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US President George W. Bush has been on a technology tour lately, promising wonderful things to potential voters and campaign contributors. In addition to his recent broadband promotion scheme, Junior is also promising to unleash the healing power of the database to improve the health of every lucky American who can afford medical care.

And not a minute too soon. The Bush administration is currently fighting to allow employers to drop older retirees from their medical insurance plans, thereby creating an equation of profound Hobbesian elegance that couldn't please the industry more: increased revenue coming from younger, healthier people, and fewer benefits going to older, needier ones.

To take up the slack, Junior is invoking the powerful voodoo of high technology, which, he says, will reduce health care costs for everyone and dramatically improve the quality of medical services. To realize this worthy goal, he has created a new federal office, called the National Information Technology Coordinator, within the Department of Health and Human Services (HHS).

Once the project gets off the ground, it should be possible to computerize the medical records of all Americans within about ten years' time, Bush reckoned, and in so doing, make everyone healthier.

Pennies from Heaven

A few companies and lobbyists have already rushed to approve. For example, AuthentiDate Holding Corp., owner of software outfit Trac Medical Solutions, Inc., "applauded President's [sic] Bush's call for electronic medical records, stating that it 'stands ready to lend its expertise in security and tamper proof technology,'" according to a company press release.

The American Medical Informatics Association, a lobbying outfit for the medical IT industry, "believes that the [proposed scheme] will profoundly improve the health of the American people... Seamless and interoperable transmission of health data will increase efficiency, improve quality of care, reduce medical errors, and reduce administrative costs," the group declared in its own press release.

The program may never be realized on a grand scale, of course, because there are enormous obstacles involving patient confidentiality, preventing unauthorized access to, and misuse of, the data, and ensuring system availability and data accuracy.

Misuse of the data could include 'health discrimination' by employers, lenders and insurers, and of course myriad nuisances from the direct marketing and privacy invasion industries.

Additionally, a system of this sort, were it relied upon, would be so mission critical that anything less than 100 per cent availability could be fatal. Similarly, even minor errors could prove fatal as well. It's a fair bet that public support will fizzle as these and other obstacles are encountered in the real world.

But not before a plethora of tech companies will have profited mightily from the big database dream. Which of course is the point: the program is chiefly an election-season shot in the arm for technology sector and insurance industry giants to whom Bush is paying court. ®

Thomas C Greene is the author of Computer Security for the Home and Small Office, a complete guide to system hardening, online anonymity, encryption, and data hygiene for Windows and Linux, available at discount in the USA, and in the UK.

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