As an individual, I won’t lose my medical records because I have three backups and offsite and whatever. You probably do too.

But how do you remain really decentralized when the system has to work for a 76-year-old who can’t even remember what Google is, much less his password. Will this work in the golden hour after a stroke, when literally every minute matters?

So we would make a medical record “bank”, which is federated sensibly, and require everyone to use it. And eventually we end up with a similar system that we have now.