Mayfly Fourteen
Keep healthcare private? ~ A friend in need ~ Do bigger blocks unblock bitcoin’s energy block? ~ Amusement arcade
Keep healthcare private?
Haha, I’m not going to argue for privatised medicine. No, I’m introducing questions about about how private health data should be used.
Data held in GP medical records will soon be collected by a new service called General Practice Data for Planning and Research data collection. From July onwards data that is currently siloed at your GP will be taken by NHS Digital and centralised. This includes records about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals, recalls, appointments, mental health, STDs, gender, ethnicity and sexual orientation.
On the face of things it makes a lot of sense to move health data into a central store.
It enables all services you use to access the same information. Anyone with any experience of the NHS will know the frustration of having to repeat case history again and again as you navigate services which are in no way joined up.
It allows analysis of a massive data set which may uncover trends and links that would not otherwise be spotted. Even tiny changes in public health can make a massive difference: font design, when spread over millions of leaflets and millions of people, can literally save lives. So machine learning on big data of millions of health records…?
The problem is this. The easier data is to use, the easier it is to use. Are you confident there will not be data breaches? Are you confident data will not be sold to private companies? Are you confident you will not receive marketing based on your health history? Are you confident the success of employment, insurance or credit applications will not be influenced by your health? If not now, in the future? Is this a price worth paying for any public health benefits? Is this something we trust this government not to sell? Or the next government? Or the one after?
Here’s what NHS Digital has to say: “NHS Digital does not sell data. It does however charge those who want to access its data for the costs of making the data available to them…We do not make profits from the service. The data will only be used for health and care planning and research purposes by organisations who have a legal basis and legitimate need to use the data…We do not allow data to be used solely for commercial purposes”.
Am I being overly cynical when I worry that they say ‘will not’ rather than ‘can not’? Am I being overly cynical if I read them as saying they will allow data to be used for commercial purposes so long as there’s also some health and care planning or research purpose?
This should be bigger news. There should be more public debate. Unless you do something it’s happening to your data. You have until June 23rd to opt out (form for your GP here). See Medconfidential, the advocacy group, for more information to help you with your decision. And remember doing nothing is a decision.
I scooped the FT, who I’m glad to say are covering this on the front page now.
A friend in need
I thought this survey had interesting results.
I always had this rather sentimental instinct that said the less people had, the more generous they were. If you were flush one day you shared it around. Another day, when someone else was flush, you might benefit in kind. If you’re poor you empathise with other people’s poverty. In some respects this has resonated with my own experience both backpacking in poorer countries or at home. Just watch who’s more or less likely to give money to a begger in London. Is it the white man in the suit or the black woman in a cleaner’s uniform? The question for this survey is slightly different. But my expectations of generosity multiplied by an expectation that family units are likely to be larger and tighter in poorer countries, meant I would have predicted the outcome to have been exactly opposite. So here’s yet one more way in which poverty is iniquitous.
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Do bigger blocks unblock bitcoin’s energy block?
Are you bored of bitcoin yet? Sorry for banging on. But big things are happening in cryptoworld. Bitcoin has recovered from a precipitous drop on May 19th but has still decreased in value by 20% since I wrote last week and 37% since the beginning of May. Everyone’s getting on the energy bandwagon, including the FT. But the swings are more down to Chinese threats of increased control, Musk’s shit-tweeting, and trad-finance’s twin fears of inflation and bitcoin’s inability to be a hedge against that inflation.
I’m still concerned about the handbrake. A reader sent me this article by Paul Veradittakit at Pantera Capital defending bitcoin’s energy consumption.
It tried to move the discussion from energy consumption (which is a business problem) to carbon emissions (which it makes out is a moral problem), and then to argue that something like bitcoin can’t be responsible for morals. He concluded that energy consumption is not “a particularly useful framework for judging the moral worth of a technology or activity”, and I agree. I presume he did this because he thought the moral discusion was easier to sidestep than a plain business problem. There’s quite a lot of cultish with us or against us phrasing, making out anyone who points out problems with bitcoin is scared of decentralised finance or has some other axe to grind. Again this seems like a defence mechanism. I’m not making a moral judgement. I love the idea of decentralised finance. I just don’t think it’s viable at any scale with the proof of work mechanisms as we have them. Is there a deliberate move to make it a tribal political argument to blind people from simple calculations?
There were some good points though.
He argues that bitcoin mining can act as energy buyer of last resort. This is a good argument for NOW. I just suspect it’s not a good argument in 10 years if crypto does start to really make inroads into banking — because then energy demands will have increased so much they’ll have swamped what’s available as curtailed energy. Plus there are plenty of initiatives trying to reduce the waste of curtailed energy, not least improvements in batteries, which will make this argument weaker over time too.
He points out that proof of work (and therefore energy consumed) is only for the block, so if you increase the number of transactions on each block, then energy per transaction logged decreases. I need to work that out a bit more. What are the ramifications in block times and fraud if you add more transactions to the mempool before adding to the block? I think you may be just opening up another attack point for fraud. In other words, the proof of work prevents double spending, but if you have more stuff in the mempool awaiting the proof of work, you have more stuff that is vulnerable waiting to be protected, and surely that has problems attached. I found this comment in another article: “layered or sidechain approaches which propose new trust models like Lightning, Liquid, RSK, and Stacks introduce the potential to batch thousands of transactions and settle them on the base layer. A single Bitcoin transaction can settle millions of lightning payments.” But this doesn’t address the safety concerns.
In conclusion I’m still left thinking if crypto is to go mainstream it needs a better safety catch than proof of work (and the other attempts out there at the moment are still energetically expensive - if multiplied out to global banking scale) OR we need some breakthrough in how much cheap energy we can produce.
Amusement arcade
I consume therefore I am.
Visual
I needed something quite vapid this week and am a few episodes into Ridley Scott’s The Terror on BBC Iplayer. The premise is good: sailors stuck on icebound ship in the arctic encountering an Eskimo shaman and…but as so often happens the set up is more engaging than the unravelling. May perservere.
Partridge on This Time is better, although its now less about laughing than it is about squirming at the awkwardness.
And Motherland was watchable. But, again as so often, what was a comedy has become a soap opera. Even so, anything with Sharon Horgan’s influence is going to be quite good.
And then…
Right, that’s it. A short one this week. Thanks for staying with me. Peace and love.