The University of Hawaii Cancer Center's ransomware attack in August reveals an uncomfortable truth: our collective sympathy for healthcare ransomware victims has become a shield protecting organizations from accountability for inexcusable security failures.
When I read that UH paid the ransom and that files containing Social Security numbers from the 1990s were compromised, my first reaction wasn't sympathy. It was frustration. Here's an organization entrusted with cancer research data, storing decades-old files with SSNs in systems so poorly secured that ransomware operators waltzed in and encrypted them. Yet the dominant narrative remains: another healthcare victim struck by cybercriminals.
This framing is not just wrong, it's dangerous. By treating every healthcare ransomware incident as an unavoidable tragedy rather than a preventable failure, we're subsidizing poor security practices and feeding the very ransomware ecosystem we claim to want to stop.
The Victimhood Shield
Healthcare organizations have perfected the art of deflection after ransomware attacks. The playbook is predictable: emphasize the mission (saving lives, advancing research), minimize responsibility (sophisticated threat actors, resource constraints), and pivot quickly to recovery efforts. The University of Hawaii hit every note perfectly.
But let's examine what actually happened here. UH stored research files containing SSNs from the 1990s on systems that could be compromised by ransomware operators. This isn't a case of cutting-edge attackers exploiting a zero-day vulnerability in mission-critical equipment. This is basic data hygiene failure.
Think about it: these SSNs were collected in the 1990s, when Bill Clinton was president and Windows 95 was revolutionary. UH continued storing this data for three decades without apparently asking fundamental questions like "Do we still need this?" or "Should decades-old participant data be sitting on networked systems?"
The breach notification mentions that UH had "adopted different identification methods" since the 1990s, implying they knew SSNs were problematic for research participant identification. Yet they kept the old data anyway, creating a liability that persisted for decades until ransomware operators finally cashed in.
The Ransom Payment Problem
Perhaps most troubling is UH's decision to pay the ransom. The university frames this as a noble choice to "protect individuals whose information may have been affected." But paying ransoms doesn't protect victims, it perpetuates the ransomware economy.
Every ransom payment sends a signal to other attackers: healthcare organizations will pay, and they'll wrap the decision in moral language about protecting patients. This makes healthcare an increasingly attractive target, not a protected sector.
The university claims they secured "destruction of the information the threat actors illegally obtained." This is either naive or deliberately misleading. Ransomware operators regularly lie about data deletion, and there's no technical mechanism to verify destruction of stolen data. UH essentially paid protection money to criminals based on their promise to delete the evidence.
Meanwhile, the actual victims, the research participants whose 30-year-old SSNs were exposed, haven't even been notified yet because UH is still "determining contact information." So much for protecting those affected.
The Resource Constraint Myth
Healthcare organizations routinely claim they lack resources for proper cybersecurity, and this argument gets sympathetic coverage. But resource allocation is a choice that reflects priorities.
UH operates across 10 campuses with thousands of faculty and staff. The Cancer Center alone has over 500 people. These are not small, under-resourced community clinics struggling to keep the lights on. These are substantial institutions with budgets, IT departments, and presumably some form of risk management.
The security measures UH implemented after the attack, endpoint protection software, system replacement, password resets, firewall updates, third-party audits, reveal what proper security looks like. The implicit admission here is that these basic protections weren't in place before the attack.
How do you justify storing decades of sensitive research data without endpoint protection? How do you operate in 2025 without current firewall software? These aren't resource problems, they're priority problems.
The Sympathy Trap
Our reflexive sympathy for healthcare ransomware victims creates a moral hazard. Organizations that fail to implement basic security measures face no real consequences beyond the ransomware attack itself. They receive sympathy, insurance payouts, and often continue operating with minimal changes.
This dynamic is particularly problematic in research contexts. UH's Cancer Center conducts studies that rely on public trust. Research participants volunteer their data believing it will be protected. When that trust is violated through preventable security failures, the response should include serious accountability, not just sympathy.
Compare this to other sectors. When a financial institution suffers a data breach due to poor security practices, regulators impose fines, require specific remediation, and mandate ongoing compliance monitoring. Healthcare organizations face far lighter regulatory pressure and benefit from public sympathy that financial institutions don't receive.
The result is a sector where security failures are treated as unfortunate events rather than preventable outcomes of poor decision-making.
The Real Victims
The true victims in healthcare ransomware attacks aren't the organizations, they're the individuals whose data gets compromised. In UH's case, that's cancer research participants who trusted the university with their information decades ago and now find their SSNs in the hands of criminals.
These participants didn't choose UH's security posture. They didn't decide to store their data for 30 years. They certainly didn't consent to having their information held for ransom. Yet they bear the consequences while the organization that failed them receives sympathy and moves on.
This misplaced focus on institutional victimhood obscures the real harm and the real accountability questions. Instead of asking "How can we help UH recover?" we should be asking "How did UH fail its research participants, and what systemic changes prevent similar failures?"
A Different Framework
Healthcare ransomware demands a different response framework focused on accountability rather than sympathy. This starts with honest assessment of what went wrong and why.
Organizations should face pressure to explain not just what they're doing to recover, but what they failed to do to prevent the attack. Basic questions like "When did you last audit data retention policies?" and "What security measures were in place before the attack?" should be standard, not afterthoughts.
Regulatory responses should focus on systemic improvements rather than incident response. If UH had properly secured systems and current data retention policies, this attack either wouldn't have succeeded or would have had minimal impact.
Payment of ransoms should trigger enhanced regulatory scrutiny, not understanding nods about difficult decisions. Every ransom payment funds future attacks and makes healthcare organizations more attractive targets.
The Stakes Are Rising
Healthcare organizations handle increasingly valuable data while facing increasingly sophisticated threats. The old model of sympathy-driven incident response isn't keeping pace with this reality.
UH's attack demonstrates the long tail of poor security decisions. Data collected in the 1990s became a liability in 2025 because nobody made the hard decision to properly secure or dispose of it. How many other healthcare organizations are carrying similar time bombs?
The current approach essentially socializes the costs of poor security practices while privatizing the benefits of operating cheaply. Insurance covers breaches, public sympathy provides political cover, and organizations continue operating with minimal consequences.
This is unsustainable. As ransomware attacks become more frequent and more damaging, healthcare organizations must face the same accountability standards as other sectors handling sensitive data.
Healthcare's mission is important, but it doesn't justify exemption from basic security expectations. Research participants, patients, and the public deserve better than sympathy theater after preventable failures.
The question isn't whether healthcare organizations deserve sympathy after ransomware attacks. It's whether our sympathy is preventing the accountability necessary to stop these attacks from happening in the first place.
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