When I asked President Ilves how he observes Estonia’s technological, social, and cultural changes from 2006 until now, the first thing he mentioned was the advent of fully digital prescription. Estonia, like nearly every other EU member state, has universal health care. Since 2002, Estonia has issued digital ID cards to all citizens and legal residents. These cards allow access to a “citizen’s portal,” enabling all kinds of government services to exist entirely online: essentially any interaction with the government can be done online, ranging from paying taxes, to voting, to even picking up a prescription.
“In the United States, 5,000 people die a year because of doctor’s bad handwriting,” he said. “It’s very simple. You go to the doctor, and he writes the prescription in the computer, and you go to any pharmacy in the country, and you stick your card in the reader, and you identify yourself, and you get your prescription.”
As he pointed out repeatedly, “the stumbling blocks are not technological,” but rather, are bureaucratic.
I’m pretty sure we have the same digital prescription system here in The Netherlands – it really is as simple as the doctor sending out his prescription to the pharmacy for you, so it’s ready for you right as you pick it up after the doctor’s visit. I have no idea if this system I encounter here in my small, rural hometown is nationwide. In addition, I’d also assume that in the US, not every doctor is still using paper prescriptions – it’s probably a patchwork of digital and paper.
Setting that all aside – I have never heard a head of state speak this eloquently about digital matters, the internet, open source, and similar topics. Looking at my own politicians, who barely know how to hold a smartphone, yet decide on crucial digital matters, this is a huge breath of fresh air. I know too little about the man’s policy positions and history other than what’s being said in this interview, so it might be that Estonians who know him will hold a different view.
Really do watch the video interview.
According to Wikipedia, Estonia has a population of about 1.3 million. Of all the political entities that I live in (of which there are many), the closest in size to Estonia is my county. Estonia has a President. I have a County Chairman. The Chairman has nothing to do with the health care system, and the current incumbent is probably no where as savvy regarding technology as is the Estonian President. Having said that, whenever I need a prescription filled, the order is sent electronically to my local, family-owned pharmacy, which is a few blocks from my house. Oh yes, by land area my county is mostly farms.
That’s half the population [of my Municipality]
Here is some background on some of the technical things Estonia does and how they fail:
https://media.ccc.de/v/31c3_-_6344_-_en_-_saal_1_-_201412281400_-_se…
Yes, they like to forge ahead, but maybe they aren’t thinking hard enough about the consequences.
Wonderful point. Countries/politicians like to brag about this and that but many times using pencil and paper works just as well and is – safer. E-voting is one area open to all sorts of manipulations. It is not only the will that is needed but wisdom as well.
I don’t wish my country to be a guinea pig for anything e-related.
And about e-prescriptions: what is the big deal? I went to the doctor he gave me a piece of paper and voila I got the medicine. With e-prescription my life is in no way easier.
With an electronic prescription you won’t have to remember to take the paper with you, you don’t have to worry about your toddler finding it and scribbling on it, or your dog eating it, wind can’t rip it out of your fingers, or anything like that. Sure, if it’s just a one-off thing it may not change much, but if it’s an on-going prescription then it definitely matters, and the older you get or the more trouble you have with your memory or such the more important it gets.
Over here it has definitely been a boon to the elderly and me, with forgetting stuff all the time, have also benefited greatly from not having to worry about the paper — I just show my ID at the pharmacy and pick up the meds for the next 3 months.
Beneficial, indeed. And well intended. But those of Us flying around can’t help but worrying about the fragile state of IT security and privacy.
Also if it is a medicine you take for a long period of time you don’t have to return to the doctor when you need more, the prescription is automatically renewed. Also the doctors spend less time and it is VERY noticeable.
You are right.
In Belgium they have e-voting.
But the system is closed source and almost closed hardware.
Only the private company which made the system can ensure that the votes are the truly ones.
Politics says they have audits on it.
Just imagine ONU observers in Belgium, who wants to check the e-votes…
They only have access to data, not the code.
Acceptable ?
Fully democratic ?
Being elections a so determinant process at Democracies. Shouldn’t be allowed e-voting.
And been around [and inside] computers all my adult life.
PDF version for “text” people here: https://jhalderm.com/pub/papers/ivoting-ccs14.pdf
I’m estonian
and won’t neither defend or attack linked analysis – I have not enough real knowledge about topic. I know that this report is often used here as political tool by one political party – whose electorate is mostly older people, not using computers that much.
Half of problems described were procedural and not inherent to electronic voting. Another half seem real problems.
Little history too
I remember votings in soviet era. This was easy – you went into voting station, got ballot, throw it into box and you were done. Or once I was late and voting comission head told me ‘welcome again, you already voted’. Or, while serving my time in USSR army, I was almost sentenced to not arrive at voting station before 8AM. And, for voting days we were offered rare-seen goods, like oranges or sausage… No bananas though
Of course all elections ended with 99% participation, where 99.9% voters voted for same candidates of ‘block of communists and working people’, whatever that meant. There was no one other to ‘vote’ for anyway.
Coming from such background I think e-voting does not seem so insecure at all
I’m sorry to say but I think you are confusing a political system with the possibility of attack. When you look at the voting process from far away you have basically 2 major points of attack:
A) near the voter, where the vote is cast
B) at a central location where the votes from all over the country are counted.
With pencil/paper it becomes really hard for one person or a small group to attack A. You’ll need a large number of people to attack such a pencil/paper system. With electronic voting this becomes a lot easier. A small group of attackers can have a big impact. That is what people are afraid of.
With a pencil/paper system you can go to places and do recounts and you can gather the numbers independently and count them, just like the central location would do. With a full electronic system this does not apply.
It should be a dual-system. You vote on a computer (fully open source, chip to software), which then prints out your vote, so you can check it and then put it in a traditional ballot box. On election night, you have instant results – over the next few days, the paper ballots are counted.
Eventually you’d end up at voting from home, or wherever, greatly removing barriers to voting, and making it possible to have more votes on more things.
Agreed, it’s the best electronic voting I can think of.
The voting systems that did do this, for example, in the US had a lot of printer failures though.
I wouldn’t be surprised if we do end up with such a system in NL.
Voting on the Internet fully electronic is however not such a system as previously mentioned. And I can’t see how you ended up with that conclusion.
‘Failures’, certainly, Lennie
A little harder for a pencil to ‘fail’. Lots of redundancy around, by the way.
As for ‘manual’ modes. Lots of failures at voting boot setup, closure, failing to present witnesses, private counting and recounting, deliberate low affluence districts -giving chance to quick tampering-, etc. etc. etc.
Nowadays, manual mode A LOT MORE resilient and trustful.
I don’t know if it was deliberate, but sometimes companies just build crappy products.
I can’t see point in this, at least not here (we are small country).
First, it doesn’t help lazy people, who just don’t go to vist ballot box. And those who go, probably won’t vote using computer.
Second, our paper ballots are usually counted within 1-4 hours after election is ended – pretty fast to get preliminary results. And this makes great show – half of country sits behind screens and waits for results to collect and seats in parliament to deliver
Sorry, I rather meant that because our roots lie in different political system, we (our generation, who should be more careful than facebook childs) don’t take any kind of voting very seriously – consequently we tend to downplay possible voting problems and attached risks.
But no system is flawless. Problems and risks with paper voting are known for hundreds of years, voting procedures are established and so on. Using simple voting machines has created new set of problems, which are not all solved. Every innovation (like voting by e-mail – I think this is possible for some voters in some countries) creates again new problems, which often are not trivial to solve.
I would say that most risks with e-voting are related to not understanding them and to very short history of e-voting; this causes all these procedural problems and indirectly many of hacking possibilities either.
Or other problems, like one simple design flaw, which did affect first version of voting software: authors of software didn’t take into account that some screens had very small vertical resolution, this way on some netbooks few combo boxes displayed itself partially off the screen and people could not see last candidates (fortunately ordered randomly) in bigger districts. Nothing like taking over voting systems, just a small UI glitch.
This is actually a very important reason why experts suggest to stay with the old system of voting.
Like Florida? In 2000?
I had always assumed the ‘bad handwriting’ in the past was deliberate in order to obscure the drugs so that only pharmacists would be able to decipher what was required thus reducing the likelihood that prescriptions would be abused by addicts. Probably an old wives tale but one that certainly persisted.
In the UK, at my GP prescriptions either come out of a printer or are sent directly to a designated pharmacy. Repeat prescriptions are made online to be collected from the pharmacy. I doubt that the US is really that far behind.
In Seattle, WA which is near where I live it is all electronic. My doctor tells me what he is sending to my pharmacy and by now they know me just by seeing me. Before that you have to show your driver’s license or other picture I.D. and then you pay for it. How much you pay depends on whether you have insurance (not nearly enough people do in America) and how much insurance pays. Thankfully I work in I.T. and most IT jobs have good insurance. Most. Not all.
The latest ‘democratic’ trend in the U.S. is to open polls for one day with the number of precincts cut down. It’s completely meant to cause long lines for the in person voter that typically is younger. Meanwhile the mail in votes are older people, and they hold more overall sway.
Cheeses!
That stinks just from opening the bag.
Said by a very old man…