Lawrence Journal-World, Sept. 15

Imagine if Alexander Graham Bell had another idea when he invented the telephone: Third parties could listen in on the phone calls and use the information from your conversations to sell you other goods and services.

Such activity today would be illegal in America, and if the telephone companies tried to change the law, privacy advocates would be wild with rage. It is hard to even fathom that such a proposal would gain support from either end of the political spectrum.

And yet, America has a huge industry that is allowed to use very similar practices. Of course, we are talking about Google and Facebook. Everybody, it seems, is talking about those two tech Titans and various spinoffs such as Instagram and YouTube. The companies are now under investigation by the federal government and nearly every state’s attorney general.

Much of the focus has been on whether the companies are too big and need to be broken up to promote more competition and compliance with antitrust laws aimed at preventing monopolies.

To focus on the size of the companies, though, is the wrong approach. Focus on their practices.

Go back to that antiquated piece of technology that forever changed the world: the telephone. It seems like it provides a reasonable model for government regulation. Yes, Ma Bell did get broken up, and perhaps that will prove necessary for Facebook and Google. But it seems wiser for government regulators to start with some basic matters of privacy and process. Consider these:

. Is a telephone provider allowed to keep track of whom you call, then sell that list to others who then use it to try to sell you goods and services? No. Then why should a company like Google be allowed to keep track of what websites you visit and use that information to sell you goods and services? Federal regulation could put an end to that. (Greater regulation of the wireless phone providers, though, could be useful because there are concerns they are selling information about the location where you use your phones.)

. Is a telephone company allowed to listen in on your phone calls, keeping track of key words in hopes of gleaning information that will be useful in selling you a good or service? No. Then why should email providers - or more often app companies that pay email providers for access - be allowed to monitor your personal emails for keywords that they use to advertise goods and services to you? Federal regulation could put an end to that.

Changing just those two practices could make a huge improvement in the privacy of our online world. It also would require a huge adjustment on the part of consumers. As regulations grow, it may become harder for companies to provide consumers with some services they like. That reminder you get out of nowhere that you have a meeting coming up? It may well be you got it because the provider saw it in your email. But if people want that service, they can specifically sign up for it - and maybe even pay for it - knowing what the privacy tradeoffs are. Currently, so many people are automatically opted in to settings that have massive privacy tradeoffs. The companies know most people never will take the time to change their settings. Again, would we let the phone companies automatically opt everybody into a program that lets them listen to our phone calls? No. Federal regulation can fix this too.

That is a scary phrase for many people: “federal regulation can fix this.” Such skepticism is understandable. But government is best equipped to tackle problems that are so large in scale that they are very difficult for individuals to solve. The internet fits that model.

Such changes will be fought by tech companies with the very money they have earned by accessing your private information. Not only has there never been a free lunch on the internet; you actually are funding to make the world a less private place. Consumers need to figure out whether they are fine with that. If not, they need to come up with a plan to change it - either through regulation or major changes in how they make the internet a part of their lives.

Here’s one piece of advice, though: Make all such plans via telephone. They are less likely to be overheard.

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Sept. 15, The Topeka Capital-Journal

The House and Senate interim committee on insurance heard testimony Thursday about how states across the country are addressing health care costs. Experts from the National Conference of State Legislatures and the Kansas Health Institute gave their takes, as lawmakers listened and gave their own commentary.

Unfortunately, some of those early comments suggest that actually addressing these problems in Kansas won’t be easy. Blame was placed on the Affordable Care Act and malpractice insurance costs, both convenient ideological targets for lawmakers who would rather not confront insurance or drug companies.

The nub of the problem was actually succinctly put by KHI’s president, Robert St. Peter. According to The Topeka Capital-Journal’s Tim Carpenter, St. Peter “told legislators the rise in health spending reflected an aging population, business concentration in the insurance industry, the volume of services consumed by patients, the price of pharmaceutical medicines and prevalence of chronic diseases, such as obesity.”

Not a single one of those problems is easy to address or convenient to address.

Making the population younger on average would require substantially increasing the population, likely through immigration. That would be a challenging sell these days.

Increasing instance industry competition would require disrupting a business model that has been exceptionally profitable. Given that those same businesses are more than willing to lobby, lawmakers would tread carefully.

The volume of services consumed by patients? Lowering them meaningfully could well lead to calls of rationing and “death panels.” Who wants to tell patients they can’t have an extra test?

The price of medicines? Again, that means tinkering with businesses determined to wield political clout in defense of their profits.

Reducing the prevalence of chronic diseases seems easy only in comparison. But any progress there would take many years to unfurl, and those staggering under the burden of increased health care costs don’t have that long to wait.

Once you look beyond convenient ideological punching bags (the ACA, trial lawyers), the reason that health care costs so much in the United States is because we use a lot of it and are unwilling to make difficult choices that might end up reducing the profits of insurers and drug companies.

Calls to abolish private insurance and institute a “Medicare for All” plan have become common among liberal Democrats. That might have seemed extreme 10 or even five years ago, and we’re certainly not endorsing them. But looking at the challenges to actually making health care affordable, bold thinking and brave choices might be the only ticket out of this mess.

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