“Cyberattacks on health systems are on a steady rise, and their costs are mushrooming. Experts said there are a variety of reasons for the increase, including that criminals are getting more advanced and more aspects of health care are online.
When a cyberattack struck Sky Lakes Medical Center, a community hospital in southern Oregon, in late October 2020, its computers were down for three weeks. The most mundane tasks became arduous. Nurses had to check on critical patients every 15 minutes in case their vital signs changed. Doctors scribbled down their orders and the swelling mounds of paper took over whole rooms. In three weeks, the hospital ran through 60,000 sheets of paper.
Sky Lakes had to rebuild or replace 2,500 computers and clean its network to get back online. Even after it hired extra staff, it took six months to input all the paper records into the system. In total, John Gaede, Sky Lakes director of information services, says his organization spent $10 million — a big expense for a nonprofit with roughly $4.4 million in annual operating income (the organization did not pay a ransom).
For hospitals with limited budgets, there are questions about how well they can protect themselves. The attack on Sky Lakes was part of a wave of attacks in 2020 and 2021 connected to a criminal group in Eastern Europe.
“Our budgets typically have a margin of maybe 3 percent a year,” Gaede said, “but we’re supposed to compete with nation-state actors?”
Health data is lucrative on the black market, making hospitals a popular target. Plus, if a health system has ransomware insurance, criminals may think they’re guaranteed a payout. Ransomware ties up hospital records in encrypted files until a fee is paid.
“Back when ransoms were $50,000, it was cheaper to pay them than to deal with a lawsuit that would have cost far more,” says Omid Rahmani, associate director at Fitch Ratings, a credit rating agency, adding that ransoms now cost millions. “The landscape’s changed and because of that the cyber insurance side has changed — and that’s really connected to the rise of ransomware.”
In its annual cost of a data breach report, IBM writes the global average cost of an attack on a health system rose from about $7 million to over $9 million in 2021. But remediating these violations in the U.S. can be far more expensive.”
“Nearly every component of Trump’s plan revolved around then-Vice President Mike Pence succumbing to pressure. In Trump’s view, Pence — who presided over the counting of state electors on Jan. 6, 2021 — could single-handedly reject Biden’s electors or postpone the count altogether and let GOP state legislatures approve pro-Trump electors instead.
Pence, relying on the advice of his counsel Greg Jacob, balked at Trump’s strategy. Jacob and other White House lawyers repeatedly told Trump the scheme was illegal.
Even that could’ve gone differently. Jacob has also made clear that there was one scenario in which Pence might have been obligated to flip the outcome: if any state legislatures had actually pulled the trigger and adopted Trump electors. In that scenario — where a state legislature and governor have certified competing slates, with one saying Biden won and the other declaring the state for Trump — Jacob said it would be reasonable to defer to the text of the Constitution, which gives state legislatures the ultimate power to choose electors.
“A reasonable argument might further be made that when resolving a dispute between competing electoral slates … the Constitution places a firm thumb on the scale on the side of the State legislature,” Jacob wrote.
That’s why John Eastman, an attorney who designed much of Trump’s plans to stay in power, spent the final hours before the riot on Jan. 6 pushing Pence to delay — contending that Pennsylvania’s legislature appeared on the verge of reconvening to appoint Trump electors. Had Pence or Jacob agreed to a delay — particularly as the Capitol recovered — Trump, Eastman and lawyer Rudy Giuliani intended to use the time to bring legislatures back into season.”
“The decline of motor vehicle deaths in America over the past two decades is part of a broader trend that began in the 1960s. Ralph Nader’s seminal 1965 exposé, Unsafe at Any Speed, catalyzed an auto safety movement that culminated in the creation of the National Highway Traffic Safety Administration (NHTSA), which set up the infrastructure for automobile safety.
From the 1970s onward, the NHTSA would maintained a database on motor vehicle-related deaths, make research investments, and provide safety certifications for cars on the market, incentivizing auto companies to adopt safety procedures. The work of the NHTSA and civil society groups like the Insurance Institute for Highway Safety helped usher in a new era where safety features like seat belts and airbags became standardized. All of this, along with measures like universal state licensing of drivers and registration of cars, led to the decline in youth and overall American motor vehicle mortality. The CDC would eventually tout this decline as one of the country’s biggest public health achievements of the 20th century.
And as Lee recounts in the NEJM article, that progress continued into the 21st century. In 1998, frontal airbags became mandatory in all cars and trucks sold in the US. Other improvements like automatic emergency braking, blind-spot detection, side airbags, and rear-facing cameras also contributed to an improved auto safety landscape. “What we’ve seen is more than a half-century of efforts to make the automobile safer,” said Mitchell Moss, a professor of urban policy and planning and director of the Rudin Center for Transportation at New York University.
If cars went one way with safety, guns went the other. Guns are one of the only consumer goods whose safety is not regulated by any government agency. Gun manufacturers are also very insulated from lawsuits, and perhaps consequently, have little incentive to design safer guns, such as “smart guns” that would only be operable by the users they are registered to. As Moss said, “We really have a Wild West approach to the manufacture of weapons in this country.””
“You try to explain two broad things about sustained economic growth: why it started when it did (in the mid-18th century) and why it started where it did (England). Let’s start with the when. What took so long? Humans invented agriculture maybe 10,000 years ago. Why did it take 9,800 years or so for that to lead to real economic growth?”
…
“This is one of the key questions in all of economics. Its answer is central to why some countries grew rich while others have not. The simplest answer is that economic growth occurred only after the rate of technological innovation became highly sustained. Without sustained technological innovation, any one-off economic improvement will not lead to sustained growth. Incomes will rise in the short run, but over time people will have more babies and those babies will eat up all the economic surplus. This is known as the “Malthusian trap,” after Thomas Malthus, a British clergyman of the late 18th century. This Malthusian logic explains the pre-industrial world pretty well.”
…
“The question is why it took so long for the rate of technological innovation to grow as it did. This is one of the central questions we attempt to answer in this book. And there is not one “silver bullet” answer. For one, sustained innovation requires institutions that limit confiscation by the government (and protect other property rights more generally). But most societies in world history were weak on this dimension.
Sustained innovation also requires cultural values that support innovation and encourage understanding of how the world works. Societies in which work is looked down upon are unlikely to experience sustained innovation.
Ultimately (and this matters for the acceleration in growth we observe from the late 19th to the 20th centuries), it also helps if families limit the number of children they have. This does not necessarily contribute to innovation, but it does mean that innovation will more quickly translate into growth.
Most societies in world history had none of these features, let alone all of them. It took a while for all of these preconditions to coalesce in one nation. But once it did, economic growth took off.”
…
“[In our view], the decisive break responsible for industrialization rests on developments that seem to be only indirectly connected to the story of colonial exploitation. But future work might change my opinion on this subject.”
…
“On the one hand, the sugar economy boomed in the 17th and 18th centuries, and cotton was the major input into the textile factories at the center of Britain’s industrialization. These crops were produced with slave and coerced labor.
On the other hand, the evidence is fairly weak of a connection between the products of exploited labor and the innovations that were central to the onset of modern economic growth. This is not to deny a connection between the two, and reasonable people disagree over the relevant counterfactuals. Had there been no slave labor in the New World, would the Lancashire factories have been able to get enough cheap cotton to make innovation worthwhile? Would innovation have been possible with more expensive cotton of different quality from other parts of the world?
Our book leads to the conclusion that there is no silver bullet explanation for why the world became rich. Colonization likely played some role, and it likely played a much greater role in keeping large parts of the formerly colonized world poor. But there are many key features of the onset of growth that cannot really be accounted for by colonization. Most importantly, explaining how the world became rich requires an explanation for why the rate of technological change rose so rapidly. Colonization may have played an indirect role in this process, but there are many other causes we highlight that were much more direct and relevant.”
“Ukraine covers less than 6 percent of Europe’s land area, but it’s home to more than a third of the continent’s biodiversity. It’s also highly industrialized, with hundreds of chemical plants, nearly 150 coal mines, and more than a dozen nuclear reactors — including Europe’s largest.
So, one obvious problem is the destruction of these facilities. In March, shelling in the northern Ukrainian town of Novoselytsya caused an ammonia leak at a fertilizer factory, threatening residents by contaminating groundwater and soil. Then there are those exploding tanks of nitric acid. Meanwhile, damage to coal-fired power plants can cause electrical water pumps to fail, allowing contaminated water in mines to spill over and pollute the groundwater.”
…
“Russia has also attacked oil and gas storage facilities, lighting up the sky with explosions that pollute the air and release carbon dioxide.”
…
“The stuff inside the rockets that both sides are using can poison the environment, too, according to the Ukrainian advocacy group Center for Environmental Initiatives Ecoaction. When they explode, artillery rockets can produce a number of noxious substances including hydrogen cyanide vapor and nitrogen oxides, which can cause acid rain, Ecoaction said.
In April, the Ukrainian army shot down a Russian missile, and some of the debris fell on an agricultural site, leaking toxic chemicals into the soil and water, CNN’s Ivana Kottasová reported. Officials told people living nearby not to drink water from wells and there were reports of dead fish in a river several miles away, Kottasová reported.”
“The problem is that there’s very little evidence that surveillance technology effectively stops these kinds of tragedies. Experts even warn that these systems can create a culture of surveillance at schools that harms students. At many schools, networks of cameras running AI-based software would join other forms of surveillance that schools already have, like metal detectors and on-campus police officers.
“In an attempt to stop, let’s say, a shooter like what happened at Uvalde, those schools have actually extended a cost to the students that attend them,” Odis Johnson Jr, the executive director of the Johns Hopkins Center for Safe and Healthy Schools, told Recode. “There are other things we now have to consider when we seek to fortify our schools, which makes them feel like prisons and the students themselves feel like suspects.”
Still, schools and other venues often turn to surveillance technology in the wake of gun violence.”
…
“Even more advanced forms of surveillance tech have a tendency to miss warning signs. So-called weapon detection technology has accuracy issues and can flag all sorts of items that aren’t weapons, like walkie-talkies, laptops, umbrellas, and eyeglass cases. If it’s designed to work with security cameras, this tech also wouldn’t necessarily pick up any weapons that are hidden or covered. As critical studies by researchers like Joy Buolamwini, Timnit Gebru, and Deborah Raji have demonstrated, racism and sexism can be built inadvertently into facial recognition software. One firm, SN Technologies, offered a facial recognition algorithm to one New York school district that was 16 times more likely to misidentify Black women than white men, according to an analysis conducted by the National Institute of Standards and Technology. There’s evidence, too, that recognition technology may identify children’s faces less accurately than those of adults.”
…
“Research conducted by Johnson, the Johns Hopkins professor, and Jason Jabbari, a research professor at Washington University in St. Louis, found that a wide range of surveillance tools, including measures like security cameras and dress codes, hurt students’ academic performance at schools that used them. That’s partly because the deployment of surveillance measures — which, again, rarely stops mass shooters — tends to increase the likelihood that school officials or law enforcement at schools will punish or suspend students.
“Given the rarity of school shooting events, digital surveillance is more likely to be used to address minor disciplinary issues,” Barabas, the MIT researcher, explained. “Expanded use of school surveillance is likely to amplify these trends in ways that have a disproportionate impact on students of color, who are frequently disciplined for infractions that are both less serious and more discretionary than white students.”
This is all a reminder that schools often don’t use this technology in the way that it’s marketed. When one school deployed Avigilon’s software, school administrators used it to track when one girl went to the bathroom to eat lunch, supposedly because they wanted to stop bullying. An executive at one facial recognition company told Recode in 2019 that its technology was sometimes used to track the faces of parents who had been barred from contacting their children by a legal ruling or court order. Some schools have even used monitoring software to track and surveil protesters.”