If you accept, as I do, the proposition that free public online information can help you manage your health and access better care, there are over 1.3 billion people in China whose well-being is in jeopardy. 

Tragically, this is not due to poverty, but to China's bewildering resistance to Google's courageous plans to push back on the country's censorship of Google's Chinese search site, Google.cn. (The decision was prompted in part by a cyber-attack on Google that the company traced to China.) I say bewildering not because China's censorial actions on intellectual property and basic freedoms are without precedent, but rather because those actions violate the interests of the Chinese people. The company has been praised in China by Internet users for its innovations, its superior English-language search results as compared to competitors (notably Baidu.com), and for enabling access to more trusted information. Access to less filtered information through Google's PageRank algorithm allows Chinese Internet users to know which research institutes or media or health agencies or public officials to trust.

Not only is China shuttering access to information for its citizens, it is exacting this punishment with a gag-order that is one part Molière and one part Orwell. The Communist Party's Propaganda Department issued "requests" to journalists last week to halt their coverage of the possible closure of Google's Chinese Web site. The state-run Xinhua news agency has accused Google of "sensationalizing" Chinese Internet censorship and of violating "basic international practices" that uphold local customs and laws. "We welcome Google to stay if it wants, but it has to abide by Chinese law. There is no space to bargain on this issue," the editorial said.

What is doubly tragic is that China's behavior injures the freedoms of people elsewhere, notably the Chinese Diaspora with loved ones inside China. The globalization of healthcare means that China's resistance to change affects everyone's health. Here's how:

1. Pandemics are global. If Chinese people's postings on social networks like Twitter or YouTube are censored, these postings are not searchable on Google. This makes it harder for public health agencies around the world to find out who is sick, and where they are sick, in real-time. If public health experts cannot access these postings and videos, then it's harder to know where outbreaks are emerging and to stop them before they migrate over air, land and sea.
2. Medical tourism to China is growing. China is fast emerging as a destination of choice for people seeking cardiology, neurology, and orthopedic services. Many leading Chinese hospitals provide treatments that combine Traditional Chinese Medicine with Western techniques. North Americans, despite access to Google.cn from their home country, may not be able to access Chinese citizens' Web postings about the quality of health services in China. Therefore, for someone in North America seeking healthcare in China, possibly out of a desire to be close to their Chinese-resident relatives post-surgery, this impairs health-seeking decisions about where to go for care in China and how to navigate the Chinese healthcare system.
3. There are thousands of research institutes in China. If researchers at these organizations are wary of posting controversial findings online, such as the sociological impact of the country's one-child policy, then researchers and policy-makers around the world will suffer from a lack of access to vast repositories of important new knowledge. China's National Population and Family Planning Commission has suggested the one-child policy will remain in force for a decade. The policy has been linked to an increase in forced abortions and female infanticide, as well as to involuntary bachelorhood.

The fate of Google's China policy therefore affects the world's health. By dint of its size alone, China is poised to be the innovation capital of the world. I suspect Sergey Brin, the Russian-born co-founder of Google who is the chief advocate for its current confrontation with China's leadership, knows this. In 1979, when Brin was six, he emigrated to the United States. In The Google Story, Sergey's father, Michael Brin, tells how the family left for the United States because the Communist Party barred Jews from professional ranks and denied them entry into universities. Now, Google fights discrimination. It is becoming the best, free university for everyone on the planet, rich or poor. It has an open admissions process as long as you possess a cheap, Web-enabled cell phone. Unfiltered trusted information is a ticket to freedom.

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