizen can’t reliably predict but do seem to capture the more obvious benefits.

  • http://deaneckles.com/blog Dean Eckles

    It sounds like your students are authoritarian. This isn’t about not wanting change — it’s about the choice to use state power to make everything just right (often consistent with traditional values in some way).

  • http://un-thought.blogspot.com/ Floccina

    Don’t insurance companies have data on all the medical care that their insured have received?

  • http://www.gwern.net gwern

    > Last year, commenters’ main complaint was that it is impossible guarantee privacy. And this is true. In principle, any piece of info you publish about someone could be the last little clue someone else needs to uncover a great secret about them.

    In principle? The research on de-anonymizing large data sets has gone a lot further than ‘in principle’. I found a ton of papers and results when I spent an hour or two reading on the topic for http://www.gwern.net/Death%20Note%20Anonymity#de-anonymization

    If you want to argue the results will be more useful than damaging, fine, but don’t try to handwave away the damage as merely theoretical. That’s as dishonest as advocates of regulation ignoring prevented gains and only counting prevented losses.

  • zach

    I’m surprised that your students don’t seem to be reading your blog.. then they should know better!