David H. Freedman

Personalized health care and artificial intelligence could improve your life—at a cost to your privacy

From my cover story in the April 5, 2019, issue of Newsweek

Andres Rubiano first got the news that his blood pressure was too high in the 1990s, when he was in his late 30s. His doctor prescribed medication and encouraged him to get more exercise and cut down on salt, a regimen Rubiano wasn’t very diligent in following. Then, four years ago, his doctor convinced him to enroll in a pilot project. Once a day, Rubiano slipped on an automatic cuff that wirelessly relayed blood pressure readings to a team of clinicians. His Apple Watch sent off heart-rate and physical-activity readings. Soon, Rubiano was getting text messages and emails about his readings, and his doctor called every month to discuss them. His blood pressure dropped from 150 over 100 to a reasonable 130 over 78….Read more

The Japanese neatness consultant has inspired millions to declutter. But the mania also raises some interesting questions.

From my article in the January 19, 2019, issue of New Scientist

A CLUTTER-free kitchen, living room or office resonates with a clean, graceful aesthetic. Neatness implies organisation and discipline. Stress and inefficiency disappear with stray socks and the morning’s dishes. That’s the promise of Japanese neatness consultant Marie Kondo, as she espouses “the life-changing magic of tidying up” in her Netflix series. But why are so many of us obsessed—and defeated—by the demands of tidiness? Read more

Most cancer patients never get into lifesaving drug trials because of barriers at community hospitals

From my article in the January 2019 issue of Scientific American

The drugs available in clinical trials often represent the latest in research, and many turn out to be significantly more effective than standard treatments. But whereas about one third of cancer patients in the U.S. meet the criteria for a trial with a new drug, only about 4 percent end up in such tests, according to National Cancer Institute estimates. The main reason for the massive shortfall: in the nonacademic community hospitals where most cancer patients are treated, doctors do not feel they have the time, the incentives or the support to learn about available trials, to qualify and enroll patients, or to provide the extra follow-up care such trials often call for. Because nationally about 85 per-cent of cancer patients end up at community hospitals, most of the low participation in cancer trials is attributable to the failure of those hospitals to enroll their patients. Major academic hospitals enroll about 20 percent or so of cancer patients in trials, but community hospitals typically enroll less than one percent.

All of which makes it astonishing that a small community hospital in the middle of rural Nebraska manages to place some 35 percent of its cancer patients in trials. That achievement is due almost entirely to the sheer determination and dedication of a single doctor named Mehmet Copur…. Read more (may be paywalled)

Driverless cars are coming fast. That could be a big upgrade to life in America—or a complete nightmare, if we don’t quickly take control of the situation

From my cover story in the Dec. 14, 2018, issue of Newsweek.

At the dawn of the 20th century, the automobile was heralded as a way to free cities from the scourge of horse manure. Cars delivered on that promise, and they made us a far more mobile society. But they also stuck us with a slew of pervasive problems that haunt us today: urban blight, suburban sprawl, congestion, a rich-poor divide, a health-crushing lack of physical activity and enough pollution to upend the Earth’s climate.

Most U.S. cities seem positioned to once again allow technology to overwhelm them. New York City, for example, currently has no testing program in place for driverless cars—General Motors was planning one for 2019 but canceled it when the City Council raised concerns about safety. Singapore, some European countries and China are taking steps to prepare for AVs, but not one major U.S. city has introduced new traffic or development laws intended to boost AVs or push drivers to use them. If cities don’t get their development acts together soon, driverless vehicles will likely make traffic far worse in the coming years….Read more

Americans whose treatments aren’t covered by insurance are saving thousands and getting good care by going outside the country

From my article in the November 2018 issue of Men’s Journal

Three years ago, Justin Bull was goofing around with friends, swinging on a tree rope, when he lost his grip. The 29-year-old multi-sport athlete and dirt biker plunged 35 feet, landing on his right shoulder and snapping a tendon. Worse yet, he was uninsured, which meant getting surgery in his hometown of Fort Worth, Texas, would cost $40,000, all out-of-pocket. “I was looking at going into serious debt,” he says.

Then Bull’s mother made a surprising suggestion: Go abroad to get it done. A few years before, she’d traveled to the Czech Republic for surgery on her ankle. The procedure had been top-notch, complication-free, and a huge cost-saver. Bull did some research and opted for the Hospitales Amerimed in Cancún, Mexico—an orthopedic-surgery destination for professional athletes worldwide. Bull says it couldn’t have gone better. Total cost of airfare, a week in a resort for two, and all medical costs: $7,400. He checked with two U.S. surgeons afterward who said the work on his shoulder passed muster….Read more

Obsolete, easily hacked voting machines in counties with close congressional elections–and no way to do a recount. How could Russia resist?

From my cover story in the October 26, 2018, issue of Newsweek

Security is tight at the Bucks County, Pennsylvania, Government Administration Building in Doylestown, a three-story brick structure with no windows. That’s where officials retreat on election night to tally the votes recorded on the county’s 900 or so voting machines. Unfortunately, Russian hackers won’t need to come calling there on Election Day. Cyberexperts warn that they could use more sophisticated means of changing the outcomes of close races or sowing confusion in an effort to throw the U.S. elections into disrepute. The 2018 midterms offer a compelling target: a patchwork of 3,000 or so county governments that administer elections, often on a shoestring budget, many of them with outdated electronic voting machines vulnerable to manipulation….Read more

Facebook and others are turning your personal health information into a hot business commodity

From my article in the August 2018 issue of Men’s Journal

When the news broke that Facebook had allowed third-party apps to harvest troves of data from its users to influence U.S. elections, people (rightfully) freaked out. Now here’s something else to worry about: Facebook and others are turning your personal health information into a hot business commodity. Facebook and others have reportedly been looking into selling user information to hospitals and medical institutions eager to identify patients and build digital profiles that might include diagnoses, tests, prescriptions, and even sex-drive data.

This health data can be found in your posts, app downloads, fitness trackers, and phone activity, where it can be gathered and sold. And what Facebook has attempted to do is only a snippet of the kinds of health privacy violations hanging over the online world….Read more

The truth about concussions is more nuanced than most of what we’ve heard 

From my article in June 2018 in Men’s Journal

What the public has heard about research into chronic traumatic encephalopathy—the degenerative brain disease that seems to be caused by repeated blows to the head—suggests that suffering concussions as a kid is likely to cause depression, memory problems, and violent behavior years later. But what if this new conventional wisdom doesn’t get it quite right? Christopher Giza has been calling for a bit of calm and context. A pediatric neurologist who heads UCLA’s BrainSport program, Giza is one of the world’s leading experts on concussions in contact-heavy sports. Before you pull your youngsters from football—or sign them up for it—Giza has some advice. Read more