Follow The Money

Years ago, when I was working as a medical transcriptionist, one of the more conservative women I met looked me in the eye and warned me that the Internet was a place of evil. I was a bit startled by her assertiveness since the Internet was created by mankind and, therefore, was a reflection of mankind. As digital word processing became more pervasive (and doctors were forced to use computers instead of making illegible scribbles in a patient's medical record), the rush to monetize medical data picked up momentum.

A profession that had been built on a solid foundation of protecting patient confidentiality and maintaining a safety net for doctors who couldn't dictate their way out of a paper bag was easily subverted by new technological advances.

• Optical character recognition (OCR) technology allowed anyone to scan a handwritten or previously published document and convert much of what the scanner read to digital text. But it wasn't 100% accurate.
• Speech recognition software became popular as a back-office engine for converting sound to digitized text. But it wasn't 100% accurate.
• Reports that had been formatted with HIPAA-protected patient information isolated in headers and footers could be mined for data whose market value would develop handsome new revenue streams from market research firms without betraying a patient's privacy.

With increased pressure to reduce administrative costs by converting paper-based medical records to searchable electronic health records (EHRs), the predictable outcome was that greed triumphed over integrity.

• Transcriptionists who had spent years tuning their ears to the quirks of doctors with foreign accents (or American physicians who could not make a coherent sentence) found themselves unable to compete with transcription farms in India, Ireland, and the Philippines which severely undercut their incomes.
• Physicians who resented having to pay professional rates for transcription were delighted to have their expenses drastically reduced by firms that outsourced their dictation overseas.
• Physician groups banded together to market their data mining potential to anyone willing to pay a decent price.
• As older transcriptionists retired or were forced to find another source of income, the safety net which had protected so many patients from critical mistakes routinely made by tired physicians as they dictated medical reports vanished into thin air.

It took a while before people in the healthcare information management (HIM) field realized they were facing a new set of problems.

• When lawsuits were filed against surgeons who had operated on the wrong arm or leg, some medical transcriptionists were quick to suggest that the problem might have been due to a surgeon's mistake while dictating reports (hospitals now employ strict pre-surgery protocols to make sure a patient knows which part of the body should undergo surgery).
• Despite the insistence that medical data that had been outsourced overseas could not be compromised because of how the software was designed, there was no guarantee that a rogue agent in India or some other country could not download reports and sell patient-identified information on the black market.
• In 2011, a data breach at Tricare jeopardized the confidentiality of personally-identifiable and supposedly protected healthcare information (including Social Security numbers) of 4.9 million military patients.

Fast forward to 2018. Shocked Americans are now learning about the methodologies used by Cambridge Analytica to harvest information from millions of Facebook users without their knowledge and then weaponize that data to subvert the Brexit vote and the 2016 Presidential election in the United States.




To get a better understanding of what's been done and what's at stake, I recommend three recent articles:

• An OpEd piece by Thomas L. Friedman published in The New York Times entitled "Get Me Back My Turkey."
• Michelangelo Signorile's provocative piece on HuffPost entitled "It Matters That A Gay Man Helped Trump Backers Exploit Facebook Data" (which confirmed my suspicion that Rebekah Mercer might be a fag hag).
• "Data Scientist That Passed Info To C.A. Looked For Dark Triad Via Personality Quiz."

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Think back, if you will, to a sunnier era of computer threats as depicted in such hack-tastic movies as War Games (1983), Sneakers (1992), and the venal slickness of Gordon Gekko in 1987's Wall Street, a vulture capitalist whose credo was that "Greed is good." Then rewind the clock to the financial crisis of 2007-2008, when so many investors and homeowners suddenly found themselves up shit's creek without a paddle as their investments seemed to evaporate into thin air.

Try to remember the financial pain inflicted by the Enron scandal when the company's house of cards collapsed, triggering panic among millions of Americans who had been pawns in the energy industry's equivalent of a Ponzi scheme. While homes across America were being foreclosed, there were still people playing the stock market who actively sought alternatives for high-return investments in global markets.

Oddly enough, China seemed to have great potential for rapid growth, giving it the aura of a 21st century gold rush opportunity. With a grifter like Donald Trump in the White House, Americans are now witnessing an intense effort to deregulate financial restrictions put into place during the Obama administration as the nation struggled to pull itself back from the brink of a terrifying economic crisis.

Poster art for The China Hu$tle

Jed Rothstein's stunning new documentary entitled The China Hu$tle offers a textbook lesson in how to exploit a legal loophole in order to drive a creative redistribution of wealth. The film's protagonist, Dan David, looks straight into the camera and warns the viewer that "there are no good guys in this film." But Dan has a story to tell and Rothstein does a bang-up job of explaining the intricacies of how a lot of American money that has been invested in China might disappear in the wink of an eye.

Some parts of Mr. David's story require an understanding of global finance, others require an appreciation for the differing ways that culture affects how business is conducted in the United States and China. The key issue is that Americans are prohibited by law from directly investing in Chinese markets. The legal loophole at the crux of the film is a form of reverse merger which has allowed more than 300 Chinese businesses to take over dormant American companies (that were once active on a stock exchange) and change their names in order to attract new investors with publicly-traded stock offerings.

Dan David tries to lobby Congress in The China Hu$tle

When some of Dan David's clients suddenly started losing their investments in such companies, he became determined to make sure they regained their money. Together with some friends in the investment industry, he started investigating the types of transactions that could lead to a firm's sudden collapse. What he discovered was a massive pattern of fraud involving falsified balance sheets, nonexistent inventories, and dubious profits (all made possible by this legal loophole).

When Mr. David hired a lobbyist to help him warn members of Congress what was happening, they got a polite brush-off. In the long run, he and his colleagues managed to get their clients' money back by betting that certain companies will fail, rather than succeed. With the help of some carefully targeted short sells, they found ways to sink the stock value of fraudulent Chinese companies.


Part financial thriller, part horror story, The China Hu$tle unfolds like a cross between a spy novel and one of Rachel Maddow's cause-and-effect analyses of the backstory to a breaking political scoop. With an understanding that the greed Gordon Gekko worshipped is not just good (it's also insatiable), Rothstein gives viewers a clearer understanding of why capitalism needs to be held accountable for its crimes and why transparency is one of the best weapons against financial fraud.

While Rothstein's documentary contains plenty of input from journalists and talking heads from the finance industry, the most nervous and revealing on-camera behavior comes from retired General Wesley Clark, a former director of an online gambling company known as The Stars Group (which had done business with the Appleby law firm named in 2017 in The Paradise Papers). People intensely focused on trying to determine what (or how much) Donald Trump owes to Russian oligarchs may want to pay equally careful attention to the Chinese business community's attempts to pull off one of the biggest heists in history. Here's the trailer: