[askonomm]

In Estonia all of our records (incl. Health) are digitized and online in a central system that both doctors and you can access. It works wonders. Every doctor I go to can see my entire medical history with a press of a button, and I don't have to deal with any of that. Likewise when they prescribe new things, I can see my prescriptions right there, and so forth. We're a 100% online nation now, and clearly when done well it's remarkably good.

[fire_lake]

Does one big digital system make a cyber attack more damaging?

[jillesvangurp]

In theory yes. But having accurate & complete information in the hands of nurses and doctors saves lives on a daily basis as well.

[willvarfar]

Estonia is frequently targeted by massive coordinated and sophisticated cyber attacks. So far it has proved very resilient and secure.

[llm_trw]

Efficiency and resiliency are usually orthogonal.

[HPsquared]

Like a physical structure made of one large component is often the strongest and lightest, most rigid etc. But it's the most vulnerable to cracking or other failures.

[inglor_cz]

Well, they are engaged in constant low-level conflict with Russia, so their systems must be pretty hardened against hostile incursions already.

If there is one EU region where digital security must be taken as a life-and-death matter, it is the Baltics. In case of weakening of NATO, they are the foremost candidates for the next Special Military Operation.

[benterix]

> In case of weakening of NATO, they are the foremost candidates for the next Special Military Operation.

I guess the odds of Trump winning are much lower than a couple of months ago. And even if he wins, if he follows with his stupid plan of giving Ukraine to Putin, he will be criticized by all sides. So losing a Baltic state would be another bitter blow and he probably would want to avoid that as he wants to appear "strong".

Also, NATO is not just the USA. The remaining countries had no choice but to increase their military spending and will continue to support Ukraine until the last dime knowing that the fall of this country will just make Putin more aggressive. We can't just let this happen, with the next American administration or without.

[inglor_cz]

It is not really just about Trump. It is quite obvious at least since Obama that US strategic interests are reorienting towards Southeast Asia, which is understandable as half of humanity lives there.

And even with a friendly administration, it can feasibly happen that there will be more crises unfolding at the same time than the US is capable of efficiently addressing. (Say, Ukraine and Israel and Taiwan.)

I wonder how much of a choice the other countries have. Being a European and observing European political patterns, I am very sure that Finland, Sweden, Denmark and most of the former Soviet satellites will continue to support Ukraine because they know what is at stake for them. The UK may as well, given that the dislike between England and Russia goes a long way back.

But there are influential people in Germany (and I am not talking about the AfD here, but about the industrial lobby) constantly pushing in the back rooms for reconciliation with Russia at any cost, because high energy costs have made a mess of the German economy, and I can see something like a repeat of the Munich betrayal of 1938 in the future. At this phase of the war, Putin would be open to such an agreement with Germany. Not even his wildest plans foresee a re-subjugation of the former GDR, so Germany risks "nothing" (well, a lot of goodwill east of the Oder, but that may be an acceptable tradeoff for the businesspeople).

And the more distant countries such as Spain or the Netherlands or Belgium aren't really that much interested in Eastern European affairs, all the verbal proclamations notwithstanding. Although NL has some unsettled business against Russia with regards to that shot down airliner.

[anal_reactor]

While I can see populist parties pushing for an agreement with Russia, it would be a ridiculous move because it would completely split EU into two parts: Russia-lovers (countries that don't border Russia) and Russia-haters (countries that do border Russia).

[inglor_cz]

I agree that it would be a ridiculous move that would split the EU, but people have done such things in the past anyway.

The French discarded all the credibility gained through their extremely bloody victory in WWI by not helping Czechoslovakia and Poland in 1938-9. Prior to that, France was admired and followed by a dozen countries in Central and Eastern Europe which sought to emulate it. Nowadays, meh. It has been almost 90 years since the moment of French weakness and the trust is still not repaired.

Putin himself started a major land war with barely 200 000 soldiers against the second largest country in Europe. Any serious military planner would say that it is not nearly enough to ensure victory, and many people including me in fact considered the whole thing a bluff just by looking at the inadequate numbers. Yet here we are, in precisely the sort of unwinnable war of attrition that is the result of such a bad decision. It may yet end Russia as a power, not directly through the force of arms, but through later destabilization.

People are experts on stupid decisions, especially if they feel in a Zugzwang. I am not sure what German social democrats are going to do if their labor unions start to seriously push them. The threat of losing important factory jobs is potentially very destabilizing for the established left wing of the German political spectrum.

[28304283409234]

Or any other attack. I remember we had such a centralized registration system. It was used to great effect by the German Nazis when they occupied our country. Of course, occupation by foreign aggressors is highly unlikely in Estonia. Unless history repeats itself as it has (in Estonia) dozens of times.

[askonomm]

Do you want to advance your society and make life more convenient for the people or do you want to live in constant fear and create unnecessary complexities for the people? We put a lot of effort in creating secure systems, we audit them constantly, and we get a plethora of cyber attacks from Russians on a constant basis, but they haven't gotten through yet.

We believe in living the best life we can, through the means of making life as convenient as we can, and we're very happy our government thinks the same. I've lived abroad many times, in many countries, and every single time was miserable because of the unnecessary complexity every basic thing involved. I very much doubt that complexity was for security reasons, more like the incompetence of the government bureaucrats to create a cohesive system that interoperates with all the different parts.

[atoav]

Why does this need to be framed as a ditochomy?

I want my health system to be both resilient and efficient. Why? Because generally when unforeseen black-swan-type catastrophic events produce high demand in the health system, chances are other infrastructure is also affected by whatever that event was.

If the last pandemic has shown anything it is that if great minds come together and cast aside their corporations strategic or financial incentives for a moment, we can have the nice things — so for example tools that excell in multiple dimensions at once that many described as incompatible with each other: convenience, resilience, privacy, ...

If we want to move things forward, we should do our level best to not fall into the trap of false dichotomies. What is often framed as a fundamental dichotomy is usually just a tension that people with vested interests abuse to get a solution that suits them. That is not where real innovation or good engineering happens.

[wkat4242]

Are there safeguards in place to prevent the wrong people looking up your data with the touch of a button though? I'm aware of Estonia's digital prowess but for me privacy is a top concern and I'm glad we're not so all-in here.

[askonomm]

In the FAQ section of our health portal (https://www.terviseportaal.ee/en/kontaktid-ja-kkk/) it states:

> In Estonia, health information is gathered to the Health Information System, where your prescriptions and medical records are accessible to the health care professionals that provide services to you. The Health Portal enables you to view your data in the Health Information System, submit additional information, and change your personal data. You may restrict your health data if you wish. In that case, health care professionals no longer have access to your health information and the quality of medical care may be impaired, especially in emergency situations.

We take privacy very seriously. We can also see exactly who looked at our data, as there is a log of every person or institute who has done so. A little more is written here: https://e-estonia.com/i-spy-with-my-little-eyeprivacy/

[xtracto]

I understand where you are coming from. But for ME I have personally ever wondered why are people afraid of others knowing their medical history.

This I know is a very unpopular opinion, but for my specific case, I've got plenty of medical record that may be considered "shameful"? Got several colonoscopies, endoscopies, I lost a finger, I had a LIS (anal operation) , etc, etc, etc haha. Yet, I kind of don't really care if people knew about it.

Maybe I have never truly suffered discrimination (I'm what we call "whitexican" here in Mexico, so I'm privileged. And that's why I think like this.

[wkat4242]

In countries where healthcare can exclude preexisting conditions this can be a major problem.

And it's not just about shame. It's just about it being nobody's business. I'm not afraid of people knowing my history (though I imagine my mental health history may raise some eyebrows, I don't feel bad about it) but it's just none of anyone else's business and I would certainly be pissed if someone knew that I didn't confide in.