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Saturday, May 30, 2020

Top Five Worst Inventions/Ideas Still in Use (Part II)


            This entry continues my list of the top five worst inventions/ideas that are still very much in use today.  In my previous entry on this topic, I covered numbers 3-5.  Now it is time for the top two on my list.  But first, I’ll mention a few things that didn’t make it in the top five, but were close.  The QWERTY keyboard has to be one – that fact that the inefficient keyboard layout persists to today is a bad idea.  Loosely related is the persistence of worthless letters of the alphabet, namely X, Q, and C, which can be replaced by other letters.  I also find that words spelled oddly…or should I say weirdly…make no sense either.  Can’t we just hold to some basic spelling rules?  Another thing that probably should be in my top five is the "rule" that people get to vote on taxes for public schools but almost nothing else.  Why does that make sense?
            As I mentioned before, I think you should try making your own list and writing it up.  Let me know and I will add links.  But remember, the inventions still have to be in use today.  Without further ado, here are my top two worst inventions that are still in use today. 

Worst Idea #2:  The Health Insurance Portability and Accountability Act...aka "HIPAA"
            HIPAA is a law passed by the US Congress in 1996.  Otherwise referred to as the "Privacy Act" because that is the most visible outcome of the law.  Actually there continue to be additions to the original law.  Some of you probably have never heard of it and so it doesn't make sense that it would be the #2 Worst Idea on my list.  And, honestly, to a certain extent, I am using it here as an example of a law that started with a good idea, got expanded upon in the process of being put together, and then, when passed, had many unintended consequences.  Such laws are, in general, very bad ideas.  Also, unfortunately, such laws are very difficult to undo once they have been enacted.  In my experience, HIPAA is a perfect example of such a situation, it is very bad, and makes it to #2 on my list of the worst ideas that are still part of our daily lives.
            You may not think of HIPAA as part of your daily life, but if you have ever been to the hospital or doctor's office, you had to fill out at least one form that was solely related to the HIPAA law and its subsequent derivatives.  You probably didn't read the HIPAA form because you had 50 other forms to fill out and that one seemed pretty irrelevant.  If you don't work in the healthcare industry in some way, then it probably has little consequence to you.  It wouldn't make your list or even cross your mind.
            I work in medical research and I deal with the consequences, both intended and unintended, every day, whether at work or at home!  And, for the most part, those consequences are entirely a waste of time.  Yes, there are some good things about the general concepts that were part of the original law, but the whole concept of "patient privacy" took on a life of its own.  One annoying thing is that often, even if everyone, including the patient, agree that some of the law's requirements are a waste of time, it is not allowable to bypass the requirements.  It's like creating a 25 mile per hour zone on a freeway so that a family can cross from one side to the other, and then that family says, no, we'll take the bridge five miles down the road, yet the 25 mile per hour zone is left in place.  There's no logic there.  Red tape for the sake of red tape.
            The unintended consequences have to do with the “privacy” part of the law, which, as I understand, wasn’t even the original intent of the law (and the word “privacy” doesn’t even appear in the title).  The original intent was to make sure that health information could “stay with the patient” – meaning it was “portable” (that is in the title) when the patient is treated at different hospitals and clinics.  The privacy part came in under the “accountability” portion of the law.  This also was a good idea, but this is where the really bad (and probably unintended) concepts arise. 
            The HIPAA law and related laws have spawned a whole industry.  Check it out for yourself (for example:  https://www.hipaatraining.com/).  There are companies that sell entire training programs on how to navigate the HIPAA laws.  Every institution doing research had to create an entire process to meet the requirements of HIPAA that rivals the process for obtaining informed consent for research.  All such institutions now have a "Privacy Officer" and a staff of people whose entire job is to make sure that everyone in the institution is following the HIPAA laws so that the institution doesn't get fined.  That is a bad unintended outcome - at least I sure hope it was an untended outcome!!
            I don't know anything about Congressman Bill Archer, but he gets my thumbs down for introducing this bill to Congress.  This was a Pandora's Box.  There are some good things in this law, but there are also some really poorly thought-out aspects that, at this point, are nearly impossible to undo.  It is more red tape that slows progress and created a whole industry that creates nothing productive.  It's like creating a new tax that just goes to pay the salaries of the people collecting the new tax. 
            Laws with unintended consequences, baggage and red tape are #2 on my list.  But, in my opinion, there is one clear winner...
           

Worst Idea #1:  Hand Blow Dryers
            Yes, I'm talking about those stupid hand dryers that you find in public bathrooms.  It seems like they have been around for about 30 years or so.  Someone decided it was a way to save trees by reducing the use of paper towels.  They did a good job of marketing them to cities and counties and states, and so they are everywhere now.  I hate them.  If they were a good idea, people would install them in their homes.  They don't.
            Maybe they don't bother you.  They bother me because of a number of factors that come together:  1) I end up in lots of places where the bathrooms have hand dryers (like rest stops and so on), 2) unlike most men (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504379/), I always wash my hands after using the bathroom, 3) I like my hands to be dry, 4) I don't want to spend any more time in a public restroom than I have to, so I want to get in and get out.
            The thing is, paper towels work great.  They are fast, efficient, and they just work.  It's hard to improve on something that is so simple:  a wimpy piece of paper.  With a paper towel, you can dry your hands in 5 seconds.  You can even dry your hands as you're walking out the door if you really are in a hurry.  You can take a paper towel with you to clean something up.  Hand blow dryers take what seems like forever to work and they cement you to one specific spot.  If you really want your hands fully dry, you've got to stand right there until they are dry.  I've timed them - they take maybe 30-60 seconds typically.  But that is a five- to ten-fold increase in the time it takes to dry your hands.  That's a poor trade-off.  In my observation, men are much more likely not to wash their hands at all, or to leave with completely wet hands, when the only option for drying their hands is one of those ridiculous hand blow dryers.  Further, recently I've noticed some bathrooms have both paper towels and a hand dryer.  In those cases, I have never ever observed anyone opting for using the hand dryer.  Does anyone think they are better at drying your hands???
            Part of the problem with hand blow dryers is not the dryer itself but the way they are implemented in public restrooms.  First, there is often just one, which then becomes the main bottleneck in a busy bathroom.  Again, what happens?  People don't wash their hands because they don't want to stand in a line waiting for the one precious dryer.  This is especially great if it is an old wimpy dryer that takes forever to work.  Also, I've sometimes observed them to be placed up high, which means that when you use it, it blows water all over you.  If you're in a wheelchair, then you're really stuck, not to mention that the dryers are against the wall which makes them hard to get to in a wheelchair.  Paper towels you just grab and go and dry your hands anywhere.  There is never a line for people waiting to get paper towels!
            Of course, the big supposed draw of hand dryers is that you are doing your part to save trees by making hand drying much more inconvenient.  If that was really the goal, then they should be crank operated (or put a pedal down below and operate the fan with your foot).  To install a device that sucks up electricity to drive a heater and high-powered fan in exchange for a paper towel dispenser that uses no energy at all seems like a very questionable trade-off for claiming that it is "good for the environment."  It also takes energy and resources to build the hand dryers.  Of course the same can be said for the process of making paper towels.  At home we use cloth towels, which have to be washed and require energy and water.  It's not simple to figure out which option is the most energy efficient.  My guess is that they are all pretty similar and that the impact on the environment is not drastically different among the different options.  If I were to rate things on a scale of 1 to 5, where 1 = no impact on the environment and 5 = huge impact on the environment, I'd say they would all be given a "2".  Therefore, the decision regarding what option for hand drying should be made on other factors...like efficiency of hand drying!  I'm pretty sure that you could do a lot more to help the environment by riding a bicycle instead of driving a car.
            Somewhere along the line, the marketers of hand dryers needed an additional sales gimmick beyond the idea that they were good for the environment, so they came up with the idea that they spread less germs.  I assume the point was that there was less touching of things with a blow dryer?  I don't know - it's not like you're grabbing the same paper towel that someone else used.  I think the idea was that with a manual paper towel dispenser, you sometimes had to pull some kind of lever to get the next towel out.  But there are plenty of other ways to design a paper towel dispenser so that you don't have to touch anything other than the towel.  Further, a lot of hand dryers have a button you have to push, so that totally defeats the "no-touch" concept.  Maybe the argument was that air had less germs than paper???  Well, as you probably know, that concept was totally debunked.  As it turns out, hand dryers are really good at blowing germs onto your hands, as described in this study:  https://aem.asm.org/content/84/8/e00044-18.abstract
            One thing I found while traveling across the country one time when I was on crutches for a bad knee:  hand dryers are as inconvenient as you can get.  I don't think anyone thought this through.  After you hobble to the sink to wash your hands, you now have to find where the hand dryer is, because it is never right next to the sink (probably because that would be an even bigger bottleneck - or maybe someone doesn't want to mix water and high current hand dryers!).  If you need your crutches to walk over to where the dryer is, you have to grab the crutches with your wet hands.  Also, there's no place to rest your crutches near the hand dryer.  Paper towels just work better - assuming they are placed next to the sink, where they should be.
            Another limitation is if you want to dry some other part of your body other than your hands.  For example, when you drive across the country, it is not uncommon that you want to wash your face or your mouth.  Hand dryers are not designed to dry your face.  Paper towels just work better.  It's obvious.
            So, in summary hand dryers are slow, they are inconvenient, they spread germs, and they probably use up just as much energy and have just as much impact on the environment as paper towels.   For those reasons, hand air dryers are the #1 worst invention that we currently still use.  That's an invention I'd like to see disappear!

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