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It's simply absurd that there is a debilitating concern about privacy when it comes to public sector activities while the private sector and especially the tech giants are by far the bigger threat in the privacy realm.

The focus on privacy in the public sector is weaponized by multiple actors. On one side, it is the target of bad faith complaining by those that wish to diminish the government's capabilities and on the other it is a useful bureaucratic scapegoat in the face of larger, structural issues.

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People were given the ability to get vaccines with few questions asked because encouraging more people to get vaccinated was more important than counting them. Undocumented immigrants for instance are wary of providing information about themselves to authorities. People who have been convicted of crimes often exhibit suspicion of bureaucratic authorities and shy away from them.

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"It's simply absurd that there is a debilitating concern about privacy when it comes to public sector activities while the private sector and especially the tech giants are by far the bigger threat in the privacy realm."

I agree that there's a privacy problem in the private sector. I also agree that the public sector needs to be better at counting.

But privacy from the government is a WAY bigger problem than privacy from the private sector.

The big difference is the private sector uses that data to try and sell you something. The public sector can use that data to send men with guns to your house. Or less drastic, fine you.

I think what most Americans REALLY don't want, is a profile sitting somewhere on a government server for each citizen.

Me personally, I want even stronger privacy protections than that. I would pretty much ban facial recognition, license plate readers, drone tracking, and pretty much any other mass surveillance use by the government. The government should also be banned from purchasing that data from private providers.

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https://www.sciencealert.com/this-new-ultracompact-camera-is-the-size-of-a-grain-of-salt/amp

These are going to be scattered all over the globe in ten years whether you like it or not. If you try to stop it, a million private actors and 190-odd governments will lie to you, say they're not doing it, and then do it anyway.

If we don't regulate the way the data can be used, shared, and publicized, and attach draconian penalties to misusing it, then there will be NO privacy at all in two decades.

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I agree with you on the need for legal protections. And I agree that governments lie. But I don't think we should give the government the legal right to access or create that information.

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Ehh. I’m relatively agnostic on *creating* it. Not least because it’s not possible to prevent it. If you try, people will just do it anyway. And if thinking it can’t be harvested lulls you into a false sense of security, then you won’t be prepared to actually protect people from the vast amounts of data that exist about them.

What I want is horrific, draconian, positively Wallachian penalties for using it in any but the most thoroughly vetted manner.

TL;DR Trying to prevent these cameras from being produced in their billions is a fool’s errand, but we can execute the first rich asshole who uses them to stalk an ex and livestream it on YouTube.

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"The big difference is the private sector uses that data to try and sell you something. The public sector can use that data to send men with guns to your house. Or less drastic, fine you.

I think what most Americans REALLY don't want, is a profile sitting somewhere on a government server for each citizen.'

Once this data exists, seems pretty trivial for a government to acquire it.

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Yea, if it exists the government has it or very, very quickly could.

The only protections that are worth a damn are legal, and if democracy and its norms end we're all screwed.

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People generally don't seem to care about the amount of information they give to tech companies compared to the government. Perhaps it is because the benefits of allowing Google complete access to your life are realized on an immediate and personal level (because you can login to everything or get your email on your phone or whatever) but the benefits of allowing the government to have better data seems more abstract.

One of the things I often found a bit odd with the Yang campaign was the focus on owning your data and data privacy combined with the (perhaps unofficial) call to "Google Andrew Yang". We could have at least went with DuckDuckGo.

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The government has a monopoly on violence and throwing you in prison, Google and Facebook do not.

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This is really great, Matt! Privacy concerns also block inter-agency information sharing, and then they enter into bizarre and incomplete MOUs are created to 'share what we can'.

But the claim that no one is counting cannot be overstated. In Virginia, for example, the best eviction data we have is from an academic institution who has an unpaid intern pull the numbers from the court records. Due to the scale, the data is only regional. To the point of the article, eviction data is registered twice already by statute and we don't care to count; one being the court documentation mentioned, but another by sheriff's when they place a notice of eviction.

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Things like this are why McConnell is a genius to try and run on absolutely zero policy substance. Americans don't want the government to do anything because the government is messing up everything it tries to do!

I used to just blame this on Republicans (and it is still largely their fault) but at some point the party of expanding government needs to take responsibility for improving government. Through COVID, in particular, the US Government has seen a MASSIVE erosion in state capacity that shows no signs of being mitigated. It doesn't even really seem like anyone cares. I can't blame that on Mitch McConnell.

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Agreed, I and others have gone through the same shift over the last two years.

My new theory regarding the government is: "If y'all can't actually accomplish anything of use, ever, regardless of funding, then maybe the tax nuts are right and we should just take home as much money as possible regardless of knock-on effects. So, to repurpose an otherwise useless phrase, go do the work."

There are things only the government can buy for me at all, which it's always going to do (roads, bridges, etc)... then there are things that a competent, functioning government could buy more cheaply or better than I can (healthcare, public education).

The problem is, if "competent" goes out the window, then even those latter two, which should be core functions and are in most of the globe, are best left alone even if the outcome of private provision is in every way worse than what's possible.

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It is going to take them 3-6 months to process my passport, which I would have thought is in the first category.

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Republicans did that on purpose! Reagan said taxes should hurt 50 years ago. Republicans cut the IRS budget by 20% after they retook the House in 2010. I really find it amazing intelligent people can't see that.

Turbotax also bears a lot of blame. It's the one lobbying both parties to prevent the IRS from using information it already knows to prefill Americans' returns.

https://www.irs.gov/statistics/irs-budget-and-workforce

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I literally wrote both parties involved in the Turbotax abomination! Bipartisan corruption is the most effective corruption money can buy.

Do you think IRS customer service was improved by Republicans cutting 20,000 people out of a workforce of 95k?

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My wife used to work in real property management for the government. I asked her once how long a permit should take if everyone actually did their jobs (a rare occurrence) , and you cut the red tape but still protected the environment etc. She said "one or two months"

I then asked how long it actually takes "1 to 2 years"

There are some good people in the government. But there are also a LOT of people just collecting paychecks and trying to do as little as possible. And there's also a lot of red tape that serves no useful purpose. Except it allows the people trying to do no work to put up roadblocks. So they don't actually have to do anything.

A large part of the problem is the government protections that make it almost impossible to fire employees. For example, even after being convicted in state court for sexual assault that occurred on the job, the government employee kept his.

Government is too big and too important to be this incompetent.

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I don't agree with this. Running any large organisation successfully requires consistently good leadership. About half the time, the US government has leadership that verges towards actively wrecking things.

You'd need a managerial dream team to overcome the challenge Democrats face each time they regain power. Combine that with the leaders the Democrats actually have and it's kinda impressive the federal government is able to do anything.

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founding

Look to the states, then. NY, NJ, CA, MI, IL are definitely not well-run. MA is pretty good, but they've had split leadership between legislature and governor for quite a while. At the city level - Baltimore, Detroit, Chicago, SF - it is even worse.

I lived in Indiana during Mitch Daniels tenure as Governor, and it was pretty well-run. Florida's version of the DMV is also good. Admittedly, both states don't have the expansive network of programs the states mentioned above have...but that is a feature, not a bug.

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Kudos to MY for observing that counting is the archetypal state capacity. Early governments developed cuneiform to keep tax records. Writing down numbers is older than writing complete sentences.

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Any reason to think part of the problem is the denominator being low (ACS population estimates?) in addition to the numerator being off? I believe I recently saw 99% reported for youth vaccination in Chelsea, Massachusetts, a low-income, predominantly Latino city that folks have suspected for a while has a big census undercount.

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I would be more skeptical of the argument that “the government could be better if it weren’t for those dastardly privacy concerns!”

It seems more likely that the government’s limited capacity has more to do with the government’s limited capacity than it has to do with that capacity being somehow artificially limited by privacy concerns. With your specific example of the CDC vaccine data, that is borne out by the Washington Post’s several deep dives into why the CDC vaccine data is wrong - it’s largely apart from the privacy protections, and the protections could be maintained even with greatly improving data quality.

One of the few decisions we’ve seemingly gotten right in this pandemic is to prioritize getting shots in arms over being meticulous about ensuring they are “properly” given and “properly” recorded. We should expect that our taxes fund a state with enough functional capability to make that the primary concerns (e.g. vaccination) a priority (as it should be!) and then to fix the data reporting later. We shouldn’t let the state off the hook because they make noises about being hamstrung by privacy concerns, and we really shouldn’t immediately acquiesce on the privacy concerns in hopes it delivers us more effective government.

Ultimately, I really would not want to have to live with an ineffective government AND no privacy protections from that government.

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I don't believe the issue is specific privacy regulations, but rather the amorphous feeling that any attempt to do the job of collecting and analyzing data well is a violation of privacy.

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That's probably correct at a specific level - if there was a real will to have this data accurately, it could be done within existing privacy laws.

But at a more general level, I think excessive, vaguely articulated privacy fears do have a chilling effect on efforts to build robust, useful data collection and aggregation systems.

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founding

There’s a reason that I can’t get an electronic version of my vaccine record to use in states with a vaccine mandate, and it’s because my Governor is so opposed to vaccine mandates and vaccination that he has banned Texas companies from making any sort of electronic record, in addition to stopping the state from doing it.

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I scanned my paper card and keep a PDF and images on my phone. I recently used that as proof of vaccination in order to get credentials to a trade show in Las Vegas.

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founding

Yes, there are workarounds, involving either the paper card, or (sometimes) a photograph of the paper card. But it would be much more reassuring if I could just have a QR code on my phone that accessed a state database.

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I don’t know what you find reassuring about a QR code. I mean, are there some people using counterfeit vaccine cards? Sure, but so what?

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founding

What I find reassuring about the QR code is that I know I won't lose it, and it won't get torn or misplaced. Having an important record like this only on paper just seems like it makes things harder and worse (in addition to whatever security advantages it has for actually verifying the public health features).

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Huh, did you go to re:invent? We could have had a slow boring meetup if you did.

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No, nor have I ever heard of that. I was there mid-November for a few days. I hadn’t been to Vegas for years. I was amazed at how much marijuana people were smoking out in public.

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> It's so stupid how after 9/11 there was a clamor to give up privacy

Yeap. It was stupid. Clamoring for giving up on privacy because of a pandemic is also stupid.

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founding

"Privacy" isn't one thing, where we either have to have all of it, or give it all up. Presumably different aspects of privacy have different amounts of value, and different things that harm different aspects of privacy might have more or less relevance to various actual social issues. The pandemic might very reasonably change some cost/benefit analyses so that we give up some amounts of privacy (and demand extra privacy in others). I would think that a society is incredibly stupid if some new social/political/public health development didn't cause *some* change in its conception of which aspects of privacy were important and which were worth giving up. We did it for the automobile and we did it for the internet.

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I think FrigidWind probably phrased it incorrectly. It's not a choice between privacy/not-privacy, it's a choice of *how much* capacity we are "buying" with *how much* privacy.

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"It's so stupid how after 9/11 there was a clamor to give up privacy, but not so in a pandemic that has killed 266x that number."

A lot of us look back and think we let government erode WAY to much privacy after 9/11, and we don't want to do it again

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Why is that lead pipe graphic so bad?

"lead pipes" per 100,000 people? What counts as a "lead pipe"? A "pipe" isn't a useful fundamental unit. Is a 100' water supply line from the meter to the house a single pipe? Is the 20" supply from the wall to the faucet a single pipe? Are they equally dangerous?

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I got my unofficial booster in Oregon, but my first two shots in Idaho, so I assume I am not counted accurately. And yes, I used the I don't have insurance, this is my first shot method prior to boosters being approved, since I was heading to work in Argentina.

A few states do have state vaccination records (Idaho does, as do a few other west coast states).

One of my pet peeves as far as data goes is our CDC numbers for deaths and cases doesn't include vaccination status. I can break it down by age, sex, race, some contributing conditions, but not vaccination status.

Anonymizing of data is one of those stupid things. The census is doing it making it pretty much impossible to get accurate block census data.

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Yes, but it isn’t that the Census went rogue. A big problem is the pressure from Congress to make things anonymous because of the pressure from lobbyists to make things anonymous. The Census of Manufactures is a perfect example. Every 5 years this report on industry comes out but if there are fewer than 4 firms in an industry very little can legally be reported… exactly the type of concentrated industry one would like to know more about.

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You would think that deaths by vaccination status would be one of the most important pieces of data. And plenty of other countries track it that way. It just goes to show how deep the problems with the CDC go.

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How much more state capacity would we have if Biden were younger and more energetic? I doubt it would make that big a difference. I like to fantasize about a younger president leaning on the FDA and CDC to not do things the stupid way, to take some risks and weigh costs and benefits among uncertainty rather than defaulting to orthodoxy. The problem is 1) bureaucrats are risk averse people who accept middling salaries for job security and pensions and 2) everything important winds up being litigated, so whichever federal judge the computer assigns gets a temporary veto. Compounding this problem are the liberals who want judicial review of everything because it keeps the right from veering too far from elite consensus.

Obama was prime aged and brilliant. What feats of administrative puissance did he perform? The ACA rollout was on par with Biden Covid mitigation, n’est pas? I suspect this is the state of affairs a nation with so old and creaky a constitution deserves.

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founding

I think it’s pretty clear that this is a structural problem and not about one individual being low energy or whatever. You’re not going to fix this with a new President unless you get Congress to rewrite a lot of rules.

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When Biden had the opportunity to make a big, scary change with powers squarely in his office (GTFO of AFG), he did so. That's my lazy zeroth-order framing of "why did Biden do/not do X"--I'm guessing he couldn't.

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That's a very broad generalization about federal bureaucrats. They are risk averse because the system in general is risk averse, works on consensus, and punishes taking high risk, high reward bets. Also yes, federal bureaucrats up and down the chain (from GS-11s to SESs) accept lower wages for job security but generally do their job because they genuinely want to serve the American people.

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"but generally do their job because they genuinely want to serve the American people."

Have you never met anyone working for the government?

There are some good people, but a LOT of lazy people trying to do the minimum amount of work necessary. Combine that with the fact that it's almost impossible to fire them. And you get general government incompetence on a range of issues.

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The difference with the ACA rollout compared to CDC/FDA incompetence is that after the massive ACA website failure, Obama brought in tech experts to correct the problem. The ACA website was fully functional within a few weeks of him shaking things up.

Has Biden even tried to do a single thing to correct the incompetence at the CDC/FDA?

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Are there a comparable group of experts who could help fix the CDC/FDA? Obama benefited from a bunch of silicon valley types who had built a lot of websites and felt fired up to do civil service. Is there a comparable group that Biden could unleash on the public health agencies?

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After the last two years, unleashing a pack of rabid wolves would likely be an improvement.

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I mean, haha, yes, I share your frustration. But seriously, I don't think that just anyone could successfully reform the public health agencies.

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I could have improved the CDC simply by issuing faster approvals for vaccines and having fewer regulations. It wouldn’t even take a budget. Just wifi and the ability to type “approved.”

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So which part of the approval pipeline do you want to keep and what parts do you consider redundant? On what basis? Are you suggesting that we simply shouldn't have any kind of approval apparatus for EUAs for vaccines? That seems... not tenable. And I say that as someone who is like six notches more libertarian than most Americans.

(btw, the FDA, I think, is the real controlling agency over whether it is possible to legally distribute vaccines -- the CDC does weigh in, but they aren't ultimately the people who extend the EUA.)

None of this is, AT ALL, me saying that the CDC and FDA are doing a good job. I agree with the criticisms. I'm just saying that I don't think that any old random person can successfully analyze the good from the bad and carve away most of the bad while keeping most of the good and also not have the agencies just fall apart internally.

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Sometimes, "reform" actually means "burn it to the ground and start over".

See early 20th century Progressive civil service reform for an example, actually a highly relevant one, to boot.

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I've seen you say this "burn it to the ground and start over" a couple of times.

What does that look like for the CDC?

Can you give me an example of the most recently created agency you think is operating well in this regard?

The two big ones that come to mind for me don't seem to be doing that great - DOH seems terribly designed and the CFPB has been mired in lawsuits since inception and seems to have been hit the bureaucratic wall pretty quickly as well.

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IMO, the FDA/CDC failure is a different sort from the ACA rollout failure. There are some similarities, in that both were underpinned by a failures at the organizational culture level, but imo there were also an important differences.

ACA's rollout problem was from a failure to project manage outside contractors. Aside from missing project management expertise, the failure really wasn't about corralling in-house technical expertise.

OTOH, I sense the FDA and CDC have plenty of capable experts on staff. Their problem seems to be much more about org structure and culture and an ability to do sense-making and decision-making using partial and unreliable information.

Scott Gottlieb spelled out some sensible seeming reforms in his latest book.

https://twitter.com/ScottGottliebMD/with_replies

(and he's a great twitter follow for covid stuff along w/Eric Topal, imo)

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The HIPAA privacy regime was created with one goal: to keep (ostensibly) straight people from being embarrassed by a public HIV diagnosis. That's it. That was the whole goal. It really doesn't make any sense in the current context, and in a functioning democracy, the legislature would go back and rejigger the rules to ban the things we don't want (Target sending ad flyers to people they know are pregnant through surveillance) and allow things we do want (parents to be able to get their child's PCR test result without needing a doctor to break the rules by pushing the release info button, for a personal example). Alas.

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Any suggested reading on why HIPAA was created?

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Angels in America.

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Oregon actually has a pretty solid set of COVID-19 data that I find credible and useful. Sure, there are a few issues but nothing huge: https://public.tableau.com/app/profile/oregon.health.authority.covid.19/viz/OregonsCOVID-19DataDashboards-TableofContents/TableofContentsStatewide

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Matt regularly deletes his Twitter history.

Let me suggest that this is not the action of someone who is vastly unconcerned with the general notion that there might be career or social consequences to people being able to rifle through your history.

It's kind of hard to say what parts of your personal life are and aren't likely to come back to haunt you, and it's by no means crazy to want to be conservative with what you leave around to find (I assume this is part of the calculus that Matt uses to delete *everything*, not just takes he finds retrospectively suspect).

Now, on the other hand, it's only getting easier to surveil people, and at some point I do think we need an approach to privacy that's not just trying to hold back the tide. But I'm not sure that blithe dismissal of privacy concerns is it.

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I agree with this take. I'd also point out that the downsides of lack of commercial privacy is usually capped at identity theft, while the downsides lack of government privacy is going to jail. (there is evidence that governments are buying commercial data, so this line is getting less distinct - but at least you can opt not to participate in a lot of commercial activity)

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I would ban the government's from buying commercial data.

I would also ban government use of facial recognition software, license plate readers, and other forms of government mass surveillance.

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https://www.sciencealert.com/this-new-ultracompact-camera-is-the-size-of-a-grain-of-salt/amp

Let's just admit that any mid-sized company is going to be able to litter the landscape with these things in two decades and get on with the business of making policy that responds to that reality.

Trying to pretend technologies like this can be regulated in some way is a fools errand, "tryjng to hold back the tide" as you note. We *must* constrain how the government and private actors are permitted to share, use, and publicize data, with absolutely *draconian* financial and personal penalties for failing to follow the rules. Make blackmail all but a death penalty offense.

Otherwise there's no chance that any of us enjoy any privacy at all.

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I live in Wisconsin. As I write this, the Wisconsin Department of Health Services vaccine dashboard has a note reading:

"*As of November 2, 2021, children ages 5-11 are eligible to receive the COVID-19 vaccine. DHS is working to integrate data on vaccinations in the 5-11 age group into the COVID-19 Vaccines for Wisconsin Residents dashboard and will make that data available as soon as possible."

I don't have kids, but I cannot emphasize how freaking frosty I would feel if I were trying to understand the health risks my young children faced at school when, in our declared state of emergency, people can't get a database updated in a *month*. My faith in such declarations is not enhanced by this lackadaisical ineptitude.

(and it's not as if 5-11 approval appeared on 11/2 as some existential shock to the system, we knew this was coming further months in advance)

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In my own experience, the government's incompetence is limitless. I served on active duty in the army for three years and I am currently in the NJ National Guard. On active duty many of our vehicles would not start or could not be driven for another reason. People pretended to train more than we actually trained. Our facilities were left to degrade, basic maintenance just wasn't done. Money flowed down the drain in an unimaginable way. In the NJ Guard, I signed a contract promising a bonus for a three year contract. I was supposed to be paid one half the sum (less taxes) in May of 2020 and the second Half in April 2021. I have not received even the first payment. I am consistently told "they are working on it" and "it is coming soon". Incredibly frustrating.

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"In my own experience, the government's incompetence is limitless"

This is my own experience as well. I would also add there's a large amount of laziness

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I am somebody who got a J&J dose in March and then got a somewhat illicit Pfizer dose in July. California, at least, seems to have correctly counted me: my electronic vax card shows both doses (I assume because i showed my driver's license in both cases).

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I think you’re underestimating the size of the privacy zealot community. A lot of people are very concerned about this for reasons I can’t quite grasp.

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Are you self employed? I am. If I weren’t, I would be worried about what my employer might find out and how a digital trail might look if I ever needed a job

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Your hypothetical *private sector* employer can do whatever the hell they want in this regard already, and Google/Facebook/Twitter make it pretty damned easy for them to do it.

I don't know why we keep regarding *government* as the threat here.

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How exactly do G/FB/T make it easy to get your health info?

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Given the context I was speaking to data other than health data.

But even there, I'm pretty damned confident, given the general level of respect I've seen for HIIPA among medical practitioners and insurance workers, that any potential employer can casually call and pretend to be an employee's spouse if they somehow desired health data.

People just don't pay attention to this shit, even with a ton of training.

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I have had the exact opposite experience. I have been on a high-deductible health insurance plan for the past few years. Whenever I got medical bills for my wife and called to ask for details I was, without exception, met with absolute refusal unless there was the necessary release form on file signed by my wife.

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I feel like you're skipping a really big step here when you go from, "I could Google this dude," to "I could call a doctor and pretend to be this dude's spouse and commit a *criminal offense* and it's possible I could get something!"

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Of course. But again, I was originally speaking to data other than health data. You know, data that an employer might be concerned about?

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Digital health trail?

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