Memia 2021.16: 👀👀4 eyes and a wink😉// digital! decentralised! Health NZ🩺// dragon up🐉// signal utu👅// universal creative income💰

I-OH-TEEEE! / I-OH-TEEEE!

Kia ora,

Welcome to this week’s Memia newsletter, covering the interplay between emerging tech and the rapidly unfolding future. I try to take a global perspective but often focus in on what’s happening in my corner of the world - Aotearoa New Zealand and the wider Asia-Pacific region. I hope you find it engaging…and if you do, please feel free to share with a friend or colleague!

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Events from this week:

🩺Digital! Decentralised! Health NZ

After over three years of sideline detractors decrying the Ardern government’s inaction on any major reforms, Labour’s own “action man” - Health Minister Andrew Little - finally dropped a big rock into the pond last week with his announcement of a new, consolidated national health service:

  • “All DHBs will be replaced by one national organisation, Health New Zealand

  • A new Māori Health Authority will have the power to commission health services, monitor the state of Māori health and develop policy

  • New Public Health Agency will be created

  • Strengthened Ministry of Health will monitor performance and advise Government”

RNZ canvased a range of expert reactions from the supportive to the melodramatic:

“like an atomic bomb being dropped with no warning“

- Acting Canterbury DHB Chair Mark Solomon

Seriously…? Like a tiny country of 5M population really needs 20 pseudo-sovereign mini-me bureaucracies? (Refer also…Local Government).

Well…here’s another reckon:

“Underwhelming and fails to imagine the possible”

- Sideline carper Ben Reid

In the announcement and also the RNZ coverage, there isn’t a *single* use of the words “digital”, “technology” or “innovation” looking forward.

Instead the announcement seems totally preoccupied with cost-saving efficiencies from organisational restructuring - without any modernisation of service design or user experience. Remind me what century we’re in again?

Why can’t a new 21st century public health service be re-imagined from the ground up based upon a few simple principles? Such as:

  1. Defined population-wide health outcome data measured consistently, frequently and transparently across the whole system

  2. A single unified digital health record

    • …fully accessible by the patient…

    • …which meets international security and portability standards.

  3. Equal access to all services which can be delivered digitally

    • Meet increased demand for (more convenient) GP services by supporting digital telemedicine where possible

    • Remote health monitoring, alerting and prediction

    • (With broadband satellite internet, rural connectivity issues diminish towards zero.)

  4. Location-based differential access for services which must be delivered in-person or in a specialised built facility (eg hospital, GP clinic)

    • (As currently), live 200km from a major population centre, expect to travel for in-person treatment.

    • …BUT transparent algorithms and subsidised travel to maximize equity of geographic access

  5. Decentralised, distributed workforce by default

    • Administrative and telemedicine roles which don’t require in-person presence can be filled anywhere in the country (…?or outside…?)

    • Further: take this transformation opportunity to introduce an alternative operating model for national government, away from proximity-biased Wellington-centric bureaucracy

My relatively limited personal experiences of medical care in Aotearoa are a combination of high quality people (both clinical and administrative) but archaic paper-based and client-server IT systems and communications. In 2021, many digital natives expect better.

Hopefully some of these - frankly glaring - omissions will be addressed by the time the final restructuring proposal is completed in a year. Otherwise a wasted, once-in-a-technological-generation opportunity.

Some of these sentiments echoed by NZHIT:

[Weak] signals

The usual roundup of emerging tech stories from this week:

Future of money:

Lots of developments percolating this week around this abstract concept called “money”:

Wild west crypto:

Slightly less wild, less west world of Central Bank Digital Currencies (CBDCs):

Two pieces of monetary meta-commentary:

  • And challenging from the pseudonymous Concoda (“Navigating the absurdity of late-stage capitalism”) on Medium: How the Elites Plan to Stop the Mother of All Bubbles From Bursting. (h/t spotting Andrew Leckie):

    “Right now, maintaining the status quo means creating modern but also batshit economic policies. We’re in a crazy scenario where every traditional monetary and fiscal tool has become ineffective. These only act as psychological tricks to convince us the authorities have control over the banks while the opposite is true. Fed officials can’t even define money, but that’s what you get when you back your currency with nothing. Instead, their new role is to support the massive house of cards that the financial aristocracy has constructed over the past half-century.”🤔

Mind expanding

“Like crafty genies, AIs will grant our wishes and then hack them, exploiting our social, political, and economic systems like never before.”

  • I’ve always been enticed by the insights of the World Values Survey - latest dataset analysis is out, summarised in the map below:

Rollcall

Around Aotearoa this week:

Hidden gems

(Two more of the same ilk here and here).

  • Closer to home, over the Anzac weekend I was support crew for Ms. 15yo’s team taking part in the very well organised, but very long (13-hour!!) Kaikoura Adventure Race in the north-eastern mountains of Te Wai Pounamu. It really is one of the most stunning parts of the country…plus, in between transitions we managed to pay a visit to the baby seals further up the coast! After the Kaikoura earthquakes and with the Covid lockdown significantly reducing tourist numbers, the coastal wildlife in this part of the South Island appears to be thriving.🦭

As always thanks 🙏🙏🙏 for letting me into your inbox each week - and to everyone who sends in comments and feedback…much appreciated!

More again next week.

Ngā mihi / Cheers

Ben