I don't want to live in a world where insurance companies or employers have any need or incentive to have this data. Like most developed nations outside the U.S. for example.
I'm from the US, but I live in a country with "national health care" and... look it sucks. You know what I miss? 1990s era health care for tech workers in the US. When you went in and everything was covered for a $20 co-pay.
You want a specific medication, or a non-generic medication in Australia? Too bad. It's not that it costs more, you just can't get it. Things like Wellbutrin are as illegal as crack. And if you do something like tell your doctor that you tried a bunch of medications and Vyvanse is what works best... they'll literally treat you like someone trying to score opiates. They don't like it when you have an opinion on medications, and you get all sorts of lectures about how bad drug advertising is. It's a very dated, "I'm the doctor, you have to do what I say..." mentality.
And the wait times... "Oh, did you need back surgery? Because you're under 65 and you are over weight, that means you're now bottom on the list... and you'll have to wait for 1-2 years to have this done." A co-worker of mine here is a larger woman, but she just paid out of pocket rather than go on a 2-year wait list. Oh, and the recovery room... there were like 4 people crammed in one room sharing one bathroom. Doctors came in and were talking about care and medical details, in front of total strangers and her visiting guests. No privacy at all. The government would absolutely use health / fitness data to prioritize care... it's not that everyone gets unlimited treatment, they still have budgets.
What else? Remember those classes in college where you couldn't understand the professor because he had such a thick accent? Yeah, that's pretty much every doctor here now. You go to the ER and you need stitches, you end up waiting for a few hours and when you're finally seen the doctor is like, "Why weren't you escalated faster?" "I couldn't understand what your triage nurse was saying, she doesn't speak English... and I haven't got a clue if she understood me... she just told me to sit and wait..." My friend needed 14 stitches and waited over 3 hours in the ER holding a bloody towel on her hand. Only got someone to do something when she started dripping blood on the floor after it had soaked through the towel.
Anyway I know health care sucks in the US, and I do want to get to a point where governments pick up the bill... but holy hell, if the choices at present are what we have in the US or what they have in Australia... man, they both really suck. If you're someone with a job, and with any money, the US model works slightly better.
thats kind of the issue though. If or when the implementation goes wrong you wont have any other options. In one case the UK's NHS even prevented parents from going abroad for treatments for their terminally ill child.
And there won't be any transparency because the people administering the system have all the power and don't like being embarrassed. Meanwhile then public schools and public broadcasts will bang the drum for that system on a daily basis making sure most citizens feel dependent on it, no matter how bad it really is.
And just to make it real, I personally know someone who was told to wait half a year for an appointment. They personally knew a doctor who told them "you can't wait that long, I am going to pull some strings". Turns out it was cancer. This is in Germany, btw, and it's not an isolated case.
I'll add another thing to my experience in Australia. As an immigrant, I'm not covered by national health care. Taxed at a higher rate, plus paying for a visa, and a small fortune if I apply for a PR... and they do nothing to cover me during this time period. Employers don't cover people here, so all I can get is private insurance.
But... private insurance doesn't really cover anything for a year after you pay for the tier you want. So you can get like just emergency coverage -- things like simple ER visits, but things like minor surgery, or anything they can deem is a "pre-existing" condition will take a least a year of paying premiums before you're eligible for benefits. Things like an appendicitis are not covered, there's a cap of like $5k or something on everything in the first year. Luckily I didn't need much coverage... but I'm the best plan I can find here, and if you get seriously ill the first year you're over here you're really just fucked. There's medical screening before your visa can be accepted, but they don't at all cover you if you get in trouble here.
An American friend needed hernia surgery, and he had to pay entirely out of pocket because his insurance wouldn't cover it. Health care... not like it's a regular service you can price compare when you need treatment. You just say, "Fix it!" and I think it cost him something like $18k to have the surgery. Mind you he had health insurance, but, again, it doesn't cover anything the first year you have it.
And it's next to impossible to get anything around mental health covered, even with the top tier private insurance here. Want to maintain your prescription of Adderall? Good luck finding a doctor here who will give you a script. It's all pretty shitty. On top of that... it's all a digitized system, where the government gets full access to your records. There's a question on the visa applications if you've ever seen a psychiatrist. The lawyers strongly caution you not to answer yes on it, as it supposedly makes it harder to get a visa approved... but since it's all data the state has access too... pretty hard to keep any of it a secret.
Anyway look, is the US perfect? No, and I've never been through immigration in the US. But the Australian system is pretty far from perfect. Take people, put them a billion miles away from their friend and family, and then penalize them for getting homesick and seeking mental health... that's insane. (=
I've ranted enough, but a lot of this strikes home for me. I've come to the other side of the world so I can score my long-term medication, medication that something like 10% of the people in the US are on, illegally from prep school kids. That's my experience with the Australian system.
Universal healthcare systems merely change the point of information demand based on who is responsible for the cost, from private companies to governments.
The notion that the authoritarian-creep and spy-on-everyone mentality that continues rapidly spreading in most developed nations, won't apply to this type of healthcare data, is obviously false. There is no entity that wants to track people more than governments (and in all possible regards), it's not even remotely close. It doesn't matter whether we're talking about the US, France, UK, Australia, South Korea, Japan or Germany.
