A Vortex of Problems with Big Tech – Benton Foundation

Friday, February 1, 2019

Weekly Digest

A Vortex of Problems with Big Tech

You’re reading the Benton Foundation’s Weekly Round-up, a recap of the biggest (or most overlooked) telecommunications stories of the week. The round-up is delivered via e-mail each Friday.

Round-Up for the Week of January 28 – February 1, 2019

McBeath

In the last Weekly Digest, I presented a retrospective of a major policy story from 2018: The democratic harms of “Big Tech.” This week, a polar vortex accompanied a vortex of more privacy abuses from Big Tech, and further concerns about the very bigness of Big Tech.

A New Day, A New Privacy Violation

Every day this week, Benton’s Headlines Daily Digest shared news of new privacy violations by Big Tech companies, specifically Apple, Facebook, and Google. The major news: Facebook has been secretly paying users — some as young as 13 years old — $20 each month to install a “research app” that collected intimate information about online behavior and communications. To get the app on consumers’ devices, Facebook took advantage of the Apple Enterprise Developer Program — a program that allows companies to create apps for their own employees and offer them without first submitting to Apple for review.

Some lawmakers are not happy.

House Commerce Committee Chairman Frank Pallone (D-NJ) tweeted, “Parents warn their children to beware of strangers handing out candy. Apparently that adage should apply to Facebook too. This is one more example of why Americans need strong, comprehensive privacy law.”

Senator Ed Markey (D-MA) said, “It is inherently manipulative to offer teens money in exchange for their personal information when younger users don’t have a clear understanding how much data they’re handing over and how sensitive it is.” He continued, “Congress also needs to pass legislation that updates children’s online privacy rules for the 21st century. I will be reintroducing my ‘Do Not Track Kids Act’ to update the Children’s Online Privacy Protection Act by instituting key privacy safeguards for teens.”

“Wiretapping teens is not research, and it should never be permissible,” said Senator Richard Blumenthal (D-CT). “Instead of learning its lesson when it was caught spying on consumers using the supposedly ‘private’ Onavo VPN app, Facebook rebranded the intrusive app and circumvented Apple’s attempts to protect iPhone users.” Senator Blumenthal said that he would be sending letters to Apple and Google to probe them on their involvement by hosting the apps.

Apple, too, was not happy. The company cut off Facebook’s enterprise developer access for all of its apps, not just the offending research app.

“We designed our Enterprise Developer Program solely for the internal distribution of apps within an organization,” an Apple spokesman said. “Facebook has been using their membership to distribute a data-collecting app to consumers, which is a clear breach of their agreement with Apple.”

But Facebook wasn’t the only company taking advantage of this loophole. Google has been running Screenwise Meter, which invited users aged 18 and up (or 13 if part of a family group) to download the app by way of a special code and registration process using an Enterprise Certificate.

Google said:

The Screenwise Meter iOS app should not have operated under Apple’s developer enterprise program — this was a mistake, and we apologize. We have disabled this app on iOS devices. This app is completely voluntary and always has been. We’ve been upfront with users about the way we use their data in this app, we have no access to encrypted data in apps and on devices, and users can opt out of the program at any time.

Privacy Violations Or Not, Profits Were Up for Facebook

The standoff between Apple and Facebook erupted hours before the social-networking giant reported record revenues in the fourth quarter of 2018, beating analysts’ expectations. Facebook’s revenue exceeded $16.9 billion. And its net income rose to $6.88 billion, from $4.27 billion a year earlier. Facebook now has 1.2 billion daily, active users and about 2.7 billion people use Facebook along with its other services, including Instagram, Messenger, and WhatsApp.

“But do that many people really use Facebook?” asked Jack Nicas this week. “While the company discloses its estimates of fake accounts, its figures have fluctuated and are confusing. Even Facebook admits its understanding of the numbers is tenuous.”

Aaron Greenspan, Facebook Co-Founder Mark Zuckerberg’s Harvard University classmate who now tracks the company, issued a report questioning how many authentic users Facebook has. Greenspan, who started a site called “the Face Book” while at Harvard and settled a trademark dispute with Facebook in 2009, said he believed the social network has far more fake accounts than it has disclosed, posing a grave risk to its business.

“Facebook has been lying to the public about the scale of its problem with fake accounts, which likely exceed 50% of its network,” Greenspan wrote. “Its official metrics—many of which it has stopped reporting quarterly—are self-contradictory and even farcical. The company has lost control of its own product.”

“The fact there are so many unexplained differences and so many gaps, it paints a picture that, when you combine all these factors together, it would indicate there’s something going on here that they’re trying to hide,” he said.

Facebook Announces Plan to Integrate Messaging Services

Zuckerberg said he plans to integrate all of Facebook’s messaging services — WhatsApp, Instagram, and Facebook Messenger. The move requires thousands of employees to reconfigure how the services function at their most basic levels, but Zuckerberg has also ordered all of the apps to incorporate end-to-end encryption, a significant step that protects messages from being viewed by anyone except the participants in the conversation.

Reactions were mixed. On the one hand, privacy advocates viewed the expansion of end-to-end encryption as a positive move for consumer protection. “Making WhatsApp-level end-to-end encryption the standard for Facebook Messenger and Instagram would in one simple move radically improve the privacy and security of the communications of millions of people,” wrote Gus Rossi for Public Knowledge.

But others were more skeptical.

“Good for encryption but bad for competition and privacy,” tweeted Senate Communications Subcommittee Ranking Member Brian Schatz (D-HI).

“When it comes to privacy, we can no longer give Facebook the benefit of the doubt,” said Senator Markey. “Now that Facebook plans to integrate its messaging services, we need more than mere assurances from the company that this move will not come at the expense of users’ data privacy and security. We cannot allow platform integration to become privacy disintegration.”

“Once again, Mark Zuckerberg appears eager to breach his commitments in favor of consolidating control over people and their data,” said Senator Blumenthal. “Facebook and Google’s dominance over data has already harmed consumers and the economy. The FTC and the Department of Justice must take Big Tech’s invasive, anticompetitive practices seriously and begin to vigorously enforce our laws.”

And the calls to break up Facebook are mounting.

Advocacy groups, led by the Electronic Privacy Information Center, wrote in a letter to Federal Trade Commission Chairman Joseph Simons that modest enforcement actions would not be adequate to curb Facebook’s privacy practices. They urged the FTC to require Facebook to divest from subsidiaries like WhatsApp and Instagram and to impose a fine of at least $2 billion on the social media giant. The wrote:

Given that Facebook’s violations are so numerous in scale, severe in nature, impactful for such a large portion of the American public and central to the company’s business model, and given the company’s massive size and influence over American consumers, penalties and remedies that go far beyond the Commission’s recent actions are called for.

What’s Next for Big Tech and Privacy Violations?

Can competition between Big Tech keep privacy violations in check? Apple cutting off Facebook’s enterprise developer access due to its breach of agreement was seen by some as a way to police Facebook’s privacy patterns.

Kevin Roose, writing for the New York Times, said Apple’s move was “the clearest sign yet that the cold war between Facebook and Apple over data use and privacy is heating up.”

Roose posited that perhaps only Apple CEO Tim Cook can fix Facebook’s privacy problem.

[If] Cook truly wants to protect Apple users from privacy-violating apps, he could remove all of Facebook’s products — including Instagram and WhatsApp — from the App Store until the company can prove, in a real and measurable way, that it cares about its users’ privacy. Shutting off Facebook’s access to Apple devices would be a radical step, tantamount to declaring war on a major competitor. But Apple has banned developers for smaller infractions in the past. And in the absence of government regulation, there may be no other option for bringing the company to heel on privacy.

“It’s weird but probably necessary/inevitable that Apple is now Facebook’s de facto privacy regulator.” — Kevin Roose

But there’s a problem with Roose’s position. Apple didn’t cut off Facebook due to its privacy violations — it was because of a technicality in how the company used the enterprise loophole to distribute the research app to consumers.

And, furthermore, can Apple be trusted with privacy protection?

Uh… probably not.

This week, iPhone users discovered a bug in Apple’s FaceTime video-calling application that allowed a person to hear audio from a person they were calling before the call was accepted. On Monday, a Houston attorney sued Apple, on the grounds that the company was negligent when it allowed the recording of a private deposition.

New York State Attorney General Letitia James announced that she has launched an investigation into the circumstances of the FaceTime bug. “This FaceTime breach is a serious threat to the security and privacy of the millions of New Yorkers who have put their trust in Apple and its products over the years,” James said. “New Yorkers shouldn’t have to choose between their private communications and their privacy rights.”

Senator Amy Klobuchar (D-MN) called the bug “a clear violation of consumers’ privacy protections and a reminder of why we need comprehensive privacy legislation.”

Conclusion: A Privacy Showdown Ahead?

All signs point to lots of policy debates over the privacy violations of Big Tech in 2019. Whether those debates turn into meaningful privacy legislation will be one of the main telecommunications policy stories in 2019.

And Facebook seems to be preparing.

On Tuesday, Facebook said it had hired three veteran privacy activists to “bring in new perspectives to the privacy team at Facebook, including people who can look at our products, policies and processes with a critical eye,” according to Rob Sherman, Facebook’s deputy chief privacy officer. The hires include:

  • Nate Cardozo, an attorney with the Electronic Frontier Foundation, who has been very publicly critical of the company in recent years.
  • Robyn Greene, senior policy counsel with the Open Technology Institute.
  • Nathan White, senior legislative manager for Access Now.

The vortex of problems with Big Tech rolls on. And we’ll be covering it.

For all the news over how policy can protect consumer privacy and serve the public interest, be sure to subscribe to our Headlines Daily Digest newsletter.


Quick Bits

Weekend Reads (resist tl;dr)

ICYMI from Benton

Events Calendar for February 4-8, 2019

Feb 5 — The Great Airwaves Robbery II, New America panel

Feb 6 — Winning the Race to 5G and the Next Era of Technology Innovation in the United States, Senate Commerce Committee hearing

Feb 6 — Senate Commerce Committee Executive Session

Feb 7 — Preserving an Open Internet for Consumers, Small Businesses, and Free Speech, House Communications Subcommittee hearing

New Malware Targets Apple Mac Computers to Steal and Mine Cryptos – CoinDesk

A recently discovered form of malware steals browser cookies and other information on victims’ Apple Mac computers to steal cryptocurrencies.

Researchers at cybersecurity firm Palo Alto Networks published a report on Thursday, saying that the malware, dubbed “CookieMiner,” intercepts browser cookies related to cryptocurrency exchanges and wallet service providers’ websites visited by the victims.

The malicious code targets exchanges and services including Binance, Coinbase, Poloniex, Bittrex, Bitstamp and MyEtherWallet, as well as any website having “blockchain” in its domain name, the researchers found.

The malware also tries to steal credit card information from major issuers, such as Visa, Mastercard, American Express and Discover, as well as saved usernames and passwords in Chrome, iPhone text messages that are backed up to iTunes and crypto wallet keys.

If CookieMiner succeeds at stealing those details, hackers can gain full access to victims’ crypto exchange and wallet accounts to steal funds.

The researchers explained:

“CookieMiner tries to navigate past the authentication process by stealing a combination of the login credentials, text messages, and web cookies.”

MyEtherWallet founder and CEO Kosala Hemachandra told CoinDesk via email: “[MyEtherWallet] is not a cryptocurrency exchange but an interface to interact with the Ethereum blockchain. We do not use cookies so this malware … will not affect our users as long as they do not save their passwords with Chrome.”

CookieMiner has another string to its bow too – it changes a victim’s system configuration to maliciously load crypto mining software. The coinminer is similar to a variant that mines monero, but instead targets a lesser-known cryptocurrency called Koto, the researchers said.

The researchers suggested that cryptocurrency users should keep “an eye on their security settings and digital assets to prevent compromise and leakage.” They also noted that the malware checks if an application firewall program called Little Snitch is running on a victim’s computer. “If so, it will stop and exit,” they said

Monero is by far the most popular cryptocurrency among hackers, though. Last month, a study by college researchers showed that hackers have mined nearly 5 percent of the total monero in circulation.

Deployments of crypto-mining malware are rapidly growing in number. A study from McAfee, published in December, showed that there were nearly 4 million new mining malware threats in the third quarter of 2018 alone, compared to less than 500,000 in 2017 and 2016.

Edit (09:15 UTC, Feb. 7 2019): Updated with comment from MyEtherWallet founder and CEO Kosala Hemachandra.

Apple MacBook image via Shutterstock

Now, Your Chi Beverage Drink Is From The Coca-Cola Company – WeeTracker Media

Onitsha; a city in South-Eastern Nigeria, is home to perhaps one of Africa’s largest population of traders and artisans. Come daylight or nightfall, rains or shine; the famous Onitsha Main Market is a beehive of activities as scores of people and goods can be seen trying to find their way through a gridlock of human bodies.

Businessmen in endless rows of shops, market women in stalls, hawkers milling about with their wares on their heads or in wheelbarrows, roadside sellers displaying their wares on tables or on sacks spread over the ground while still hoping for the day’s first sale even after dusk, trucks being loaded and unloaded by the ‘agboros’ in workmanlike fashion, and of course, the unscrupulous elements walking aimlessly and waiting to pounce on the slightest whiff of laxity or novice – that’s just a typical day in Onitsha.

People from various parts of Nigeria and even beyond throng Onitsha for all sorts of reasons. The city is as famous for its commercial appeal as it is notorious for being the hub of counterfeit products. And unsuspecting first-timers are left with tales of woe more often than not.

Perhaps the most damning case of the spate of counterfeit products in the market is the proliferation of fake drugs.

Unwholesome medicines are still a problem in Nigeria and this is not helped by the fact that drugs are sold in traditional marketplaces instead of licensed pharmacies.

And in Onitsha lies the country’s largest open, unregulated drug market where just about anyone can visit and get a fix of just about anything.

Although the menace was somewhat curtailed by the vigorous crusade of the early 2000s led by Dr. Dora Akunyili, of blessed memory – the then Director-General of the country’s National Agency for Food and Drugs Administration and Control (NAFDAC) – the situation still creates a haven for the distribution of fake medicines which have injurious consequences on the health of unsuspecting buyers.

The late DG oversaw a raid of the drug market in Onitsha which led to the confiscation and destruction of counterfeit drugs worth hundreds of billions of naira during her time at the agency. But it is still worrying that even after her departure from the agency in 2008 and unfortunate demise six years after, around NGN 29 Bn (USD 80 Mn) worth of counterfeit drugs were still reported to have been destroyed between 2015 and 2017 in Nigeria, with the Onitsha drug market, again, accounting for a sizeable chunk of that.

Source: CNN

Enough about the problem, though – how about we talk solutions? And how fitting is it that a group of schoolgirls from the same city has come up with an ideal one?

Onitsha certainly doesn’t get as many mentions as the usual suspects when it comes to tech innovations in Nigeria, and understandably so – the city is more about trade and commerce – but it does feel refreshing for once, to take a break from all the talk of business and dab into tech.

Teenagers; Jessica Osita, Promise Nnalue, Nwabuaku Ossai, Adaeze Onuigbo, and Vivian Okoye, are all students of Regina Pacis Secondary School, Onitsha, in Anambra State, who became the toast of all and sundry when they went all the way to Silicon Valley last year and brought home the gold.

These five girls are members of ‘Save-A-Soul;’ the only African team which participated in last year’s Technovation Challenge which took place in the United States, and they saw off stiff competition from other teams from China, Spain, Turkey, Uzbekistan, and even the host country, to become global champions in the junior category of the competition. And you might be able to guess what innovation took them all the way.

The Technovation program mentors young girls around the globe on how to use technology to solve problems in their communities and the girls coasted to victory in the global competition on the backs of an idea founded on curbing the menace of counterfeit drugs in Nigeria. They developed FD-Detector; an app that detects fake drugs.

The journey started when the team’s mentor, Mrs. Uche Onwuamaegbu-Ugwu, was shown up on a trip abroad. She was attending an educational summit and was captivated at the STEM and Robotic models she came across in an exhibition stand, and at the same time embarrassed for not knowing the first thing about them.

The educator feared for the fate and future of the children under her care and many others back home. So she channeled that inner apprehension into something productive by importing that STEM culture into her homeland.

Uche returned to Nigeria and in her capacity as an educator; she set up Edufun Technik Hub. She founded the institution on the idea of taking STEM and Robotics education materials to different schools to bring young students up to speed. And Team Save-A-Soul was put together in one of those schools that she had sought out.

The girls had shown quite an aptitude and appetite for what the educator served up and when the chance to compete came along, the girls were willing participants. With permission, they put in three hours three times a week into working on various projects. But it was the chance to compete by coming up with a technology-driven social impact idea that indeed brought out their inner genius.

Source: Quartz

Their brainstorming sessions involved identifying societal problems that demanded solutions and one a casual walk around a mall near their ‘war room,’ the idea hit them.

They discovered a counterfeit drug problem and further discussions with a pharmacist in the mall gave them further insight. They also learned of the efforts of NAFDAC to curb the problem with its Mobile Authentication Service, as well as the pitfalls and loopholes of the technology.

In an effort to solve the problem, they opted for something different and innovative – an app that uses 2D barcode technology to verify drug authenticity and expiration dates.

They decided to furnish the barcode with two layers of information; one that will be visible to the human eye and another that can only be read by anyone using their app.

They put in several months of work into designing and developing the app, as well as putting together a good pitch, and in May 2018, they traveled from Onitsha to Nigeria’s capital, Abuja, for the regionals.

Their victory in the regionals won them several commendations and accolades from prominent figures in both Nigeria and beyond but they were going to do one better. They rode the crest of that victory to Silicon Valley and won the global grand prize in the junior category – no mean feat!

The team is now looking to market its solution to big pharmaceutical companies to push the project through the design and development phase. Such companies would pay to have their drugs in the FD Detector Database.

Verifying drugs will only require scanning a barcode on the drug at the point of purchase with a mobile phone which has the app installed. No added piece of equipment, and no text messages. If adopted widely, it could help alleviate the country’s struggles with counterfeit medicines, and some 200 million people will have five teenagers to thank.

Featured Image Courtesy: CNN

Education Budget 2019: From tax-free education to an upskilling allowance, here’s what education experts want – India Today

By 2020, the average age of people will be 46 years in the US, 42 years in Europe, 48 years in Japan, but only 27 in India. This means that India’s demographic dividend is a huge scope for us to capture the job market and can be a big boost for the country’s economy. But this can only happen if today’s youth and students are provided with the correct skills to help them secure future jobs. For that, we need a good education budget.

Ahead of the general elections, the government will present an interim Budget tomorrow, February 1. The last Budget session 2019 of the present NDA government is likely to be presented by interim Finance Minister Piyush Goyal in the Lok Sabha, who was given additional charge of the Finance Ministry as Arun Jaitley has gone to the US for treatment.

The education budget of 2018 was one of the least valued at just 3.5 percent. Here is what education experts are expecting from the Budget session 2019:

1. All-over increase in Education Budget

India needs to increase its Education Budget in the Budget Session 2019.

Ravi Sreedharan, Founder and Director, Indian School of Development Management (ISDM):

“While it might sound ambitious, there is a need to double the current levels of spending in the two areas of public education and public health as a percentage of GDP. Spend on Education as a percentage of GDP is still around 3% versus the aspirational goal of 6%. Lots of developing and developed countries in the world have already been earmarking and spending close to this ballpark (as a percentage of GDP) on education.

Given the widespread inequality and poverty in India, education needs to play a critical role in bringing about intergenerational social and economic mobility with primary public education standing out as the most important area of focus.

Without a good quality government schooling system, it’s impossible to envision us moving towards a just, equitable, humane and sustainable society. Without that the potential demographic dividend we could benefit from is nothing but a pipe dream.”

Rohit Manglik, CEO, EduGorilla:

“The upcoming education budget needs to take initiatives such as allocating bigger spending on education, provision for proper teacher training along with higher pay and administrative incentives.

Incentives need to be provided to encourage research in all disciplines and for augmenting the technical capacity of the central educational institutions like NCERT, NUEPA, IGNOU and many more.

Furthermore, a comprehensive scheme on lines of Ayushman Bharat can be a great start to improve the quality of education.”

Prof. Indradeep Ghosh, Associate Professor & Dean (Faculty), Meghnad Desai Academy of Economics:

In an election year, it would be only appropriate to expect that the government will release an optimistic picture of its finances, which is to say that even though expenditures will be shown to increase on account of various programmes being announced ahead of elections, the revenue side will also appear buoyant and on the rise.

The truth of the matter may be more unpalatable, though. India’s fiscal situation is well known to follow a political cycle, and there is a real danger that FRBM mandates will not be respected in projections, and that the signal picked up by foreign investors will be a largely negative one, irrespective of what the budget actually says.

To allay such fears, the government should try to offer as realistic a vision as possible of the future course of policy if it is re-elected, and especially provide indications of how it proposes to solve critical problems of the Indian economy such as insufficient job creation and deficient infrastructure.

2. Tax-free education to boost ed-tech

Zishaan Hayath, CEO & Co-founder, Toppr:

“Two key steps need to be made – education needs more funding by the government, and it must be tax-free. The budget reserved for education reforms has been constantly declining over the last five years.

Currently, ed-tech is taxed at 18% GST which limits affordability to high-income groups. Education is not a luxury. In fact, online learning is the only way to cater to individual needs at a fraction of the cost. This should be made tax-free to lower after-school education costs for students.”

Shobhit Bhatnagar, Co-founder, Gradeup:

“In a country with over 200 million students, online education can play a major role in improving learning outcomes at a large scale. The government needs to actively support early stage industries like ed-tech that can create impact at scale.

Today, the GST rate for all educational services outside of schools and colleges is 18%, which is same rate bracket as discretionary items such as perfumes, chocolates etc. The government should move educational services to a no GST or the 5% slab.”

Vineet Chaturvedi, Co-founder, Edureka:

“Speaking specifically of the ed-tech industry, a reduction in GST would greatly help boost a culture of up-skilling among Indians and this is indeed the need of the hour for India to maintain an edge in technical skills.

Education and up-skilling is no luxury and it should not be taxed as such. It’s said that India lags behind even Sudan when it comes to its investments in education and healthcare mapped as a measurement of its commitment to economic growth, according to Institute for Health Metrics and Evaluation. It’s time to change that.”

Beas Dev Ralhan, CEO, and Founder, NextEducation India Pvt Ltd:

“With the General Budget around the corner, we have high hopes from the government and expect that a substantial amount would be set aside to the education sector so that we can lay a stronger foundation for new-age learning strategies.

The prerequisite for quality education becoming available to all is the free and easy access to quality e-learning resources. This can be initiated by the government through technologies such as artificial intelligence, virtual and augmented reality and cloud computing.

It is also important to ensure that internet access provided to rural areas is functional so that students from those parts can use it for effective self-learning.”

Amol Arora, Vice Chairman & Managing Director – Shemford Group of Futuristic Schools:

“For any country, the most significant returns are those garnered from investments made in its children.

The next generation is going to enter a globalized world and will be competing for jobs not just against other students but also innovative technologies that are quickly replacing human jobs.

In order to keep our children in the competition, we need to ramp up our ed-tech sector in the years to come. To that end, Budget 2019 should give certain tax breaks to ed-tech startups to enable them to reach sustainable levels.”

Sampreeth Reddy Samala, Founder and CEO, Worldview Education:

“For any education policy in India to make sense, it needs to address issues and provide solutions at a scale. From that view, potentially game-changing tax reforms in the education space are still pending. There is possibly great potential for vast private energy to be tapped into if tax reforms are brought into this space to make it attractive and competitive for private enterprises to enter, innovate and thrive.

Today, every and any educational idea which falls out of the traditional realm is taxed at par with some of the luxury products. This has to change to make investments into innovative ideas in education’ attractive which is crucial to meet the larger and current needs of an aspiring country like India.

This will also help the sector get rid of undesirable practices of working around these taxation hurdles in the name of the sector being and meant to be a novel, not for profit one. This is not only reducing the efficiency of the space but also killing innovation in education.”

Rohit Manglik, CEO, EduGorilla:

“While the Indian government has done much to safeguard the interests of all stakeholders of education, including students, the upcoming interim budget needs to address some important components of the education sector. Undoubtedly, lowering the GST rates from an existing 18% to expected 5% will make education affordable to students.”

3. Better skill development initiatives

Divya Jain, CEO, and Founder, Safeducate:

“In the previous Budget 2018, the government took key steps in skilling and also increased the funds. In this Budget session 2019, we expect that the government should take key steps in raising the quality of skills to levels demanded by a potential employer or even required for a person to start one’s own business.

The focus should be on integrating strategies to increase skilling outcomes and sustain economic growth. Current skill development initiatives should be integrated with nation-building mission programmes.

As an organization which provides skilling and get funded from the government to execute the Skilling programme, we seek some tax benefits. Constructing the skilling centre requires a lot of physical material which is being charged along with GST. We are not being able to reclaim the GST we had paid in the Inward supplies. Also, we have various certification and degree programmes in Logistics and Supply chain management where we are not being exempted from GST.

Support in terms of medical allowance for students that are being trained in skilling programmes is also required. As technology is changing, the Government needs to allocate more funds to improve the quality and develop excellence in Skilling centres.

The government has promised and initiated schemes in Skilling such as PMKVY 2.0, DDU-GKY, NAPS, Bharatmala and Sagarmala, PMKK etc. These schemes have helped us to reach the rural parts of India – ‘the real India’.”

Vineet Chaturvedi, Co-founder, Edureka:

“Skilling and continuous learning have become sufficiently important requirements in today’s competitive professional landscape so much so that even the Indian government has taken note of it and launched skill development initiatives.

What could accelerate India’s skill development story even further and provide fodder to corporate growth is a ‘skilling allowance’ for all tax-paying individuals. Such a rebate that rewards continuous learning will go a long way in creating an industry relevant workforce that can make India a skill hot spot.

Continuous learning is a necessity and not just an option anymore and by treating it on par with necessary allowances such as HRA, LTA, DA & others, GOI would be doing India a great service. After all, India’s biggest strength is its human resource.

Such an allowance will also be beneficial to IT, ITes industries which are subject to frequent skill churn and the ed-tech industry which has been working towards addressing this skilling need on ground.”

Nikhil Barshikar, Founder and MD at Imarticus Learning:

With technology disrupting jobs across sectors, it is important to bridge the skilling gap. The budget session 2019 should focus on skill development as it will directly impact the economy for the better.

We strongly feel the need for allocating more funds towards specialization i.e. in higher and further education, with the vision of enhancing the training and the research amenities for reskilling the workforce.

Tax rebates and incentive schemes will encourage educational institutions to expand their operations in Tier 2 & 3 cities.”

Dr. Jamshed Bharucha, Vice Chancellor, SRM University AP, Amaravati:

“The need to invest in the soft skills development within the education sector is highly important so that qualified, talented and gifted young Indians are not handicapped in any way by communication abilities that can impede their success on a national and international stage.”

Amol Arora, Vice Chairman & Managing Director – Shemford Group of Futuristic Schools:

“The government should grant financial incentives for organizations setting up educational institutes in rural and underserved areas. Currently, the private sector in education is viewed with distrust which is why concrete steps should be taken to show that public-private partnerships can be a win-win for all — delivering quality without fleecing the parents.”

4. Resolution of the angel tax for startups

Siraj Dhanani, Co-Founder and CEO, InnAccel Technologies:

“In the budget session 2019, the govt should continue the focus on healthcare and invest substantially in upgrading the primary and secondary health tiers in the country. This upgrade can leverage the indigenous medical technologies developed specifically for Indian healthcare needs, and thereby support the Make in India initiative.

I hope the budget provides a comprehensive resolution to the angel tax issue being faced by startups, especially ones based on generating intellectual property like medical technology startups.

Raising capital for startups working on affordable healthcare is already difficult- it is made more so by this angel tax, which is effectively a tax on Indian innovation.”

5. Relief for Small and Medium-sized Enterprises (SMEs)

Ankit Gupta, Vice President and COO, Exportersindia.com:

“Despite making huge contributions to the economy, SMEs often face a multitude of challenges that restrict their growth. Due to numerous issues like lack of sustainability, insufficient funds, limited access to resources, heavy competition from large entities, small enterprises often fail to meet their true potential.

Although the ongoing digital revolution has allowed better connectivity while enabling MSMEs and SMEs to gain exposure to the global market, the struggle is constant. However, with the 2019 Union Budget approaching fast, the scenario may change.

Though the recent GST reform has given a huge relief to the SME sector, easy availability of loans, allocation of money in the digital lending sector and tax breaks would be our prime expectations for SMEs from this Budget 2019.”

6. Better student guidance and career counselling

Prateek Bhargava, Founder & CEO, Mindler:

“We at Mindler believe that allocation for funds to drive career counseling and guidance initiatives are a critical need at the ground level. There is a big need to drive students towards careers which are in sync with their abilities rather than blindly following a few career domain.

While national boards have made the need for guidance services mandatory, most schools have not implemented the same primarily due to lack of digital infra to implement state of the art platforms or lack of certified experts in this domain.

Identifying and mapping talent towards right domains is critical for our country, which has the largest youth population globally, if it wants to reap the demographic dividend. We hope the government will enlarge focus on PPP in providing high-quality career guidance to school students across India.

Lastly, in keeping with its recent declaration that it is open to reconsider GST rates on certain components in the education sector, we hope the government will review GST on ancillary services in education.”

7. More research funds

Dr. Jamshed Bharucha, Vice Chancellor, SRM University AP, Amaravati:

“Quality education needs to be made available to all. If we have to keep up with western nations and with regional neighbours in fields of science and technology, our educational institutions need to step up funding on research for a wide range of applications from health sciences, bio-medical, genomics, data science, machine learning, agriculture and food production, space and astrophysics.

University-led research can be an important bridge between ideas and practical applicability in the industry. We need to put in a greater focus on this and commit resources to centres of excellence that will tackle the areas where research is most needed and of national significance. This needs to be done with a sense of urgency on a national scale.

Because university research needs and national priorities(such as Defence Tech, Health & Sanitation, Nutrition & Food) are so closely aligned, Budget 2019 should also focus on University Research funding.”

8. More focus on teacher training and digital upgradation

Prateek Bhargava, Founder & CEO, Mindler:

“The government of the day’s efforts to drive growth, investment and embrace technology in education are all steps in the right direction, however, investment into technology upgradation and teachers training has been falling short.

While this is an interim budget, we hope that it will pave way for higher allocation in these two critical elements as they will usher in much-needed improvement in quality outcomes, allowing schools to leverage the power of digital solutions that bring high quality, personalization and focus on evaluation of outcomes.”

Zishaan Hayath, CEO & Co-founder, Toppr:

“The education budget should be used to digitise schools at a mass level so that every student can access quality education. It should also be used to upskill teachers and close the gap between the education system and current employer demands.

Beas Dev Ralhan, CEO, and Founder, NextEducation India Pvt Ltd:

“Training teachers on the latest pedagogies and Information and Communication Technology (ICT) is the need of the hour as they are expected to employ innovative teaching methods and make use of digital tools in the classrooms. However, there is a dearth of 11 lakh adequately qualified teachers in the K-12 segments.

Even though the government is trying to tackle the situation with initiatives such as Teacher Professional Development courses on the digital platform Diksha, this issue also needs prioritizing in the upcoming budget.

We also hope that the government provides the right kind of infrastructural support for a system of education that is on a par with global standards, and help Indian students face the challenges of tomorrow.”

Read:Budget 2019: Emphasis should be given on IT infrastructure and skill levels to implement AI, says experts

Read: Union Education Budget 2018: Detailed analysis of budget allocation in education sector

Read: Union Budget 2018: Blackboard in schools to bid goodbye, digital boards to takeover

Why Africa Does Not Need Unnecessary Opinions, But Proper Fact-Checking [Opinion] – WeeTracker Media

Onitsha; a city in South-Eastern Nigeria, is home to perhaps one of Africa’s largest population of traders and artisans. Come daylight or nightfall, rains or shine; the famous Onitsha Main Market is a beehive of activities as scores of people and goods can be seen trying to find their way through a gridlock of human bodies.

Businessmen in endless rows of shops, market women in stalls, hawkers milling about with their wares on their heads or in wheelbarrows, roadside sellers displaying their wares on tables or on sacks spread over the ground while still hoping for the day’s first sale even after dusk, trucks being loaded and unloaded by the ‘agboros’ in workmanlike fashion, and of course, the unscrupulous elements walking aimlessly and waiting to pounce on the slightest whiff of laxity or novice – that’s just a typical day in Onitsha.

People from various parts of Nigeria and even beyond throng Onitsha for all sorts of reasons. The city is as famous for its commercial appeal as it is notorious for being the hub of counterfeit products. And unsuspecting first-timers are left with tales of woe more often than not.

Perhaps the most damning case of the spate of counterfeit products in the market is the proliferation of fake drugs.

Unwholesome medicines are still a problem in Nigeria and this is not helped by the fact that drugs are sold in traditional marketplaces instead of licensed pharmacies.

And in Onitsha lies the country’s largest open, unregulated drug market where just about anyone can visit and get a fix of just about anything.

Although the menace was somewhat curtailed by the vigorous crusade of the early 2000s led by Dr. Dora Akunyili, of blessed memory – the then Director-General of the country’s National Agency for Food and Drugs Administration and Control (NAFDAC) – the situation still creates a haven for the distribution of fake medicines which have injurious consequences on the health of unsuspecting buyers.

The late DG oversaw a raid of the drug market in Onitsha which led to the confiscation and destruction of counterfeit drugs worth hundreds of billions of naira during her time at the agency. But it is still worrying that even after her departure from the agency in 2008 and unfortunate demise six years after, around NGN 29 Bn (USD 80 Mn) worth of counterfeit drugs were still reported to have been destroyed between 2015 and 2017 in Nigeria, with the Onitsha drug market, again, accounting for a sizeable chunk of that.

Source: CNN

Enough about the problem, though – how about we talk solutions? And how fitting is it that a group of schoolgirls from the same city has come up with an ideal one?

Onitsha certainly doesn’t get as many mentions as the usual suspects when it comes to tech innovations in Nigeria, and understandably so – the city is more about trade and commerce – but it does feel refreshing for once, to take a break from all the talk of business and dab into tech.

Teenagers; Jessica Osita, Promise Nnalue, Nwabuaku Ossai, Adaeze Onuigbo, and Vivian Okoye, are all students of Regina Pacis Secondary School, Onitsha, in Anambra State, who became the toast of all and sundry when they went all the way to Silicon Valley last year and brought home the gold.

These five girls are members of ‘Save-A-Soul;’ the only African team which participated in last year’s Technovation Challenge which took place in the United States, and they saw off stiff competition from other teams from China, Spain, Turkey, Uzbekistan, and even the host country, to become global champions in the junior category of the competition. And you might be able to guess what innovation took them all the way.

The Technovation program mentors young girls around the globe on how to use technology to solve problems in their communities and the girls coasted to victory in the global competition on the backs of an idea founded on curbing the menace of counterfeit drugs in Nigeria. They developed FD-Detector; an app that detects fake drugs.

The journey started when the team’s mentor, Mrs. Uche Onwuamaegbu-Ugwu, was shown up on a trip abroad. She was attending an educational summit and was captivated at the STEM and Robotic models she came across in an exhibition stand, and at the same time embarrassed for not knowing the first thing about them.

The educator feared for the fate and future of the children under her care and many others back home. So she channeled that inner apprehension into something productive by importing that STEM culture into her homeland.

Uche returned to Nigeria and in her capacity as an educator; she set up Edufun Technik Hub. She founded the institution on the idea of taking STEM and Robotics education materials to different schools to bring young students up to speed. And Team Save-A-Soul was put together in one of those schools that she had sought out.

The girls had shown quite an aptitude and appetite for what the educator served up and when the chance to compete came along, the girls were willing participants. With permission, they put in three hours three times a week into working on various projects. But it was the chance to compete by coming up with a technology-driven social impact idea that indeed brought out their inner genius.

Source: Quartz

Their brainstorming sessions involved identifying societal problems that demanded solutions and one a casual walk around a mall near their ‘war room,’ the idea hit them.

They discovered a counterfeit drug problem and further discussions with a pharmacist in the mall gave them further insight. They also learned of the efforts of NAFDAC to curb the problem with its Mobile Authentication Service, as well as the pitfalls and loopholes of the technology.

In an effort to solve the problem, they opted for something different and innovative – an app that uses 2D barcode technology to verify drug authenticity and expiration dates.

They decided to furnish the barcode with two layers of information; one that will be visible to the human eye and another that can only be read by anyone using their app.

They put in several months of work into designing and developing the app, as well as putting together a good pitch, and in May 2018, they traveled from Onitsha to Nigeria’s capital, Abuja, for the regionals.

Their victory in the regionals won them several commendations and accolades from prominent figures in both Nigeria and beyond but they were going to do one better. They rode the crest of that victory to Silicon Valley and won the global grand prize in the junior category – no mean feat!

The team is now looking to market its solution to big pharmaceutical companies to push the project through the design and development phase. Such companies would pay to have their drugs in the FD Detector Database.

Verifying drugs will only require scanning a barcode on the drug at the point of purchase with a mobile phone which has the app installed. No added piece of equipment, and no text messages. If adopted widely, it could help alleviate the country’s struggles with counterfeit medicines, and some 200 million people will have five teenagers to thank.

Featured Image Courtesy: CNN

Global Investment Firm Partech Closes Africa Fund Of USD 143 Mn – WeeTracker Media

Onitsha; a city in South-Eastern Nigeria, is home to perhaps one of Africa’s largest population of traders and artisans. Come daylight or nightfall, rains or shine; the famous Onitsha Main Market is a beehive of activities as scores of people and goods can be seen trying to find their way through a gridlock of human bodies.

Businessmen in endless rows of shops, market women in stalls, hawkers milling about with their wares on their heads or in wheelbarrows, roadside sellers displaying their wares on tables or on sacks spread over the ground while still hoping for the day’s first sale even after dusk, trucks being loaded and unloaded by the ‘agboros’ in workmanlike fashion, and of course, the unscrupulous elements walking aimlessly and waiting to pounce on the slightest whiff of laxity or novice – that’s just a typical day in Onitsha.

People from various parts of Nigeria and even beyond throng Onitsha for all sorts of reasons. The city is as famous for its commercial appeal as it is notorious for being the hub of counterfeit products. And unsuspecting first-timers are left with tales of woe more often than not.

Perhaps the most damning case of the spate of counterfeit products in the market is the proliferation of fake drugs.

Unwholesome medicines are still a problem in Nigeria and this is not helped by the fact that drugs are sold in traditional marketplaces instead of licensed pharmacies.

And in Onitsha lies the country’s largest open, unregulated drug market where just about anyone can visit and get a fix of just about anything.

Although the menace was somewhat curtailed by the vigorous crusade of the early 2000s led by Dr. Dora Akunyili, of blessed memory – the then Director-General of the country’s National Agency for Food and Drugs Administration and Control (NAFDAC) – the situation still creates a haven for the distribution of fake medicines which have injurious consequences on the health of unsuspecting buyers.

The late DG oversaw a raid of the drug market in Onitsha which led to the confiscation and destruction of counterfeit drugs worth hundreds of billions of naira during her time at the agency. But it is still worrying that even after her departure from the agency in 2008 and unfortunate demise six years after, around NGN 29 Bn (USD 80 Mn) worth of counterfeit drugs were still reported to have been destroyed between 2015 and 2017 in Nigeria, with the Onitsha drug market, again, accounting for a sizeable chunk of that.

Source: CNN

Enough about the problem, though – how about we talk solutions? And how fitting is it that a group of schoolgirls from the same city has come up with an ideal one?

Onitsha certainly doesn’t get as many mentions as the usual suspects when it comes to tech innovations in Nigeria, and understandably so – the city is more about trade and commerce – but it does feel refreshing for once, to take a break from all the talk of business and dab into tech.

Teenagers; Jessica Osita, Promise Nnalue, Nwabuaku Ossai, Adaeze Onuigbo, and Vivian Okoye, are all students of Regina Pacis Secondary School, Onitsha, in Anambra State, who became the toast of all and sundry when they went all the way to Silicon Valley last year and brought home the gold.

These five girls are members of ‘Save-A-Soul;’ the only African team which participated in last year’s Technovation Challenge which took place in the United States, and they saw off stiff competition from other teams from China, Spain, Turkey, Uzbekistan, and even the host country, to become global champions in the junior category of the competition. And you might be able to guess what innovation took them all the way.

The Technovation program mentors young girls around the globe on how to use technology to solve problems in their communities and the girls coasted to victory in the global competition on the backs of an idea founded on curbing the menace of counterfeit drugs in Nigeria. They developed FD-Detector; an app that detects fake drugs.

The journey started when the team’s mentor, Mrs. Uche Onwuamaegbu-Ugwu, was shown up on a trip abroad. She was attending an educational summit and was captivated at the STEM and Robotic models she came across in an exhibition stand, and at the same time embarrassed for not knowing the first thing about them.

The educator feared for the fate and future of the children under her care and many others back home. So she channeled that inner apprehension into something productive by importing that STEM culture into her homeland.

Uche returned to Nigeria and in her capacity as an educator; she set up Edufun Technik Hub. She founded the institution on the idea of taking STEM and Robotics education materials to different schools to bring young students up to speed. And Team Save-A-Soul was put together in one of those schools that she had sought out.

The girls had shown quite an aptitude and appetite for what the educator served up and when the chance to compete came along, the girls were willing participants. With permission, they put in three hours three times a week into working on various projects. But it was the chance to compete by coming up with a technology-driven social impact idea that indeed brought out their inner genius.

Source: Quartz

Their brainstorming sessions involved identifying societal problems that demanded solutions and one a casual walk around a mall near their ‘war room,’ the idea hit them.

They discovered a counterfeit drug problem and further discussions with a pharmacist in the mall gave them further insight. They also learned of the efforts of NAFDAC to curb the problem with its Mobile Authentication Service, as well as the pitfalls and loopholes of the technology.

In an effort to solve the problem, they opted for something different and innovative – an app that uses 2D barcode technology to verify drug authenticity and expiration dates.

They decided to furnish the barcode with two layers of information; one that will be visible to the human eye and another that can only be read by anyone using their app.

They put in several months of work into designing and developing the app, as well as putting together a good pitch, and in May 2018, they traveled from Onitsha to Nigeria’s capital, Abuja, for the regionals.

Their victory in the regionals won them several commendations and accolades from prominent figures in both Nigeria and beyond but they were going to do one better. They rode the crest of that victory to Silicon Valley and won the global grand prize in the junior category – no mean feat!

The team is now looking to market its solution to big pharmaceutical companies to push the project through the design and development phase. Such companies would pay to have their drugs in the FD Detector Database.

Verifying drugs will only require scanning a barcode on the drug at the point of purchase with a mobile phone which has the app installed. No added piece of equipment, and no text messages. If adopted widely, it could help alleviate the country’s struggles with counterfeit medicines, and some 200 million people will have five teenagers to thank.

Featured Image Courtesy: CNN

NYDFS Grants BitLicense to Third Bitcoin ATM Operator – CoinDesk

Another bitcoin ATM operator has received one of New York’s coveted BitLicenses.

Cottonwood Vending LLC was granted one of the virtual currency licenses Thursday, the New York Department of Financial Services announced on Twitter, joining a select group of fewer than 20 crypto companies to receive regulatory approval to operate within the Empire State.

The agency has been ramping up its awarding of its virtual currency licenses recently, with three awarded in January 2019 alone, compared to only one granted both in 2015 and 2016, and two in 2017.

Coinsource was the first bitcoin ATM operator to receive the license, which was awarded in November 2017 after a three-year application process. LibertyX joined it earlier this month, announcing that it would allow individuals to purchase bitcoin using debit cards at traditional ATMs.

Automated kiosks for buying bitcoin in the U.S. are becoming increasingly popular, with money changer Coinstar announcing earlier this month that it would enable such purchases in a number of states. While at launch, customers can only purchase bitcoin at specific stores in California, Texas and Washington, however, the company plans to expand to other parts of the country going forward.

In an email, Cottonwood CEO and founder Aniello Zampella told CoinDesk that the general public can purchase bitcoin using cash at any of the company’s machines. Select machines will also allow customers to sell bitcoin for physical cash.

“We are delighted to continue to offer the opportunity of trading bitcoin at our many locations to all those who sign up with us,” Zampella said, adding:

“It is a monumental personal achievement of mine, and also acknowledges all the hard work and tireless efforts of my support & compliance staff over the years to maintain a 24/7 safe, secure, and reliable financial service. This license will also allow us to continue to serve the historically underserved, and all New Yorkers, for many more years to come!”

Editor’s note: This article has been updated with comments from Cottonwood CEO Aniello Zampella.

ATM image via Shutterstock

New York Financial Regulators Grant BitLicense to Bitcoin ATM Operator – Cointelegraph

The New York State Department of Financial Services (NYDFS) has granted a virtual currency license, or BitLicense, to Cottonwood Vending LLC, according to an official tweet on Jan. 31.

Cottonwood Vending is a Bitcoin (BTC) ATM operator with terminals in New York City and the surrounding area. According to the tweet, the granting of such licenses “continues to advance responsible innovation in New York’s fintech industry.”

Bitcoin ATMs, or BTMs, are touchscreen kiosks that enable users to deposit cash and either buy Bitcoin, or to scan their mobile wallet, sell their crypto, and withdraw cash. Sales and purchases sync automatically to users’ mobile wallets.

In November 2018, NYDFS granted a Bitlicense to another BTM operator, Coinsource. NYDFS said in a press release that its decision followed a comprehensive and thorough review of Coinsource’s application and subjects the firm to significant regulatory conditions.

BitLicenses were introduced by NYDFS in July of 2014 by Benjamin Lawsky, New York’s first Superintendent of Financial Services. The acquisition of such a license is seen by many in the cryptocurrency and blockchain spheres as a necessary step to conducting business in the state.

Firms that receive such a license are subject to certain anti-money laundering (AML) standards and counter-terrorism financing standards. Other requirements include background checks on all employees, and records of transactions must be kept for 10 years.

Various companies in the crypto space have sought and received BitLicenses from NYDFS. In July 2018, global crypto payments processor BitPay was granted a BitLicense. At the time, BitPay CEO Stephen Pair said:

“New York state has one of the strictest policies around businesses involved in cryptocurrency and working through the approval processes to obtain a License was important to BitPay. We believe this hard work will pay off as New York presents significant business opportunities for BitPay.”

2019 Health Care Industry Outlook | Foley & Lardner LLP – JD Supra

Click here to download the PDF.

Foreword

A new wave of change is poised to disrupt the way health care is delivered in the United States. This time around, the disruption is coming not from lawmakers or the president, who have struggled to repeal or improve upon Obamacare. Rather, it is coming from a wide variety of both new entrants and established players. Some hope to make meaningful improvements, while others are seeking an entirely new approach.

Rising costs are a key driver and persistent health care inflation is by no means a new story. But it has arguably gotten out of control – health spending accounted for 17.9 percent of GDP in 2017. That’s more than $10,300 per person and rivals the tax receipts of the federal government. Warren Buffet has called health care costs “the major problem of our economy.”

Some of the nation’s most powerful and innovative companies are stepping up to tackle what the government has been unable to do, shifting the balance of health care problem solvers. Google, Apple and others have announced initiatives. Perhaps the highest-profile upstart is a joint project by JPMorgan Chase, Berkshire Hathaway and Amazon, led by prominent surgeon and best-selling author Atul Gawande.

Many of these would-be problem solvers want to cut costs by eliminating intermediaries and providing services directly to patients. Amazon recently purchased online pharmacy PillPack and now has pharmacy licenses in 49 states. Another venture, a nonprofit initiative to address the high costs and shortages of generic medications, was launched by four major health systems (Intermountain, SSM, Ascension and Trinity) and the Department of Veterans Affairs. At least 70 hospital systems, representing a third of the hospital market, have expressed an interest in joining.

As tech companies enter the health care ring, new technologies are bringing advances to the way health care is managed and delivered. In particular, artificial intelligence (AI) is touching virtually every aspect of the business, improving efficiency, patient care, supply-chain management and profitability (see our 2017 Telemedicine & Digital Health Survey for information about providers and patients embracing technology).

On the regulatory front, with Congress repeatedly failing to improve on Obamacare, state governments have started to confront the challenge. They are fighting costly care by passing initiatives to bring greater transparency and price management – and some states are even imposing price controls. Health care was the standout issue in midterm campaigning. After the elections, drug stocks rallied on the idea that congressional gridlock would lower the likelihood of price-control legislation. With the Democrats in the House, Obamacare is likely safe, and the “Medicare for all” debate will persist. State election results support the continued expansion of Medicaid, with three conservative states adopting initiatives to expand access.

The Centers for Medicare and Medicaid Services (CMS) is also actively innovating. CMS is experimenting with direct to primary care provider contracting. It is also revamping initiatives, such as the Medicare Shared Savings Program’s Accountable Care Organization program, to make providers more accountable and to take on additional risk. There is also speculation CMS has mandatory bundled payments in the pipeline.

A long-awaited demographic trend is adding urgency to the cost crisis. As baby boomers reach old age, the country faces new challenges, some of which will present opportunities for health care organizations, particularly in the area of Medicare Advantage. Obamacare, an attempt to expand coverage to population sectors that may have had difficulty securing coverage under existing systems, is currently being challenged in the courts, and has continued to attract criticism and unsuccessful attempts at improvements or rescission. Meanwhile, as the opioid crisis ravages younger populations, the health care system is looking to prevention to help patients recover and to reduce the burden posed by this epidemic.

In this report, we have assembled secondary-source research detailing these developments and the effect they are expected to have on the industry.

Market Intelligence

The health care industry experienced a wave of disruption when Obamacare was ushered in. Obamacare increased the focus on accountability and, with the creation of the exchanges, enhanced some elements of consumerism as well as expanded Medicaid. The current administration has, so far, unsuccessfully pushed to dismantle Obamacare (using both Congress and the courts), and despite a federal judge in Texas ruling the Obamacare health care law unconstitutional, industry forces initially enhanced by Obamacare show no sign of slowing.

According to recent health care industry outlooks and surveys, including reports by PwC and Avalere Health, the leading trends and issues facing the industry include:

  • The ongoing struggle to improve price transparency and enhance the patient care and member experience
  • Navigating the burgeoning Medicare Advantage market and adapting to the aging population
  • Establishing the employer as a direct provider of health care
  • Shifting to alternative payment models and value-based care
  • Combatting the opioid crisis
  • Safely implementing emerging technologies like AI and the Internet of Things (IoT) to unlock efficiencies and improve care

The outcomes of these converging trends for the industry are:

  • Continued focus on collaboration between health care organizations and non-health care organizations via investments, partnerships and acquisitions
  • Emergence of new solution providers from technology, finance and other fields developed outside of health care
  • Greater reliance on technologies and new forms of contracts and care practices to drive patient experience, reduce system waste and promote accountability in care

Price Transparency and Value-Based Care

Our high-cost health system is increasingly unacceptable to consumers. Consumers, regulators, policymakers and the industry itself continue to push back on factors that are driving costs. The federal government and several states have launched pricing and transparency initiatives, and though this trend will continue, transparency remains complicated and controversial. Legislative and corporate initiatives focus on gaining better control of provider and pharmaceutical prices and exposing significant cost increases. Although early focus was on the pharmaceutical industry, now payers and providers are having to divulge their pricing information as well. Several states are instituting price controls, requiring increased transparency and greater detail on hospital costs.

States are increasingly focusing on consumer protection and billing policies, especially the issue of balance billing. Advocates are seeking to establish standards for transparent and fair benefits for out-of-network services and for adequate network coverage.

Payers and startups are also using digital technology to bring greater transparency to health care pricing. Insurers like Priority Health and UnitedHealthcare offer online price estimators that promise to cut patient bills, although the insurers say awareness is low and only a small number of patients use these tools. Meanwhile, investors are pouring millions into a new breed of health care transparency tools. For instance, Amino, which offers real-time price estimates powered by $3 billion in annual health insurance claims data, has raised $45 million. Mpirica Health, which rates hospitals, raised $4.6 million, led by a crowdfunding platform and supported by a private equity fund. And Zocdoc, which helps book in-network appointments, has raised $223 million.

Meanwhile, value-based payment models will continue to be a tool for improving outcomes and controlling costs. The value-based care wave has given rise to many joint ventures between providers, employers and commercial insurers. Although the shift to value-based care is in motion, the industry still needs the proper tools to be able to administer alternative payment models. According to a 2018 study, 57 percent of health care executives said they do not believe physicians have the tools to succeed under value-based care, up significantly from 45 percent the previous year.

There is a call for increased co-investment between payers and providers in health care IT – including AI, machine learning, predictive analytics and blockchain – to improve alignment and accelerate value-based care adoption. For instance, most health plan executives say that blockchain can help surmount interoperability by sharing data among organizations; this is critical as providers take on more risk, given that plans have data that providers lack. Likewise, AI can be harnessed to help providers, who are now bearing more risk, achieve better outcomes. Likewise, analytics can be used to scrutinize financial, operational and clinical outcomes; to optimize what’s working; and to embed it in an organization’s value-based strategy.

Medicare Advantage and the Aging Population

According to an article by Federally Qualified Health Center (FQHC) Germane, a health care consulting firm, “the United States is experiencing a wave of aging population,” referred to as the Silver Tsunami, as the number of seniors over the age of 65 has surpassed 50 million for the first time. Within the next 25 years, this number is expected to surpass 70 million. This long-expected change in consumer demographics is creating both opportunities and challenges for the health care industry. On the health care coverage side, the market for Medicare Advantage (the private alternative to Medicare) continues to swell. Nearly 33% of Medicare’s overall beneficiaries (or 19 million people) were enrolled in Medicare Advantage plans in 2017, and that number is expected to grow.

With the growing senior consumer population, competition in the Medicare Advantage market is heating up and some players are being squeezed out of the market. Seniors are flocking toward plans that can demonstrate high quality and performance rankings and are expecting more from their plans than seniors have in the past. Aging baby boomers can be smart, tech-savvy consumers who are accustomed to online retail experiences. Additionally, tech-driven plans are entering the market, taking more direct control of patient care and bringing new technologies and approaches to care to the table. Insurers now must identify digital health and consumer experience strategies that ward off these new entrants and cater to seniors, something they didn’t have to worry about in the past.

On the provider side, the industry is adjusting to an influx of seniors that are set to enter the care system. While demand is increasing, there are also pressures on the supply side. It’s expected that about 21,500 certified geriatricians will be needed to care for the aging population (four times the amount of the current supply). Between 2010 and 2015 there was a 21% decrease in the number of first-year geriatrics residents. With the Trump administration taking a tougher stance on immigrants who currently fill geriatric care jobs, it’s expected that many senior caregivers and home aids could be impacted. While staffing is an issue, so too is the stress that the Silver Tsunami will create on care infrastructure and cost. In order to cope with increased need, the industry is exploring new care models and technologies that can help seniors age at home.

Modifications to Stark Law

Stark Law, banning physician self-referrals, is said to be hindering the value-based, patient-centered health care system and alternative payment model. “The American Hospital Association (AHA) has been vocal in pushing for changes to the physician self-referral law, calling it outdated,” according to a June 21, 2018, article by Healthcare Dive. “To reach the full potential of a value-based health system, the Stark compensation regulations must be reframed to meet the objectives of the new system, through the creation of a new exception designed specifically for value-based payment methodologies,” the AHA wrote, responding to a CMS request for information on reducing the law’s regulatory burdens.

Additionally, the AHA stresses that personal services exceptions should be modified to include the Medicare fee-for-service population so that value-based care can be enjoyed by all patients, and that risk-sharing exceptions, currently applicable to providers at financial risk, should be extended to “arrangements involving Medicare, Medicare Advantage and Medicaid,” according to an August 7, 2018, article in RevCycleIntelligence. Since CMS issued a request for information (RFI) in June 2018 to discover how care coordination and alternative payment model participation are being hindered through the Stark Law (first introduced in the late 1980s and substantially amended over the past three decades), industry stakeholders have been open in voicing their opinions and pushing for changes and revisions needed to foster improvement in health care. In late August, as CMS’s RFI period was closing, the HHS Office of Inspector General published its own RFI on “how to address any regulatory provisions that may act as barriers to coordinated care or value-based care.”

Senior Living Industry Trends

Increased vertical integration between senior living providers, health systems and payers is on the rise, as evident from joint ventures between ProMedica, a nonprofit health care system and HCR ManorCare, a large post-acute and long term care provider, as well as between Post-Acute Medical, LLC, a rehabilitation and long-term acute care provider, and Be Healthy at Home, a home health care organization. In a July 2018 conference call captured by Senior Housing News, Welltower CEO Tom DeRosa commented that “this transaction is a glimpse of the future” and that “this new joint venture will be a template for how senior housing and care can be more integrated into health systems, to more effectively manage costs and maximize quality of life for the country’s growing population of older adults.”

Since the payment model has shifted from capitated rate to value-based reimbursement, health care systems showing interest in the idea of integration is no surprise. Moreover, according to CliftonLarsonAllen’s 2018 report on senior living trends, “The significant growth in the ‘longevity economy’ (composed of 106 million people responsible for at least $7.1 trillion in annual economic activity – a figure that is expected to reach more than $13.5 trillion in real terms by 2032 according to AARP),” presents huge investment opportunities in the senior living industry. Currently, health systems are realizing the power these relationships can provide them – the power to control “more of the care continuum, to create a ‘circle of wellness’ for patients that keeps them out of the hospital and other high-cost settings,” according to a Senior Housing News article.

While providers, payers and policymakers want to focus on post-acute care integration into the health system, lack of sophisticated revenue cycle management systems to unify billing across several post-acute care facilities is still a big roadblock, according to Joe Morris, chief information officer at Landmark Hospitals. “A lot of the products that are out there started for short-term acute care facilities and were not designed for long-term acute care facilities,” he told RevCycle Intelligence in July.

Growth of Telehealth and Telepharmacy

Non-direct provider interactions, such as telehealth and telepharmacy, are becoming far more prevalent. This is being driven by a variety of factors, including a desire to reduce costs, the development of new technologies and patients’ and payors’ receptiveness to these new approaches. CMS has made it possible for physicians to bill for remote physiological monitoring in chronic care, issuing several new fee schedule codes in 2018. This will likely prompt health care providers to launch such programs. CMS has also proposed new codes that would expand the use of telemedicine, allowing providers to bill for peer-to-peer internet consultations, virtual check-ins and “asynchronous telemedicine.” Payment for the latter, which involves analyzing patients’ images and videos, sends a strong message that asynchronous telemedicine is an important and clinically valid tool.

Telepharmacy, while not necessarily a new concept, is beginning to gain more attention in the health care industry as a tool to improve patient care and coordination of pharmacy patient care and medication adherence. According to Telemedicine magazine, “Telepharmacy is growing, but the available technology is still underutilized. While the proof points for patient safety are well developed, the industry is now becoming more nuanced, exploring potential benefits of telepharmacy from an operational standpoint.” With increased telepharmacy use comes the issue of pharmacy providers following the right licensure requirements, which is complicated as the pharmacies can provide interstate service to patients, requiring the pharmacy and at least one pharmacist to have the license or some form of permit in the state where the patient resides. An article authored by Foley attorneys for Compliance Today points to the National Association of Boards of Pharmacy’s Model Act and Rules as enlightening on this challenge of multistate pharmacy practice: “The practice of telepharmacy is deemed to occur within the jurisdiction in which the patient is located and the jurisdiction(s) in which the pharmacist and, if applicable, pharmacy are located; therefore, such practice will be subject to the pharmacy practice regulations of all jurisdictions’ boards of pharmacy.” The rules or regulations authorizing the use of telepharmacy are not uniform across states, further aggravating attempts to offer telepharmacy.

Drug Pricing Battle

The issue of increasing list prices of drugs prevails, though the prices are increasing at a slower pace as compared to a few years ago. Rebates have also been increasing. According to an August 7, 2018, article in Forbes, “Companies say that the rebate growth rate has outstripped list prices. Pharmacy benefit managers (PBMs) assert that through rebates they’re stemming increases in premiums…. The insured are faced with ever-rising premiums and cost-sharing. And, without negotiating clout the growing ranks of uninsured pay the full retail price of prescription drugs.”

The Trump administration is expected to attempt significant structural changes in the pharmaceutical industry. In the May 2018 unveiling of the Department of Health and Human Services (HHS)’s blueprint titled “American Patients First,” the FDA commissioner said that he was against branded manufacturers blocking generic products from entering the market. Moreover, HHS presented some policies that will help improve price transparency for consumers and establish indication-based pricing. And HHS proposed a rule in July 2018 titled “Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection” and submitted it to the Office of Management and Budget (OMB) for regulatory review. This rule would “scale back protections currently in place that allow rebates between drug manufacturers and insurers and pharmacy benefits managers,” according to a July 19, 2018, article in Reuters. The proposed rule is not yet public, and while the OMB reviews it, the industry will closely monitor all developments as this would bring about a huge change to PBMs’ market.

A Reimagined Middleman

The health care industry’s middlemen – intermediaries such as PBMs and wholesalers – continue to make significant investments in increasing the availability, efficiency and safety of dispensing. Nonetheless, PBMs have faced legislative and public opinion challenges. As part of a broad effort to contain health care inflation, some lawmakers and regulators are eager to see greater transparency in PBM pricing and rebate practices. Meanwhile, the competitive landscape is shifting as insurers acquire and merge with PBMs. Wholesalers are facing financial struggles due to the ongoing deflation in generic drug pricing and because manufacturers are limiting branded-drug price increases due to public pressure. The market value for the health care industry’s middlemen declined nearly 30% between 2015 and 2017.

New industry entrants, like Amazon, are creating added pressure for traditional middlemen to demonstrate their value. In response to this disruption, PBMs are forming closer ties with insurers through acquisition or reimagining their business models by turning to value- and/or evidence-based care models.

Opioid Crisis and Social Determinants

Policymakers, health care organizations and consumer advocates continue to attempt to combat the opioid crisis, which is the leading cause of death in the United States for adults younger than 50. According to American Action Forum estimates, it cost the U.S. economy $702 billion in GDP between 1999 and 2015 due to people leaving the workforce. Between 2016 and 2017, emergency department visits for suspected opioid-related overdoses increased 30%, according to the Center for Disease Control. In October 2017, the White House officially declared the epidemic a national emergency but did not successfully provide a pathway to meaningful funding for the effort.

Health care organizations will continue to focus on building capabilities and collaborative opportunities that allow them “to prevent opioid misuse, improve treatments for chronic pain and support patients struggling to recover from opioid addiction,” according to PwC Health Research Institute’s 2018 annual report. Critical to these efforts are identifying and funding behavioral markers and social health determinants (e.g., food security, loneliness and social inclusion), monitoring pharmacy/claims data, reducing unnecessary opioid prescriptions by placing restrictions on prescribing practices and changing drug formularies, and working alongside first responders to expand access to medication-assisted therapy and drugs such as naloxone.

These efforts will require investing in increased patient/ member engagement and relying more heavily on technology and data, as well as ensuring care programs and coverage promote alternative – and less expensive – pain management treatments.

Internet of Things and Artificial Intelligence

Drawing on its momentum and disruption in other industries, AI is gaining traction in health care and altering the entire market – from patient care to back-end management and supply chains. AI is being leveraged by health care companies to enhance back-end decision-making, financial reporting and supply chain management, and to streamline regulatory compliance functions. Providers are also turning to AI to support patient care, leveraging it to more rapidly and accurately analyze test results, allowing them to see more patients and generate more revenue. Leading areas of provider investment include virtual personal assistants, automated data analysts, automated communications (chatbots) and automated information aggregation. Medicare is encouraging the trend by proposing changes to reimbursement policies to allow payment for new devices.

On the consumer side, 65% of consumers say they’ve experienced health-related AI and are attracted to the convenience of AI-backed health services. Consumers are becoming increasingly sophisticated in their use of health care technology and opening up to intelligent health technologies, but providers are not currently living up to consumer interest in the virtual care arena. Importantly, the entry of Amazon into the health care industry has implications for AI as Amazon has made significant strides with the technology through its Alexa assistant, which has been leveraged by Mayo Clinic to provide first-aid information and voice-driven self-care instructions.

In parallel, the industry is experiencing a proliferation of internet-connected medical (and non-medical) devices, which are playing increasingly prominent roles in patient care, record keeping and billing. In two years, the use of IoT solutions like smart scales, wearables and social platforms has nearly doubled. However, IoT devices may come under threat from cybercrime – health care is an alluring target because it is one of the most data-rich industries. The industry has seen significant data breaches, with a “525% increase in medical device cybersecurity vulnerabilities reported by the government,” according to PwC Health Research Institute’s 2018 annual report. Providers need to be proactive in data privacy, particularly as hospitals become common targets for ransomware attacks such as WannaCry, which affected several medical device makers.

Materials

Why Kerala’s Cyberdome project is an idea which must be replicated at the national level – Express Computer

Project Head: Manoj Abraham IPS, Inspector General of Police & Nodal Officer, Cyberdome Range Office,Thiruvanathapuram

In the rapidly growing and changing digital world, the investigation of cyber crimes and ensuring cyber security for citizens is one of the most challenging area for the Law Enforcement Agencies (LEAs). Since today’s cyber-crimes, involve the use of most modern and sophisticated technologies, as well as anonymity over the internet, it becomes extremely difficult, for the police, to investigate these kinds of crimes. The cyber criminals now work in a border-less environment, with legal systems of multiple jurisdictions. To make things worse, cyber crime has been evolving at an astonishing rate. Unfortunately, the police system is not equipped to take a pivotal role in cyber crime investigations and prevention of cyber crimes.

Taking into account the broader impact of cyber crimes and challenges in the cyber space, Kerala Police initiated this Project for the establishment of a Hi-tech Centre for Cyber Security and Innovations at the Technopark Campus, Trivandrum, Kerala.

Cyberdome is a technological research and development centre of Kerala Police Department, conceived as a cyber centre of excellence in cyber security, as well as technology augmentation for effective policing. It envisages as a high tech public-private partnership centre of collaboration for different stakeholders in the domain of cyber security and handling of cyber crimes in a proactive manner. One of the main objectives of the Cyberdome is to prevent cyber crimes through developing a cyber threat resilient ecosystem in the state to defend against the growing threat of cyber attacks by synergizing with other departments and nodal agencies of the state. Cyberdome makes a collective coordination among the Government departments and agencies, academia, research groups, non-profitable organizations, individual experts from the community, ethical hackers, private organizations, and other law enforcement agencies in the country with an aim of providing a safe and secure cyber world for each and every citizen in the state. The primary objective of Cyberdome is to prevent cyber crimes and ensure that our cyber resources are secured.

The importance of collaboration

To effectively tackle cybercrime, adequate cross–border provisions are required and international cooperation and mutual assistance within law enforcement, and between the other agencies, needs to be enhanced. Governments cannot contain these cyber threats single-handedly through domestic measures alone. Neither should governments be left to grapple with this danger on their own any longer, as the expertise and skill to combat these cyber threats are largely dispersed across the globe. Hence the solution is that to create collaboration with private sector and academia to conform rapidly changing technology world.

National cyber security policy also affirms in developing effective public – private partnerships models. Active partnership with the private sector is essential, not only to share intelligence and evidence, but also in the development of technical tools and measures for law enforcement to prevent online criminality. The academic community also has an important part to play in the research and development of such measures.

Cyberdome is a pioneering project as it brings together Government Departments, Law Enforcement Agencies, Industry, Academia, International Organizations and experts from the public domain for collaborating on cyber security to enhance the capabilities of the state in dealing with cyber threats as well as to provide security to the Digital Assets of the state.

Law enforcement agencies can provide real case based scenarios and requirements for research and implement new products as well as services, that will provide benefit for all stakeholders to make their infrastructure secure. An online cyber crime reporting system will be hosted to report online crimes as well as to report vulnerabilities of the websites, Apps, Services as a responsible informer. Cyberdome collaborates with around 10 national and International organisations, more than 500 IT professionals working around the globe, Nodal Officers from all major banks, around 3 Universities, more than 750 odd students and 250 Mobile Technicians within its fold. All these individuals are working on an online platform, free of cost, for preventing cyber crimes, spreading awareness on cyber security, creating digital solutions for better service delivery and in general for creating a safe cyber world.

Tackling threats proactively

Analysis is the cornerstone of all modern intelligence-led law enforcement activities and critical to all cyber intelligence purposed. Cyberdome analytical capabilities are based on advanced technology adjusted to the needs of law enforcement.

As law enforcement agencies, the police are facing ‘‘real case based scenarios’’ and gaps in research and development. The inadequacy of expertise to deal with the darker side of the exponentially expanding Information Technology is a major roadblock for the Police in India. Acquiring such expertise by recruiting manpower is not a viable option too.

Cyberdome envisages to take proactive measures against the evolving cyber threats. In this regard cyberdome regularly conducts VAPT in the Government as well as the private domains and report the same and also gives mitigation steps. The secure coding workshops being conducted by the Cyberdome equips the developers and IT admins of organisations to develop hack proof and secure websites to a large extent. Cyberdome in collaboration with the RBI, Banks, payment gateways and other wallet groups had taken measures to tackle the financial fraud and had been a great success.

Cyberdome has also started a ransomware school to understand, analyse and mitigate ransomware infections, create standard operating procedures to deal with ransomware, creating awareness among the public as well as government departments about ransomware and its precautionary steps. Some other effective steps include bursting of child pornographic groups, awareness campaigns for school children and for the general public, awareness campaigns through mass media and social media, Social media surveillance etc.

Major Achievements

• Performed VAPT (Vulnerability Assessment and Penetration Testing) on more than 100+ sites and reported their vulnerabilities

• Developed advanced Social Media lab for analytics, Cyber intelligence & monitoring Darknets.

• A software called Privacy Tracker has been developed in partnership model for preventing piracy of films

• Defaced or removed around 250+ child porn pages/ porn sites and initiated action against the culprits

• Ransomware School started to understand, analyse and mitigate ransomware infections

• Developed a malware analysis lab to analyse the behaviour of malware & its preventive measures

• Developed a SOC System(Security Operations Centre) for protecting Government digital infrastructure

• Child Safety awareness program for students, parents & Teachers named- KID GLOVE- implemented throughout the state

• Conducted around 18 workshops and 22 hackathons for police cyber training

• Conducted 80 awareness events/ workshops throughout the state, for the public

• Intensive project to prevent child pornography over social media platforms

• Developed geospatial application to pin point the location based on mobile cell data

• Prevention of Online Financial Fraud in association With RBI through a 24X7 OTP fraud Monitoring system

• 21 MoUs signed with International and National cyber security agencies.


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