Three Windows into a Digital Prison
When Code Becomes Coercion
Failure Modes of a Mandated Digital Life
Click the picture below for the 3 cases.
These are not dystopian fantasies. They are failure modes of a system that fuses identity, health, location, utilities, and money—and then lets policy flip the switch.
1) “Insulin Declined — Code 49: Non-Compliance
Insulin Declined — Code 49: When Algorithms Withhold Care
Clerical Flag → Clinical Crisis
Cashless Means Helpless
Setting: Bendigo, mid-summer.
Tom, 27, Type 1 diabetic, scans his Digital ID at the pharmacy. The till pings: “Payment blocked: Health-programme non-compliance (sugar quota exceeded). Code 49.”
His e-wallet (the eAUD CBDC) has a new “wellbeing filter” tied to his Digital ID. A supermarket data match shows he bought two bottles of sports drink after a vomiting bug. The algorithm flags “excess sugar,” auto-locks purchases of insulin “pending clinician review,” and emails him a link to book a telehealth lifestyle module—first available in 11 days.
Tom’s blood glucose is rising; the pharmacist can’t override the block because the myGovID back-end says “risk hold.” He tries cash—“No cash accepted”. He tries a friend’s card—“ID mismatch”.
Clinical outcome: That night he develops DKA (diabetic ketoacidosis). ED stabilises him—but he spends two days in ICU over an automated policy he never consented to.
Mechanism: Digital ID links retail data → “health risk” score → CBDC purchase rules enforce “care plan compliance.”
Lesson: When money becomes programmable and identity is fused across domains, a clerical flag becomes a clinical emergency.
2) “Your Treatment Is Paused — Protest Proximity Alert”
Your Treatment Is Paused” — Protest Proximity Alert
From Geo-Fence to Chemo-Fence
Safety Scoring, Silent Triage
Setting: Western Sydney, oncology day unit.
Marina, 54, has triple-negative breast cancer. Midway through chemo, she taps her Digital ID to check in. The hospital kiosk freezes: “Identity under review: security event.”
The night before, Marina walked past a noisy street rally on her way home; her phone’s location graph (synced to her Digital ID for “facility safety”) placed her within a police geo-fence. Her eAUD account is auto-flagged for “public-order review,” which pauses her gap payment and travel subsidy. The hospital’s billing module can’t accept “unverified identities,” so her infusion is rescheduled “48–72 hours.”
By the time an administrator clears it, Marina has missed her chemo window. Her tumour board later records “disease progression; consider dose intensification.”
Mechanism: Location metadata + protest geo-fence → risk score on Digital ID → CBDC payment hold → hospital access gate blocks care.
Lesson: “Safety” scoring repurposed for public-order turns into silent triage—with cancer patients as collateral.
3) “Heatwave: Account Exceeded — Energy & Travel Geo-Caps”
Heatwave Protocol — Energy & Travel Geo-Caps
Throttled Air, Frozen Wallet
Climate Controls vs Human Physiology
Setting: Adelaide, February heat dome.
Gwen, 83, COPD and heart failure, lives alone. A “climate resilience” setting on her eAUD caps energy spend and adds geo-fenced travel rules during declared heat events. At 2:10 pm her smart meter throttles air-con after she hits her weekly carbon allotment. She tries to book a rideshare to her daughter’s house—payment denied beyond 5 km: non-essential travel. She calls a taxi depot willing to take cash; the dispatcher says they can’t accept cash during “extreme weather protocols.”
By 4:30 pm Gwen is confused and tachycardic; a neighbour finds her and calls an ambulance. She survives—barely—with heat stroke and acute kidney injury.
Mechanism: Digital ID + CBDC enforce “emergency climate policies” (energy quota + geo-fenced spending) → blocks cooling and escape.
Lesson: Centralised “nudges” can become lethal when bureaucratic rules outrun physiology.
The reason these are realistic and happen once the Digital ID and CBDC has been introduced. Even worse scenarios can be envisioned.
1) One identity to rule them all = one failure to break them all
The fusion of identity, payments, health records, location, and utilities creates a single point of failure.
When identity, payments, health records, location data, and utilities are fused, you create a single point of failure. A flag on the identity layer (e.g., “verification pending,” “risk score exceeded”) cascades into everything that relies on it: pharmacy billing, hospital check-in, transport, energy accounts, banking, even government services. Outages, clerical errors, or malicious flags don’t just inconvenience people—they lock them out of life-critical services. In a federated world, one system going down is a nuisance; in an integrated world, it’s systemic paralysis for the individual.
2) “Code as policy” erases human judgement at the front line
Automated policy enforcement (algorithms + delegated legislation + terms of service) removes front-line discretion.
Automated policy enforcement—a blend of algorithms, delegated legislation, and private terms of service—moves decision-making away from clinicians, pharmacists, and reception staff to opaque rule engines. That means no bedside discretion, no “I know this patient; I’ll override it,” no common-sense exceptions. No alternative or repurposed medicines. Staff become screen-readers, not problem solvers. Because the control is embedded in code and contracts, it can be tightened without parliamentary debate—just a settings change or a vendor update. Appeals become slow, centralised, and abstract, while the harm is immediate (missed chemo windows, blocked insulin, travel denied).
3) False positives and scope-creep are features, not bugs
False positives and scope creep (health → policing → climate) are inevitable once the rails exist.
Once the rails exist, they will be repurposed. History shows that systems built for one domain (health) inevitably bleed into others (policing, taxation, climate, “safety,” speech). Each expansion is justified as “temporary,” “targeted,” or “for your protection,” but ratchets are one-way. Meanwhile, risk models generate false positives—ordinary behaviours that resemble prohibited patterns—triggering freezes and reviews. The broader the mandate, the more proxies the system uses (location, purchases, contacts), and the higher the error rate. With money and access tied to those scores, even minor misclassification becomes major deprivation.
Bottom line: Tight coupling + automated enforcement + expanding mandates guarantees that normal glitches and policy drift translate into real-world harm for ordinary patients (people).
In closing
These are not dystopian fantasies. They are failure modes of a system that fuses identity, health, location, utilities, and money—and then lets policy flip the switch. As a physician, my prescription is clear: ban coercive linkages, protect cash, keep paper pathways, outlaw programmable punishment in money, and restore informed consent. That is how we keep patients safe—and citizens free.
Remember that tyrants, politicians and bureaucrats historically have forced medical doctors and their profession to do their dirty work. The holocaust and the covid pandemic are good examples.
Ian Brighthope
