It's extremely difficult to accurately identify which emails have health info and which ones don't (even something like a person's name or IP address could count depending on the context) so they just default to sending everything through their message center. No amount of email security could change that.
Encrypted email wouldn’t require a BAA.
My understanding is that there's a thing called the "conduit exception" which basically says that if data is transiently passing through a channel and it's not being looked at, it's ok. But wherever the data lands must be HIPAA-compliant.
This seems crazy to me, but that's how it works I think. For example, if you encrypt PHI and store it in AWS without signing a BAA with them, that's a HIPAA violation, even though the data is encrypted and Amazon can't see it. But if you send encrypted data through AWS without actually storing it, that's fine.
Mail is specifically mentioned as a thing that qualifies for the conduit exception. I'm not totally clear why it isn't a HIPAA violation the moment it arrives at a destination (it's not in-transit at that point, and it's potentially not in the possession of the intended recipient either), but it seems pretty well accepted that it's not.
All that to say: I think encrypted email would still require a BAA because it's being stored, not just transmitted.
Sounds like they needed fax to be compliant, and came up with some moon logic to make that happen.
It was a law written in the 90s, it should be updated and modernized.
I agree the laws need an update. I'd imagine a general 'common communication channels' or whatever would work, rather than specifing every single one that's allowed to be used. That way, it's still illegal to snoop on your communications, regardless of whether they happen by post, phone, email, SMS, Whatsapp, or whatever else we end up using in 20 years.
Nothing electronic will ever be secure, unless it is never, ever networked. Networking changes "touch physical thing" into "everyone on the planet plus their bots" can touch it.
Even if you pass harsh laws, you need to geogate network connections to only within that legal jurisdiction. Otherwise, it's pointless.
The real, true problem is anonymousness. I used to advocate for, now I'm done. The problems anonymity solve, are a gnat compared to the ones it creates.
I'm all for ipv8, but with a unique ID in the packet identifying the person directly.
I can't drive a car, own a gun, drive a boat, buy explosives, ply many trades, and 100 other things without a license. Maybe unrestricted internet access is in that category, and bad behaviour means it is revoked.
The Internet was a toy for a long time. Now it's the backbone of all commerce, industry, personal communication, with life threatening implications at times.
Play time is over.
The criminal intent was giving somebody without a license, access to your gear to spoof you. If someone is too ignorant to not know what that means, then they would never acquire a license.
The massed will still be able to access youtube, google. They won't be able to open random ports without proxies, and yes that means even online gaming is going to be controlled.
Email is a lot harder. The older SMTP standard sends emails unencrypted so there's a possibility of a MITM reading the email. But also addresses if you get them wrong can end up in the wrong hands. For example, if someone sends an email to cogman10, I'll get it, but if they go to cogman1O I won't get it. A lot of the nuance of how secure and when it's secure gets erased by auditors to just "email is insecure".
With HIPAA, is it not possible to simply encrypt the message? The "forgot password" flow for their message center is probably email anyway.
I can upload my public key to SourceHut and all email from them becomes signed and encrypted. It's a one-time process to generate long-lived keys and another to set up with SourceHut and that's all I need to do.
I don’t think that helps at all. We already know how to consume that securely, we do it billions of times a day in web browsers.
> the inbox should work on an invite only basis. Basically you should pre-authorize the senders just like you add someone as friend on a social network.
Yes. A fundamental problem with email is that the only thing required to send email to somebody is knowledge of their email address, which as a recipient you cannot control. This is what enables spam and phishing. This needs to be changed so that in order to send email to somebody, you also need their consent. A “friend request” mechanism is one way of achieving this.
I think this is a problem that can be feasibly solved in a fairly reasonable way, and I sketched out a protocol for doing so a while back, which I described in more detail in this comment:
But then you’re left dealing with spam “friend requests”, which is still something I have to take action on, filter out, or ignore — same as spam email.
It's your client that's the problem.
I'm happy in my text only Emacs heaven.
I'm also happy with my custom 5 year old bert based spam detector which hasn't failed me once (unlike whatever gmail at work does).
This post was sent from Emacs.
Yes it does. However, I have sent messages to more than a few people who tell me that my message is completely empty. I have my client set to send text-only, no HTML, and apparently the system on the other side drops the HTML version altogether. Something on the other end only processes the HTML part. No HTML, no message.
(I believe these are Outlook/MS based systems, but I don't know for sure. It's certainly not ALL Outlook/MS systems that do this.)
For these people I have to set my client to send HTML. It's all well and good to blame them, but I can't make them do something. They may not even be in a position to do anything. And I don't have an option to tell them "too bad, so sad".
The email situation is really quite bad if you don't conform to the Big Three. I've run my own email infrastructure for a very long time, and it's quite irritating that when we get something good (like DMARC, SPF, etc) it gets forced by the Big Three because along with that we also get things like Google toying with the requirement that you have to have AAAA MX records too.
Fastmail’s spam filter is not very good.
This is kinda what 'masked email' services like Fastmail's – of which I am a delighted customer – do.
Until you've known the comfort of creating an address; giving it to a service; deciding that you want to end your relationship with them; just deleting that address, without changing your mailbox or infrastructure or archives or anything else … it's kinda life changing. I recommend everyone try it.
Also, the chances of a phisher trying to get my BigBank details by sending mail to lonely.chicken6382@spuriously-named-and-unused-other-than-for-email-domain.com are … well, it seems unlikely.
I've never felt more secure. For real.
That's why I bought my email domain and use <domain_name>@hnrobert42.com. It helps to use a password manager.
I get a lot of convincing emails to linkedin@hnrobert42.com. As well as zynga, wework, etc.
Whenever there’s this discussion on HN, someone usually points out that can sometimes be a bother, especially when giving out the email in person, because people don’t really understand how email addresses works and ask “how did you get that email” or think you’re impersonating the service, or something similar.
I guess a solution might be to add the details sneakily. E.g. instead of linkedin@hnrobert42.com, saying robert_lkdn@hnrobert42.com
But that’s like 1:100 or so. And usually I’m entering my address to a robot so it’s not an issue.
It also makes it easier to pass off a fake realname! Hi I'm John Smith, jsmith@oneofmydomains-nottooobvious.com...
You can even pick a domain sound like a legitimate mail service or company, e.g. jsmith@jgs-consulting.com.or jsmith@liberty-mail.io
All domains and addresses in this comment are fictitious - overlap with real domains is coincidental.
Which is in the RFC, but yet the sheer amount of times I sign up for something. Like a bank, or a financial firm, get the confirmation e-mail, and then click "Verify your address"
And get HTTP500 as their SQL has kicked up a stink
The amount of bots promoting Fastmail here is insane. What the actual ...
A bot I am not.
This will literally never happen. Email doesn't support the features that those messaging platforms need to have, such as recalling messages.
The security layers are also only on the sender part, not on the receiver part, which banks care a lot more about.
I'll settle for a brief edit (not retraction!) window after sending though, say 5 minutes tops.
Edit (I realize the irony): banks of course won't give a hoot about the receiver, the power dynamic is inherently not equal.
"Need".
As such, I tell anyone who sends me one to fuck off and send a real email.
And then also sends an e-mail, which sometimes I confuse and think is ANOTHER message, and log in again....
It has a "Download this message as a PDF" button, which just takes you to a web-browser wrapper....
I'm sure there's a sum of compliance reasons why this is not allowed, but it doesn't make any sense at all.
Instead, legitimate companies like banks, healthcare, etc tell users to click on a url link to their "Secure Message Center" to read or submit some critical information. It's often the only way to get the info the users need.
E.g. if I open a payment dispute with the bank, the workflow they use is the Secure Message area. I can't just use my normal email client and upload some pdf attachments. Instead, I have to log into my bank website, navigate to their Secure Message area, and then upload the docs there to submit the claim. They also don't send followup status or final resolution in an email. Instead, you log back into the Secure Message area to read the case resolution. Similar for insurance claims.
Similar situation for asking a medical imaging center for some mammograms. They will not send those as PDF or JPG attachments directly to your email address. Instead, you log into a secure message area on a healthcare website and download it from there.
No, this includes all messages from my doctor/healthcare. It's not mass spam.
Theoretically I could want to know what's in the message, but not enough to visit a website I've been logged out of again, perform multi-factor authentication, navigate to the message center and find the message and then back it up manually.
As it happens, I already knew this because the previous bill 6 months ago also included this information, but the message itself was unique and important. Certainly, there would have been financial consequences if I didn't act on that information.
I would have preferred to receive the contents by actual message rather than having to log in to read it, but that's not an option they offer. It's certainly not safe to assume it can all just be ignored.
I guess you can avoid the email spam by just directly logging into the website when you need that stuff, but how else are they supposed to notify you when something new has happened?
Then IMO they accept the responsibility of me seeing the message potentially much later than if they had stated the concern up front in e-mail.
The messages are usually PDFs, which isn't great for accessibility, e.g. using a translation tool.