The future of healthcare data could go in two very different directions. On one side is a system where consent is a checkbox, your data is used without your knowledge, and decisions about care, credit, and access are made by algorithms trained on broken information. On the other is a future where individuals own their data, control how it’s used, and benefit from its value. The choice isn’t science fiction, it’s already being made. Now is the time to decide which future we build.