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Put the increasing threats to our privacy along side the relentless demands for transparency and what do you get? Science Fiction, of course!

It’s not that the health care transparency is science fiction (well, maybe - but that’s a topic for a different post). It’s that in order to find one of the most  brilliant and disturbing discussions of transparency in America, we must go to a science fiction writer.

It’s just that we have to go to a science fiction writer to find one of the most brilliant, and yes, disturbing discussions of transparency in America.

David Brin is the noted author of a number of celebrated sci-fi novels such as Earth and Startide Rising. Waaaay back to 1998, he also published a radical-for-its-time non-fiction book — The Transparent Society. Brin examined the numerous threats to individual privacy posed by emerging electronic (and especially video) surveillance technology. His big fear though, was that governments and the private sector would increasingly restrict the free flow of information and call for more secrecy than is healthy for our society. (Think Google in China.)

Much of the angst surrounding his book was that Brin accepted the inevitability of ubiquitous digital surveillance. Can’t stop it even if we wanted to. No, he gently informed us, we can no longer be anonymous. And we cannot go back home again to that sheltering analog comfort – real or imagined – we once enjoyed.

Instead of echoing 1984’s conclusions, though, Brin argued that transparency and surveillance could be a two-way street. He really asked us to think about “reciprocal transparency” and “mutual accountability.” He believed freer society could be promoted through broad public access to the same means of electronic surveillance available to the powerful elites:

“Will the citizens share, along with the mighty, the right to access these universal monitors? Will common folk have, and exercise, a sovereign power to watch the watchers?”

With the proliferation of electronic medical information, its rising commercial and illegal value, and the seeming ease in which it can be accessed, how do we watch the watchers of our health care information? I don’t believe the current transparency debate in health care even asks the question.