Slashdot Mirror
Your Medical Treatment History Is For Sale
PizzaFace writes "The Washington Post reports on the booming business of selling your medical treatment records. Today these are mainly records of your prescriptions, but the data warehouses will soon have records of your lab tests, too. The companies selling these records make it easy for insurance companies to avoid risk by assigning each person a health score, similar to a credit score, or by flagging items in each person's history that suggest chronic or potentially expensive health problems. It's not just for insurers, either; employers who check applicants' credit scores will surely be interested in their health scores as well."
Looks to me like this is an excellent time to read up on alternative treatment methods, as the barabaric, for-profit US "healthcare system" appears hell-bent on becoming less and less available to those of us with imperfect health and fewer than several gazillions of dollars.
Here you can RTFA all on one page.
Caveat Utilitor
Unethical?
Sell my medical records and my lawyer will be in touch with your lawyer. See Health Insurance Portability and Accountability Act
mcgrew's razor: Never attribute to stupidity that which can be explained by greedy self-interest
what the fuck
(mod this '+5:insightful'. this should be the only response.)
This makes me feel sick. ...
Just like Slashdots *ridiculous* minimum length filter. I mean, I just want to type a smart-ass unfunny commment as an AC and watch with pride as it get's modded +5 funny. Is that too much to ask I asks ya.
I think this is a terrible way to go. Its not my fault that I have a certain condition that could potentially stop me from getting heath insurance. Wasn't there something like this a while back about getting your DNA mapped for potential conditions, and that insurance corporations could use that data like this article suggests? If this goes through, we are going to start seeing "Selective breeding" again so we all can afford heathcare. Then again, we are all going to die one day, so why have heath care in the first place?
This is a difficult discussion to have:
Car insurance knows how many accidents you've had. Home insurance knows what claims you've made. All the insurance companies know your criminal record.
Health records may be private - you don't particularly want your neighbors to know about it. But the company that is insuring you certainly has a right to know what type of risk they're insuring - and just like auto insurance your cost should reflect it.
At the same time, health care is something that is a necessity. So if they price it out of range, how do you protect yourself? Removing preventive care due to cost and substituting emergency care in it's place is a horrible solution, but if it's priced out of range, that is what may happen.
This is why the government is going to have to step into health care in some way. It's in the Health Insurance company's best interests to not insurance people that are high risk. In a free market, those people will end up being uninsured.
I hate government intervention in any market, but I don't see any way around it. You can walk to the store and work. You can't perform an appendectomy on yourself.
....does this mean I get to wake up again in a bath tub full of ice with a surgical incision on my belly with just enough money to call a cab?
The interesting side of this is that people who stay in good shape and are generally ahead of the curve may see some benefits in the premiums they pay. Sloth (the sin, not the hero of goonies) will be actually financially penalized.
All sorts of horrible implications to this, diseases people cant control, genetic manipulation of kids seems much more practical and desirable as a finnacial benefit to avoid fees now too. Great moral implications and debates on this one.
There's nothing Intelligent about Intelligent Design.
Watch the people who can't get insurance, and yet have a life-threatening health issue, go Rambo.
Health Care Insurance employees better watch their backs.
Blar.
.. why would an employer need to know what your credit score is?
I'm a (usually) economically conservative person, and i agree totally with this. Government controlled health care is one of the few instances where socializing an industry is in the best interests of society as a while.
And I'm busting my ass encrypting laptops for HIPAA compliance so stupid med students don't lose an anonymous list of patient encounter notes.
Just a week ago BusinessWeek had a piece about health care insurance companies buying your prescription drug history onto which they base your insurance premium.
http://www.businessweek.com/magazine/content/08_31/b4094000643943.htm
Health care probably needs more an element of solidarity. Insurance is a business and as such it is legitimate for them to aspire for higher profits. Cynically, it is also legitimate for an insurance company to deny services to higher risk individuals. It is legitimate for a business but it points to deep deficiencies in how health care finances are set up in US.
In contrast, Germany's system (and probably others in Europe) has an element of solidarity. Healthier people subsidize sicker people. American system is an insurance, set up for calamity but actually used as pre-paid service.
Says you can't discriminate against those with disabilities as long as they can perform the job with reasonable accommodations.
"It's not just for insurers, either; employers who check applicants' credit scores will surely be interested in their health scores as well."
Any employer with over 15 employees that tries to require health screening as part of the hiring process will find themselves in court rather quickly.
Another reason to despise insurance companies. I don't know what would be more disappointing finding out my daughter was a stripper or that she works for an insurance company. Either way, she's probably screwin' way too many people!
This is just another way in which the insurance industry works to defeat access to preventative medicine. You want the screening for early detection, but it might lead to you losing your insurance, or getting dropped from an employer plan and having to go it alone.
The insurance industry knows three things: Sick people cost money Healthy people cost less money Dead people cost even less money
Guess which they want the most of? The faster you move from sick to dead, the better their bottom line looks.
Every bit of data out there is for sale at this point. Its rather disgusting.
---- Booth was a patriot ----
Car insurance, purchasing habits, criminal record, credit score: all of these things are now available.
Why do we need them?
Well... for starters, we're awash in people of criminal behavior.
If you want to be free from crazy companies judging you, work hard to eliminate the real abusers of the system.
Their actions do have an impact on you -- it's the fractional distribution of socialized cost.
Anti-Globalism, Traditionalism, and FreeBSD.
I don't know why anyone would be surprised that an organization the goal of which is to maximize profits would do its best to cut costs (paying for your medical care) and maximize income (acquiring the money of you, your employer and the government i.e. other taxpayers as health-care premiums). You'd have to fail Logic 101 to think things would be otherwise.
On the other hand, what the Washington Post will suggest is the "solution" to this nonsense is even more illogical: you should give all your health-care money to another organization, Congress, which is also most interested in something other than your health -- namely, keeping political power. What do you suppose will influence Congressmen when they decide what to do with your health-care money, and how to provide you with health-care? Altruism? Your actual happiness? Using your money most efficiently? Hmmm. Is that how it works now, when Congress debates how copyright should work in the Digital Age, or whether it makes sense to subsidize turning corn into ethanol (instead of food)?
Once again, we're confronted with the nasty little fact o' life that the only agent that will ever have only your interests at heart is you. Given that, which of these three options makes sense?
(A) Give your money to a big insurance company, run by strangers with Harvard MBAs seeking to maximize profits for shareholders, then ask for some of it back when you want some health care.
(B) Give your money to Congress, run by smooth-talking lawyers seeking to maximize their terms in office through maintaining access to the massive amounts of cash necessary for perennial re-election, then ask for some of it back when you want some health care.
(C) Keep your money, and spend it on health care when and where you choose.
Strangely enough, people keep choosing (A) and (B), under the amazing delusion that somehow if you make all the transactions really complicated -- shuffle the dollar bills around fast enough -- we can receive more value in health care than we pay out in actual money. Proof that the bitter lesson of TANSTAAFL has not been learned by most adults.
Healthcare rationing! Long waiting lists! Socialism!
Of course, healthcare in the US is already rationed (just according to your ability to pay for it) and you already have to wait for procedures and tests (like the week and a half it took my wife to get the insurance company and various doctors involved to schedule an MRI that everyone agreed she needed).
Insurance companies are probably the worst type of organization to have making healthcare decisions.
System could be set up which is not part from the government. It has to have element of solidarity, this doesn't inherently come from it being the government: sicker people are subsidized by healthier individuals. Every body pays into this system and it can be separate from government taxes. This could be a solid finance base on top of which one can impose voluntary insurance for extra benefits -- getting better room, color TV, etc. while in hospital.
If it is separate is could be better managed. And there could be more focused pressure on eliminating waste and demanding better prices from hospitals and other providers. I feel it will be less so if money come from the general pool of collected taxes. It will also be more cleanly delineated on your pay check as a separate item.
I have been charging medical and insurance customers through the nose for any work I do for them, and tell them it is a reflection on what I have to spend when I need their services, tit for tat...
I see no reason that all IT professionals shouldn't reflect the ability to pay the same as these two groups do...they make more than enough to pay that higher cost, to make up for those that can't afford to pay a premium...(you hear that crap from both medical and insurance sides...they charge on the basis of ability to pay...)
tit for tat
Guess they want to put themselves out of business through some sort of nationalized health care. You'd think the threat would make them more customer focused, but I guess they're far too long gone for that.
if i have low health risk score anyway ?
Read radical news here
I have serious problems with the idea of my medical history being "made available" (whether for sale or free), but I cannot articulate a good argument that would mean that the simple existence of a national health treatment database is a bad thing.
I mean, my house could burn and I would lose the paper copies of all that stuff. I don't have it all committed to memory. I have not had "my own doctor" for anything since college (I am 25). I could see a "medical database" working *if* it gives me absolute control over where the information is sold.
Tell you what... here is what I would support. Let them create the database, but require that I am the *only* person who can request information out of it. Then, when an employer or insurer wants my medical history, they can request that I provide a copy of it, much like I am required to provide a copy of my academic transcript to an employer or potential graduate school application.
So, let the insurance company "request" a copy of my information from me. Then let me forward the request to the "medical database". That authorizes the "medical database" to send a bill to the insurance company, who will send a copy of the records when the payment is received.
Support the 30 Hour Work Week!!!
In Bubbles' voice:
That's a bit fucked if you ask me.
The problem here is that there is money at stake. The insurance companies are only interested in the amounts that we spend on health care anyway, they don't particularly care about the treatments themselves. They care about the amounts because, they would infer, high-speanding = sick = more sickness over time.
No "health care" involved. The companies are worried about how much they will spend if they take you on as a client.
Also, they have had access to physicians records for some time—again for the same reasons. And guess what (RTFA, or the "Privacy Rule" in HIPAA): HIPAA doesn't apply. When you apply for insurance, read the fine-print, because there are clauses in there about allowing them access to your medical billing records. These days they are just electronic, ergo easier to access. This is why they want access to prescription info as well, because then they can use this to more finely tune their systems of prescription drug co-pay scenarios.
I don't think that it was ever up for debate that the United States "health care" system has nothing to do with health, but another good indicator would be that insurance plans typically don't cover anything that can be deemed preventative, including basic physical examinations, and routine diagnostic testing such as STD/HIV tests, cancer-screenings, etc. Those tests are only paid for if they are deemed "necessary" for the diagnosis of a condition, rather than the prevention of a condition.
There has never been a better time for a national health-care system in the US. Also, there has never been a worse time: we don't have any more money.
If you don't know what you're doing, you can't make mistakes.
Not true, you will just end up paying for the perceived risk associated with all the people that bought hydrocortisone that will be flagged has having eczema (or something just as mondane). They are looking to increase your payments not decrease them. There is also the cost of paying for this service will is probably quite high and will also be put on to a healthy person's bill. Get real, this will be just as useful as the credit scores were for preventing people who could not pay from getting a home loan. What are you going to do it they make a mistake and find that you have an Aids drug prescription when you really don't and you get dumped from your insurance because of a pre-existing condition. Or even worse the insurance companies start basing there premiums to employers based on the perceived health of the work force. you might no get that next job if you are older or maybe over weight. The only people how will benefit from this is the investors in the data provider.
for a national health care. they are SO predatory, SO villainous, SO phony that they make worst nationalized health care system look like out of heaven.
Read radical news here
"thus the only way to increase their income is to get more and more patients"
Not really.. they can go work in a private clinic, or they can work in another country (as you already pointed out). Thank goodness there's many doctors who don't particularly care about increasing their income - who got into the job because they can genuinely help fellow man and all that sort of altruistic stuff that we, as a society, are far too eager to write off and laugh at. These are doctors who will give treatment for free if needed (and sometimes if not*), instead of some doctors only giving free treatment while on a P.R. trip to a poor country (not dissing the gesture, just dissing the motives).
And, let's be honest, they don't really -need- the higher income because they don't have to worry about multi-million dollar malpractice suits looming around every single corner and the insurance that goes with it.
I'm not saying that 'socialized' healthcare is panacea.. far from it.. but that "happy medium where everyone wins" should not be led by the desire to make more money - focus instead on reducing or eliminating the negatives you mentioned.
* I had a nasty bruised-looking toe - walked (well, semi-hopped) straight into the hospital (hadn't registered for a GP yet after moving), got to see a doc in 10 minutes who had an x-ray made 5 minutes later 'just to be safe', determined that it was indeed broken as he suspected, got me a splint, had a nurse put it on while he moved on to another patient, came back to do a quick check to make sure it was on right, and sent me on my way. That's it. Didn't send me past administration for my insurance info on my way out, and certainly not on my way in.. I was a guy with a nasty bruised-looking toe who needed to have a look at it done by a doc and that's all they cared about. Thanks, MCH. I know this is anecdotal, and I'm all too familiar with waiting lists as well, but it's not nearly as bad as some make it out to be. Being on a waiting list for an organ, however, does suck - but that seems to be the case regardless of medical system; short of countries where there's a lively 'grey'/black market in organs. Yikes.
Much like the grocery store sells milk and Britannica-salesmen sell encyclopedias to you, you are marketing and — if you are good — selling your labor to an employer.
There is nothing wrong with the employer checking up the quality of your health before buying. If you make that illegal, you should outlaw Consumer Reports and, in particular, their repair-history database...
In Soviet Washington the swamp drains you.
...is the equivalent of the free annual credit report, so I can audit the my history as represented in the database. Everything else I can take up directly with my employer, insurer or doctors.
Ask anyone in the public health field -- in some sense, there's no such things as individual health. Communicable diseases are the easiest way to show that, but it's arguably true for health care in general.
That said, I wouldn't necessarily socialize health care in general. I'd be more likely to just socialize health insurance. As other folks have pointed out, health insurance is in the business of not paying for their customers' medical expenses. Sure, at some level, someone's got to decide whether a test/procedure/medication/whatever is medically necessary. But do we really want that decision made by someone with a vested interest in saying no?
It's HIPAA not HIPPA. /sorry, pet peeve.
The problem is proving that the employer used the data against you. Its so easy to find other reasons that are hard to fight to do what ever they want that its all a big joke.
I once asked an attorney what would prevent me from being an ADA black mailer. He replied with a database that HR departments use and the some other database that employers have access to.
So, maybe you can sue - assuming that the employer fails in proving that you're a disgruntled employee - and you get some sort of compensation - whatever you get (most likely a lousy years salary) you better make it last for the rest of your life because you'll never get another job.
Yeah, prove you're being discriminated against - again - uh huh, you're just an ADA blackmailer.
Because we all know, that anyone who sues their employer is out for easy money...
It's changing the original bussiness model.
Remember that insurance was conceived with "probabilities" in mind, not certainities.
Fair play?
Sounds reasonable at first, but think for a minute: why would your doctor order a blood test to see if you have cholesterol problems if he or she had already put you on cholesterol medication because he or she knew you had cholesterol problems? Even if you switched doctors, your new doctor should know the results of that test, and at the very least you need to tell him you're on the medication. In other words: your doctor is going to know already.
At best this is a flimsy excuse to invade your privacy and raise your insurance premiums: "By reducing wasteful testing your doctor orders because he/she is an idiot, we save you money, so don't worry about invasions of privacy or your rates going up
But there's another issue that this seems to raise: accountants at your HMO second guessing your doctors. Lets say in the example above your doctor wants to test your cholesterol to see how effective it is or if you actually should still be taking it. Your HMO says "Hey, no, we're not paying for that, we know he has high cholesterol because he's on cholesterol medication, we don't need a test!"
It seems like this could be sorted out with common sense, and like the insurance agencies would have some idea of what's reasonable and what's wasteful, but they don't always. The article mentions that often medications that can be perscribed for two or more different purposes, and the insurance agencies often have a hard time understanding something that simple, denying the woman life insurance because they were convinced she was depressed, when she was actually taking prozac for hot flashes.
If they don't belive the doctor that she was postmenopausal instead of depressed, can we really expect them to use information NOT coming from the doctor correctly, in our best interests?
In the long run we're all dead anyway... so who cares?
The system can save money for insurers, said Richard Dick, an entrepreneur who built the database system that Ingenix acquired in 2002.
What was his mama thinkin'?
and introducing more of it into health care will only decrease the quality of what we do have.
You can't shop across state lines because of federal regulations. Every damn state and the feds introduce must carry rules. It is because of government intervention that health care is such a mess. We spend nearly TWO trillion dollars if all levels of government are represented and what are we getting for it? Oh, that's right, somehow its private corporations that are at fault for so many uninsured. Yet when solutions are offered some in Congress go out of their way to limit your ability to choose. One recent attempt was to remove the ability of seniors to shop around. Apparently it was too popular and less people needed government which means politicians had less ways to preserve their power.
Don't run out with the tired examples of what a mecca Canada or Britain are. I have relatives and family friends who have all been subject to that. My father had to fly back to the states for knee surgery while in Germany because it wasn't life threatening unless you call not being able to walk ok. One day here and he was back on a plane to Germany the next. Heaven forbid your over sixty and need something major. Our family friend's doctor's solution was to fly to the Mayo clinic to get his surgery NOW instead of waiting for the necessary regulatory requirements to be met in BC.
Yeah, you can cite examples on either side of the argument but all you have to do is read the news around the world to see that government controlled health care has its own set of problems and some of them are worse. Perhaps having the government help cover extreme cases would be best, no one should go bankrupt because of a medical emergency but at the same time they should not sacrifice.
My local doctor is on the verge of refusing all but private payers because the government is worse than all but one of the HMOs that he has to deal with. The government imposes treatment costs and requirements that go beyond what he feels is reasonable. He has been practicing nearly forty years, you would think he knows what is appropriate.
These fools can't run our schools, can't run airport security, and certainly cannot seem to protect our information, yet it never amazes me how many people want them to handle their health care. All it will do is create a new and more entrenched political group which will suddenly unionize and spend their money influencing elections as long as it further entrenches them and gives them power. People think the national teachers unions are out of control won't believe what will happen when the same occurs in the medical profession. Worse will be all the new bureaucrats that will be needed. The one area of employment which has never stopped growing is government. There are close to twenty five million people being paid to work in our governments. TWENTY FIVE MILLION! Think about it. Now you want more and you want them into a even more personal part of your life.
Then again I keep forgetting, the very same throw their most valuable and important parts of their life into public schools without batting an eye. After all their school, politician, local government, etc, isn't the bad one. I guess we can convince ourselves of anything if it means we don't have to look behind the door
* Winners compare their achievements to their goals, losers compare theirs to that of others.
And what happens when you're in an accident and left in a coma?
None of the doctors can access your medical records.
This is wrong on so many levels...
I sit in front of a computer every day, get no exersize except walking home from the bar when I'm too drunk to drive, I quit smoking cigarettes in 1999 but I'd smoked them for thirty years, and I eat at McDonalds almost daily. But if they had access to my medical records they would find only:
1. Hemroid surgery
2. Cataract surgery
3. Laser surgery to weld a retina back together
4. Cryotherapy to repair the same torn retina
5. Vitrectomy surgery (eye's fluid removed and replaced with a nitrogen bubble, retina reattached)
Nothing else for probably the last twenty years. No other doctor visits. In short, this is kind of bogus; it won't do them any good whatever.
mcgrew's razor: Never attribute to stupidity that which can be explained by greedy self-interest
As previously indicated, HIPPA has already defined requirements for information transfer requirements. Also, the TFA quote that "you have the fox in charge of the henhouse." does not accurately define compliance requirements.
If we are going to be 'graded' on our health, then the solution is to 'prepare' for the exam. Take care of yourself by eating reasonably, routine exercise, avoid hospitals in particular and physicians in general unless your leg is falling off, and do not allow the medical nitwits to write endless prescriptions for whatever is on the shelf.
Even if I work until 2 A.M., a short run or bike ride is mandatory before I turn in. And I am not a young buck, I am on the cusp of being an old fart - and according to my employer, I consume less health care than peers that are 15 to 20 years younger. So I am probably subsidizing YOU.
There is no cold, flu, or emotional stress that cannot be cured by a quick two-mile run, a good ale, and an aspirin or two.
Clearly someone has never known anyone to get hit by an uninsured driver. Or gotten sick. Or been the victim of someone else doing something completely god-damn stupid (see above). Or even have a knife slip while they were cutting something. I am in considerably good health. Does that mean that I have no health insurance? You never know when something MIGHT happen, and its far better than dying out in the street (minus the scumbags that would force their expenses on others). Really, we look disdainfully of people who operate beyond their means when they know better, like banks who give out loans they know people will never replay anyone. So why should we not hold people to the same standard who refuse to keep health insurance? I suppose there is the issue of affordability, but as far as I'm concerned, there is no intelligent reason for NOT WANTING health insurance.
Yeah, I feed the trolls. Can't help myself. Sorry.
Alarmism
Far from it, look at the credit score mess and where it has gotten us.
What's a credit score? It's a score about how much you love being in debt, you get in debt and pay to get more debt and pay on time to get even more debt, etc. How is that relevant to you being able to get a job? It's beyond me.
What makes you think this system won't be abused exactly like the FICO score if not even worse?
Can you imagine identity theft in this scenario? Oh boy oh boy, someone steals your identity and all of the sudden you lose your life insurance, the doctor _won't_ see you now because you lost your health insurance, and all of that is because someone bought a heart medication with your info and your insurers dropped you immediately.
Isn't that similar to how credit scores work? Someone steals your identity messing up your score and all of the sudden _you_ are the criminal, universal default on all of your accounts, collector calls who won't believe you, etc.
The whole "insurance" thing is a form of measured "gambling"/risk industry, that is: "I bet you won't die in 30 years", "I bet you won't get sick so much this year" or "I bet you won't get in a car accident".
Things like this health score significantly reduces that gambling element and turns it almost into "I'll insure you if and only if you don't need the insurance", which just smells bad.
Finally, on a privacy stand point, the idea of even more of my information being thrown about out there doesn't sound that appealing to me.
What's the solution? I don't know. Maybe one day the system will collapse on its own weight or someone will come up with a better idea, but until that day comes, we'll be in this weird relationship with these middle-men characters.
If you can't mod them join them.
Because you might contract something, for example Ebola, though a series of unlikely circumstances.
Now you're not so healthy and may not have the resources to pay for your care and treatment.
Being 100% healthy yesterday does not protect you from becoming 99% dead tomorrow.
I don't go to a doctor!
While it is popular to slag American health care, it is also vastly superior in terms of medical results across the population by a wide range of metrics. Take cancer survival rates, where the U.S. has long been the best in the world, as once again confirmed in a recent Lancet Oncology study:
"American men have a five-year survival rate of 66 percent -- compared to only 47 percent for European men." (http://www.ncpa.org/pub/ba/ba596/)
That is no small difference -- almost 20 points! -- in medical outcomes for one of the leading causes of death in the industrialized world, and a lot of other medical metrics look like this. For all the talk of preventative medicine not being available to Americans, they are actually more likely to receive it than in other industrialized countries in many cases. There is a disconnect between popular perception and the medical literature.
Clearly insurance companies are accidentally doing something right, though perhaps because dead people do not pay premiums. However, this is less of an endorsement of the current byzantine system and more a recognition that we do not want to throw out the baby with the bathwater.
It's relevant to you getting a job because if you're in a position of responsibility for money, people who have bad habits with their own money will very, very likely not have good habits with the company's money.
I'm not saying that I agree with checking EVERY employee's credit, but doing so is a reasonable step in some instances.
My blog. Good stuff (when I remember to update it). Read it.
In countries with government-run health care you don't have to ask the government for money when you get sick, you just go see your doctor.
Government-run health care makes sense just like government-run fire departments, and has less overhead than for-profit health insurance run by big-salaried executives with armies of pencil pushers whose job is to find your pre-existing conditions so they can deny your claims whenever you get sick.
"Fascism should more properly be called corporatism because it is the merger of state and corporate power." -- Mussolini
However, catering to the sickly weakens our gene pool.
I hate to break it to you, but eugenics has long fallen out of fashion among civilized folk.
In the future, when Employers look at all this shit about us, and decide that we're not worthy. They go though your chriminal record, now it's medical records, they're also getting onto the web to see what sort of stupidity you did as a teen 40+ years ago. I wonder... - Kc
-- Kevin C. Redden kcredden@ gmail 392992
How are uninsurable people suppose to obtain healthcare? And not just emergency or major surgery healthcare, but preventative healthcare?
If you don't want government involvement, then health insurance must be non-discriminatory, or else there will be no choice but to have public-funded programs to treat those who cannot afford private insurance. Or they can just get sick and die, I guess. Hey, as long as your ass is covered, right?
If you post it, they will read.
people who have bad habits with their own money will very, very likely not have good habits with the company's money.
Is that assertion backed up in any way by reality?
There is no shortage of medical conditions which come about more as a product of environment and/or chance than genetics.
If you fall down a flight of stairs, do you expect people to say, well, guess you shouldn't reproduce with that shitty sense of balance, so we're not going to fix your broken leg, so it gets infected and you die?
If I punch you in the face for being an ass, well, guess you should have seen that coming.
If you want to talk eugenics, how about sterilizing stupid people? I think that's something we can all agree on.
In the UK. I mean, I know our data is really secure, and could never get into the wrong hands. Right?
-- Lattyware (www.lattyware.co.uk)
But if you're so good with money that you never use credit cards or take loans, then you have no credit score at all, and this is considered 'bad' credit.
Well apart from nationalizing healthcare, the only option I can see is to mandate that private insurers operate as mutual insurance companies the way they did in the old days, where the policyholders were the actual shareholders. The problem these ran into was their ability to raise and maintain capital sufficient to compete with corporate insurers. The same thing happened with the mutual savings and loan banks (FSLIC insured, rather than FDIC or NCUA).
One advantage that health insurance has as a mutual insurance market is that overall healthcare costs in large populations are fairly predictable. It's not like homeowners' insurance where wildfires, earthquakes and hurricanes are going to generate a flood of claims that can wipe your small insurance company out. It sounds like there are an awful lot of patients/policyholders that would prefer a company that was just as interested in its customers as in its profits. And even if a mutual insurance company did decide to sell its data for data mining, the profits would go back to the policyholders anyway, in their role as shareholders.
Does anyone know of any true mutual insurance companies still in existence?
We are the 198 proof..
Any undisclosed third party use of your PHI (personal health information) is a direct violation of the HIPAA (Health Insurance Portability and Accountability Act)... If anyone finds out about the unapproved disclosure of your and anyone's PHI to a third party without your permission - immediately report this fraud to CMS (the Centers for Medicare and Medicaid Services) This is a serious violation for the health provider involved and can mean a fine of up to $25,000 PER VIOLATION! Your government makes all efforts to protect your PHI - just try becoming a HIPAA Compliant office :)
You know what really "weakens our gene pool"? Allowing the children of the rich to inherit money or positions of power. It stifles innovation and clogs the top spots so the serfs don't even try to excel. The only solution is shooting the little snots when they reach, say, 16.
At a minimum, these are the first kids we should send to Iraq, et seq.
Sent from the iPad I found in your car.
The US only wants to deal with the perfect human. Please apply, must have perfect health, perfect grades, perfect work history, perfect extra.
Have we started creating them yet?
http://en.wikipedia.org/wiki/Household_income_in_the_United_States Compared to what half of the house hold's in this country make, $48,201.00. A catastrophic or chronic illness is of course the leading cause of bankruptcy. http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html I don't think thinning the "insurable herd" with some "illness score" is going to solve any problem but one... Making insurance companies wealthier. We are so close to a civil revolution in so many ways... This kind of data gathering is just one more step in the direction of anarchy. Equal and oppiset and all that.
Thanks to eating disorders most chicks are reasonably good looking these days.
Its a good thing our healthcare system is so fucked up. I barely have any medical records because I cant afford to go to the doctor. My health score will be fantastic. Jokes on you assholes!
.. people who have bad habits with their own money will very, very likely not have good habits with the company's money ..
Agreed. But my point was that a credit score is not a good measure of financial success or responsibility, if you think about it a bit it's really quite the opposite. There's nothing in the making of a FICO score that measures your net worth, it only measures your debt, how long you've had it and how well are you paying it back (if you've been in debt and paying it for 10+ years you're a real winner!).
The fact that some places and so many things assume that everyone has to have a credit score shows how deep we've gotten into this mess.
My main argument was that credit scores may have seemed like a great idea one day for lenders (get approved instantly - sounds familiar from TFA?) and got so out of control that they're defining us today.
This thing can turn into a bigger beast with severe consequences worse than not getting a job or getting approved for a loan.
If you can't mod them join them.
I work for a UK bank. All employees are required to demonstrate they are financially competent, due our access to information which could potentially be used for personal financial gain. I believe that once a year we are subject to a 'silent' credit check (which doesn't affect our score). If we've a bad score, say due to falling into a debt we can't manage, then we'd be invited to a meeting discussion with our managers. A colleague of mine had such a meeting after his credit score dropped when the water utility for a previous property he lived in tried to land him with a big bill and sent debt collectors round. The next resident of his previous property hadn't declared they'd moved in, and didn't pay for the 9 months or so he lived there.
Anyway, my point was that as a worker in the financial industry, my credit score is relevant. Not the be all and end all, but relevant. Oh, and you don't necessarily have a bad credit score if you don't use credit. You just won't have a good one.
Is this a rhetorical question?
quoted for truth:
Our evidence comes from double-blind scientific studies not anecdotes
[citation needed]
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Here is a simple idea, which would make all of the insurance companies work properly, as everyone expects.
The problem with insurance companies is that they can cheat, ie. they can overestimate the risk in order to increase their own profits.
So let's separate the operational costs and profits of the insurance company from the insurance fund itself. If you would purchase insurance, you would see these parts as different entities on your bill. Under _no_ circumstances could be the money from the insurance fund be used to fund the operation of the insurance company, i.e. every investment of the fund money would have to come back to the fund. So the insurance company could well go under, even if it had large quantities of money in it's fund (these would then be redistributed back to customers). Or in the other way, if some big disaster occurs, the fund could become empty, but the operational profits of the company wouldn't be touched.
This would be an incentive for the insurance company to be honest with respect to correct calculation of risk and operational profits, and thus would encourage fair competition.
That's not being good with credit - that's being paranoid. You might be very good with money, but having no proof of it doesn't tell your employee anything.
No matter how many articles the NY Times publishes on predatory lenders or bad debt, the fact remains that everyone who borrows money does so at their own peril and signs their name to the dotted line. It's a fair subject for debate as to how much the credit markets should be regulated (personally, I fall in the middle of that spectrum) but your credit scores are (arguably) the direct result of your behavior - your 'medical score' is only partially that inasmuch as your medical condition is only partially a direct result of your behavior.
Are you insane? Hospital administration, to some degree, yes; but Doctors aren't trying to be opaque about costs, they're just having to deal with the insurance companies.
As to the requirements for surgeons, they're having to go through the training to be surgeons, not doctors. And a lot of them still mess it up. If anything, we need more training for specialists, not less--or at least better training.
My grandfather never let surgical residents close up after his surgeries because they hadn't had enough training--the hospital gave him trouble about it for a long time. One day he left a very experienced and well-known visiting specialist in his field close up after him, and the surgery itself had been fine.
The specialist botched the job and the patient died.
We don't need less training for surgeons. At the least we need better training.
Yes, it's anecdotal. But anecdotes add up, and I've seen some terrible medicine performed in my time. People die when surgeons aren't trained well.
the first kids we should send to Iraq, et seq.
And those with low IQs. Wait...they already do that!
And whether it's out of fashion or not, it's sick.
Individuals' lives have value independent of their "utility" to society. Discarding individuals in the name of humanity is the way of dictators; that sort of "kindness" is always the strong crushing the weak under noble pretenses.
As someone with a very painful, debilitating chronic health condition (very active Crohn's Disease), you should assist in paying for my health care because you're part of a society that has made euthanasia illegal and severely demonized suicide (indeed, were I to attempt it, I would likely be institutionalized). Hence, as society has taken away my only alternatives, it has an obligation to provide me with access to the requisite medical procedures and drugs.
I am not an Actuary... but my first programming job (COBOL!) was for a health insurer.
From the American Academy of Actuaries:
Principles of Insurance -- Gambling vs. Insurance
- Gambling creates a risk that did not previously exist
- Insurance transfers the financial consequences of an existing risk for a known dollar amount (premium)
I think use of credit scores to allow companies in the credit industry to more intelligently give credit to people is a good thing. Credit isn't something that everyone should be entitled to, nor does everyone need credit. The availability of credit helps people's lives, helps the economy, etc. etc..
However, the development of a health score by an industry that provides health insurance is going to decrease the amount of people who require healthcare having access to it, and it will increase the cost of healthcare and insurance for those that will require more of it. Now, you may say that this is right and proper - as those that require less healthcare will benefit from better rates of insurance. The major downside to society will be the increase in sickness - I don't seeing that being beneficial for anyone. Does the government want to see the negative effects this will have have on the economy?
Okay, so the above is a crude analysis. But don't we all benefit when access to healthcare increases? This action looks to work in the opposite direction. I'm very glad I live in a country with a Nationalised Healthcare System.
Is this a rhetorical question?
Alarmists! Panic!!!
That's not being good with credit - that's being paranoid. You might be very good with money, but having no proof of it doesn't tell your employee anything.
I disagree that not using credit is being paranoid, but that doesn't really matter. The point is that if you handle your money well enough that you never have to borrow any, this generally flags you as "inexperienced" (not necessarily bad, as someone else pointed out), instead of flagging you as "no information". This, to me, is a flaw in the system that should be addressed if employers and landlords are going to perform credit checks on people.
We have your mortgage payment history too...
Sounds just like in the movie "Gattaca"
Power corrupts the few, while weakness corrupts the many.
The information does not come from doctors. From TFA:
Ingenix and Milliman create the profiles by plumbing rich databases of prescription drug histories kept by pharmacy benefit managers (PBMs), which help insurers process drug claims.
Wikipedia has more on PBMs
Soylent Green is peoplicious!
You raise a very good point, but I'd like to try a different angle on it. Health insurance (like any insurance) is a gamble by the insurance company, but since they play averages they are guaranteed to win in the long run.
Now, if an insurance business has a better idea of your risk level, it can adjust your rate appropriately, so that its chance of having to pay for you is just slightly lower than the amount it's making from you. Your behaviour affects your rate. This makes sense, in a way.
So the more information your insurer has about you, the more each person is bearing his own risk, and the less he is bearing the risks of those around him. Literally, society is bearing less of the cost of individuals who behave dangerously.
Republicans love that kind of thing. They like the idea of personal responsibility (or at least they used to before they truly went off the deep end, and there's still a lot of that left). Socialists like a society that takes care of its weak/stupid/careless/etc--in a sense, society accepting responsibility for its members. So the more information your insurance company has about you, the more Republican (in the sense of personal responsibility) society becomes.
Would you like to keep your good-driver discount? What's wrong with your health insurer charging more to your neighbour, who is an obese smoker, than to you, who work hard and spend money to stay healthy? I'm not sure where I stand on hereditary disease--maybe "full benefits until you have kids" or something would be reasonable, if society decided that it would be better off with fewer, healthier individuals.
Of course, as I alluded to above, the responsibility for risky behaviours in individuals is partly that of the individual and partly that of the society. Sadly, the people who have decided to make it impossible to healthily commute in LA are not the people who bear the costs to society of a few million morbidly obese Californians.
Isn't that what government is supposed to be good for? Um, yeah, well, democracy, eh?
"The biggest problem with communication is the illusion that it has taken place."
Asking higher-risk customers to pay more for insurance is a form of risk-based pricing.
The problem is that in the realm of insurance, risk-based pricing is really only fair for risks that people can avoid. In the case of auto insurance, you can choose to drive carefully, not to buy car models with bad safety records, and so on. In the realm of health, however, there is relatively little you can do. You can avoid smoking, heavy drinking and drug use, and you can exercise regularly. However, that's no help if you, for example, have a congenital condition that doesn't reveal itself until you're an adult.
The conclusion this leads to is that health insurers should not vary premiums on just absolute medical risk, but rather, voluntary customer behaviors that unambiguously lead to higher health risk. E.g., it's OK if smokers pay more than non-smokers, or if the insurance company gives you a discount for going to the gym regularly. It's not OK if folks with congenital conditions can't get any health insurance at all because insurers basically set the price precisely so that such patients cannot afford it (because the company doesn't want them).
Are you adequate?
But the company that is insuring you certainly has a right to know what type of risk they're insuring - and just like auto insurance your cost should reflect it.
I don't think medical insurance companies have a "right" to know the risk at all. Medical insurance rates should be independent of risk; there is no medical, social, or economic purpose being served by letting insurance companies cherry-pick low-risk individuals and leave the high risk patients to the government.
This is why the government is going to have to step into health care in some way.
Yes, like, disallowing insurance companies to take health history into account in setting rates..
I hate government intervention in any market,
Well, then you'll be happy to know that keeping medical histories from insurance companies still permits a free market in insurance to flourish, while at the same time ensuring that everybody can get affordable insurance.
Yes, the argument that people should only be penalized for health risks they have control over leads to the conclusion that it is fair to charge smokers and heavy drinkers more for health insurance (as long as no other right of theirs is violated). Also, it is fair to give discounts to people who exercise regularly.
Are you adequate?
I hate to break it to you, but eugenics has long fallen out of fashion among civilized folk.
That doesn't mean it isn't a good idea.
You know...we wouldn't want to commit the bandwagon fallacy.
The idea of insurance (based on law of large numbers) is that entire population contributes a pool of money for medical expenses, but only a portion of the population at a tome gets sick and uses the money from the pool to cover the costs.
Now, very few individuals could actually put aside a chunk of money large enough to cover any kind of illness except perhaps common cold, but even that can run pretty high. Break a leg, get x-rays, get cast or require a surgery and your medical costs will run you bankrupt.
It is simply not possible to afford time and services of one of the most expensive professionals out there (excluding drugs and other materials) to 99% of the population.
So, really what is left is health care tax which should be taken out of each working persons salary, and put towards the common health pool for entire population. Before you object, total taxes need not go up at all. They could even go down, if a portion of the absurd amount spent on military expenses is diverted towards something more useful. Perhaps tax payers priorities need to change first before any of this can be instituted. But that would require people to think, which is not likely to happen in the land of the mental slaves, indoctrinated to follow from day they are born.
If you use credit wisely, you get a better deal by borrowing money many times than by buying things in cash. New big screen TV? Keep your cash in the bank earning interest for the 18 months of no interest they give you. You get a better credit report, and you actually have more money at the end than if you had just bought the TV outright.
Not using credit is not being exceptionally smart with your money or handling your money well, it's simply living within your means.
My blog. Good stuff (when I remember to update it). Read it.
Want insurance? Read the fine print: you must waive your HIPPA rights.
All HIPPA does is make it hard for people with a legitimate need for your medical information. (immediate family member, roommate w.r.t. communicable diseases, extended family w.r.t. genetic diseases, etc.)
Disclaimer: From a very young age (grade-school), I realized the insurance industry was a huge scam. I'm as biased as can be!
First, why do people seek medical insurance ? To cover high and/or unpredictable medical costs ? No, it's to ensure one's health. If you don't have insurance, one accident could ruin your life. That's fucked up!
If the insurance companies do everything possible to deny coverage to those who need it most, then from a consumer's perspective, the industry has failed to accomplished its expected duty.
The big problem with insurance is the company's goal is directly opposite to the customer's goal. Customers want to save money, insurance companies have to pay money... it's not a healthy relationship, hence the abuses from both sides.
The funny thing is insurance companies started out (waaaaaaay back) as cooperative funds. People got together, pooled their money and used it to help each other out of untimely situations. The commercialization of that activity is what has led to these widespread abuses.
You shouldn't be so pissed about your privacy with regards to medical history. So what if you have herpes ? Deal with it! What you _should_ be pissed about is that your insurance company is paying small fortunes for this data, fortunes that should have been paid out to beneficiaries instead.
-Billco, Fnarg.com
Gattaca anyone?
Long-term health problems demand solutions with long-term thinking.
Health insurance companies have no financial incentive to invest in preventative health care measures. Why spend money preventing illnesses that won't manifest themselves until the customer is likely covered by another insurance company? That's spending money to save your competition money.
So they spend all this effort making it someone else's problem except someone else is doing that as well and in the end, we end up with people not being treated and the government picks up the tab.
If we had single-payer *insurance*, you'd have an entity with a vested interest in preventing health care issues in the long-term, whether it's pushing efforts to quit smoking or proper eating habits.
As it is, you're expecting private companies to act against their own self-interest.
I don't understand your reasoning. Where does the taking (esp by force) take place?
Rich people are already being taxed a lot more than poorer people. The question is really how is the money collected from taxes spent.
Social justice, or responsibility would dictate that more of that money is spent on universal health care, rather than military expenses. It's really about prioritizing the budget based on more social priorities, which I honestly don't think will happen in the states any time soon.
As the island of our knowledge grows, so does the shore of our ignorance.
and you should not feed it. Let alone give four mod points to the damned thing. I don't have health insurance, because I'm 26, healthy and don't have the money for it since I'm self employed. Last month I started having heart palpitations, so I went to th ER. I had blood work done, was on an EKG and immediately saw a doctor. They charged me ~$1,000. It was the best $1,000 I ever spent. Getting professional help is worth paying for, and the US system provides it. We happen to have the best system in the world (which is one of the reasons we get so many foreign doctors.) I don't think health care is something you can short change. If I'm having a heart attack, I'm not likely to go on PriceGrabber and pick the cheapest heart surgeon. And because of the ridiculously high cost of malpractice insurance, I certainly won't get one. But because of the high costs (and high pay rates) I have a better chance of getting a competent physician. Which is a worthwhile thing. Go capitalism!!
I have a theory that the truth is never told during the nine-to-five hours. - Hunter S. Thompson
You could mandate a minimum group size for public insurance companies and require them to offer it to anyone who qualifies; combine that with portability, pretax or tax deductible premiums, and geographical groups and you have a winner. Not as profitable, but that's to be expected - insurance shouldn't be wildly profitable.
"We returned the General to El Salvador, or maybe Guatemala, it's difficult to tell from 10,000 feet"
Key point in TFA: "Most people don't even know these organizations exist. Unfortunately the federal health privacy rule does not cover many of them. . . . The lack of transparency with how all of this works is disturbing."
To everyone who are not powerles droids at Milliman and Ingenix;
Die in a fire.
PS. "Richard Dick". Ha, ha, ha, ha, ha. Your parents knew you'd be a dick.
I have a friend in the industry, higher up where everything is apparently so very clear - she doesn't seem to care that others view the very idea of the way her industry (as it currently works) is morally and ethically suspect.
Is that assertion backed up in any way by reality?
No, but you can be sure there are plenty of people who believe it. At least until they get sick and find out their precious health insurance policy wouldn't pay for half of what I they thought. Or they get divorced. Or laid off at a particularly bad point in the economic cycle. Then they are suddenly much less sanctimonious.
On the other hand, I am betting that the CEOs of Bear Sterns, Citigroup, Countrywide, etc., all had superb credit scores so we can see how well that relates to handling the company finances.
Leave the gun, take the cannolis.
But now the "insurance" corporations are picking and choosing who they'll cover and adjusting insurance rates on those who they believe will require help. This isn't insurance at all - what's happening is that the "insurance" companies are turning into nothing more than middlemen in the medical industry. The push to obtain detailed records on their policy holders (and applicants) just further supports this change.
Now the benefit to society is gone. Those healthy individuals have no problem paying for their "insurance" but those with health problems are priced out of the market. The insurance corporations make bigger profits, but society suffers. The whole point of insurance was that everyone would have care no matter what.
It's just a matter of time before people (and our government) notice what's happening. If a corporation wants to collect $1000 from someone before they'll pay a $500 medical bill then they're not providing insurance at all...
This is getting to be rediculous. My wife needed to find a new dentist. We made an appointment and went to the new dentist. He has this "Optional" form that authorized him to release your records to third parties. The form said, "By signing this form, you authorize Dr. ______ to release your information to third parties..."
We refused to sign the form and told the girl at the counter that we were not authorizing them to release any information to anybody.
The counter girl and the office manager then informed us that they could not have us as patients if we refused to allow this. Apparently, they make a lot of money selling this information and we would be cutting into their bottom line.
Sick.
Banjo - The more I know about Windoze, the more I love *nix
Like my colonoscopy photos?
Goatse, move over!
Have gnu, will travel.
Insurance companies are like any other privately held corporation--they are supposed to maximize profit for their stockholders. How do you increase profits? By trying to accept those that are not likely to require the policy to pay out and attempting to not accept and get rid those that will require the policy to pay out.
"Being on a waiting list for an organ, however, does suck - but that seems to be the case regardless of medical system; short of countries where there's a lively 'grey'/black market in organs. "
What about countries with "socially just" health care system that have decided that certain organ transplants are not economically feasible? Then it really sucks!
I guess it doesn't suck for those who are rich enough to go to grey market hospitals in other countries. So much for a socially just system.
Regarding the original posted article-- not surprised, but not happy about it either.
I also read many of the other responses, and saw the comments of those who believe that they shouldn't have to pay for others' health conditions, or that if we'd all just "be healthier" this wouldn't be an issue.
Here's my view. If some of the money I paid into my health insurance went towards helping somebody get a necessary test or procedure done to help them control a chronic disease, then money well spent. Because I myself was diagnosed with a chronic, partially genetic, incurable disease just last year. And I had to do it out of pocket, because I didn't know anything about insurance prior to this and was paying for major medical. Which shows you how often I got sick enough to go to a doctor prior to my fun little disease.
You know what the worst part is? I found out that for many people that have what I have, it gets triggered after they quit smoking. Like I did, a few months before I got majorly ill. So much for trying to better my health, right? So I may not get lung cancer, but now I've got an increased chance of colon cancer. Or maybe I'll be lucky and get both because of my malfunctioning immune system. Life's a bitch, eh? But I digress.
>Can you imagine identity theft in this scenario? Oh boy oh boy, someone steals your identity and all of the sudden you lose your life insurance, the doctor _won't_ see you now because you lost your health insurance, and all of that is because someone bought a heart medication with your info and your insurers dropped you immediately.
It's a real-world problem already. Sometimes it's health care industry insiders who have routine access to your records, and there have even been cases of organized crime setting up storefront clinics just to collect people's insurance info.
The motives can include procuring controlled substances, and just imagine having that on your record. Other motives can include billing for nonexistent procedures, leaving you stuck with multiple bogus pre-existing conditions on your record and the potential for criminal prosecution.
There's no simple way to correct your records in all the places where they live, and there's even been a suggestion that you might be prevented from looking at your own records to protect the privacy of the person whose health problems are now on your record.
any alternative effective-treatment might exist!
ALL defense of scientism & reason must be enforced, at any cost.
As Douglas Hofstadter said, he is "offended by their openmindedness",
re those who use scientific method on stuff that scientism Already Knows cannot be worth knowing.
( Scientific American column, from years ago - see Metamagical Themas )
If our society were based on blugeoning each other with clubs, this would be a relevant argument. We'd need the specific quality of physical strength and resilience to survive. But the fact is that people who are "sickly" (to use your word) can make important contributions to society exactly because the aspects of the person that is required to make those contributions is often unrelated to the health issue they may confront. Look at Stephen Hawking for example. Nothing wrong with his brain, so as long as the essential aspects of his body are functionally maintained, he can continue to make his contribution. And even when reasoning in some sort of cold/mercenary way, the cost of maintaining such a person may be much less than the cost of losing such a person's potential contribution.
Besides, natural selection is intensely focused on the high order bit--whether people survive to breeding age at all. It's not very concerned with selecting for good writers, philosphers, mathematicians, teachers, etc. Nor does it appear to care a whole lot about diseases that come up after breeding age. So the argument about the gene pool being affected by caring for the so-called "sickly" seems bogus given that a lot of people who we care for are older than breeding age and do not, at that point, contribute to the gene pool.
Natural selection isn't creating some noble super-race. It favors the strong, but also the violent and the crafty. It looks only at outcome; it doesn't moralize about tactics. And its measure of outcome seems, by modern theory, limited narrowly to "has offspring ready to play the game anew". That's a possible theory of "good", but not the only possible theory. It seems just a little limiting, in fact. Which is why society tries to circumvent it through conscious thought and group policy, for better or worse.
Kent M Pitman
Philosopher, Technologist, Writer
How does a predilection for debt show responsibility? All a credit score shows is that *given* you are in debt - you managed to keep up with payments. It doesn't say whether getting in debt in the first place was unavoidable (disaster), a calculated risk (entrepreneur), convenient (credit card), or foolish (spending more than you make).
...."I'll insure you if and only if you don't need the insurance"....
Banker:
I cannot lend you the $50,000 you want be you really do need that money. We only make loans to people that don't REALLY need money.
So now it will be the same for health insurance.
Insurance company:
We will only insure healthy people who don't need medical treatments. Your health score tells us you use too many prescription drugs and therefore can by definition in no way be healthy.
All theory is gray
....if employers and landlords are going to perform credit checks .....
We occasionally have to do such credit checks before renting to someone. The overall credit score is not as important as the unpaid bills of ordinary ongoing services, rather than not paying the credit card. Somebody who doesn't pay their utilities, for example, may not pay their rent either. Someone who has no credit card or other loans, but always pays ongoing bills in cash, would be likely to also pay their rent.
All theory is gray
You truly think the amount of interest you earn on keeping that money in the bank in any way compares to the full ticket price you pay on an item when you purchase it with "xx month interest free" deals? At most it would be a few dollars interest and you could easily knock $10 off the price of any item you even consider buying on an "interest free" deal by paying up front - not even necessarily with cash. You could save substantially more and the savings are always going to be magnitudes larger than the interest you'd make on the same money. Moral is: You ARE paying interest on that money you're borrowing, it's just hidden in the ticket price.
The solution is obvious: Make it illegal to share this information without the explicit consent of the patient. Most countries already have laws like this. Thus, if the insurance company has the information, you report them to the police, and someone goes to jail. That should teach them not to poke their noses where they don't belong.
Of course, the simpler, cheaper solution is to socialize healthcare like the rest of the western world. It works fine for the rest of us.
I hate to say it, I really, really hate to say it(and most of the time when someone says that it's meant to disguise the fact that they really are enjoying saying it, but honestly, I actually DO hate to say it)but this is just another symptom of the middle and lower class people of the United States getting hosed by large corporations.
Is there any problem, let's say real or overly hyped (global warming, I'm looking your way) that isn't a direct result of the greed of our country?
We're losing ground to China and the EU everyday.
I love capitalism but this cannibalization has got to stop. Only it won't. Our government is designed to pork us just like the corporations do. They are part and parcel.
We have a duopoly that serves none of its electorate save the upper 1%.
China owns our debt. This isn't a recession or a depression it's the end.
First comes the relative financial security of the middle class diminishing. Union jobs? Not anymore. Pensions? Nope. Health/Dental benefits? Not today my friend.
Credit crisis, sub-prime mortgage explosion, inflation, sky-high fuel costs... wonderful. Got an astronomically expensive war in Iraq? Not a problem, we'll just borrow to cover that.
Face it, we're on a sinking ship. There are no life vests, no life boats. We have to accept the fact that we've been suckered by powerful interests in the name of greed and that what we thought was America is gone forever. I just hope the next super power is a democracy.
Bravo upper 1%, bravo.
The enemy of my enemy is quite possibly also my enemy. I've made a lot of enemies.
Enable stock holders to share data about corporate executives, their health records, their private lives, credit scores of their companies, etc.
Build a website that allows people to post photos of wandering executives, health histories so that shareholders can then approach the board to remove a CEO.
Do it especially on a large corporate scale. Incorporate a company to do this, and operate under the corporate shell. If they sue you, they need to sue your corporate and not bankrupt you.
Make the records public, for sale, and provide detailed analysis of banks, especially based on credit ratings, customer satisfaction, etc.
"Doing what i can, with what i have." ~ Burt Gummer
You're making it really hard for me to defend privatized healthcare and giving us one more reason for a universal healthcare system.
“Common sense is not so common.” — Voltaire
>>read up on alternative treatment methods, as the barbaric, for-profit US "healthcare system"
>Alternative treatment methods? Like what?
How about European style publicly funded healthcare? I guess this is what the parent is hinting at? healthcare for the people rather than healthcare for profit. It's definitely got its problems (I live in the UK so speak from experience) but I'd suggest its underlying philosophy is valid. I like the idea of "we provide healthcare in order to cure people" rather than "we provide healthcare in order to make profit". In principle it feels like a better ambition.
According to this, 43% of the budges is spent on military and wars, whereas only 2.9% is spent on social programs:
http://www.globalissues.org/Geopolitics/ArmsTrade/Spending.asp
Truth be told 12% is spent of responses to poverty (which probably includes international aid).
However, the budget could be re-organized and national health care could be financed out of the budget without increase in taxes.
As the island of our knowledge grows, so does the shore of our ignorance.
Following on my prior remark about how selection is selecting the physically strong, not other attributes, I wanted to add one thing: If right now we just let the weak in the gene pool die, and we saved only the people who were physically strong, I doubt that would save us from Climate Change. Nature might recover from that on its own, but it's likely that its way of doing it will be to shed most of the species on Earth, including us, and start back with bacteria. It's nearly certain that the reason Nature has the cataclysms it does is that it's subject to the Hill Climbing Problem in its broad brush attempt to survive. That's robust in a sense. We are, in the end, a fragile species and perhaps there is a robust one that Nature might eventually come up with if the Heat Death of the Universe didn't loom so tangibly close (at least, when weighed against the speed of average case convergence for the algorithm Nature uses for coming up with good species).
Now, it's theoretically possible that Climate Change will stop suddenly of its own accord and that either brain power miraculously won't matter or adaptive physical strength will be all that's really called on to live in a world of altered air and water. So it's possible brains won't be what we need. But those who do have brainpower right now are not bullish on these options, and I think it's not because they're worried about their jobs or ego. I think they're worried for their kids and grandkids. So we'd better pay some heed to preserving their ability to see not just the calamity of the moment but the potential calamities of the future in time to do something other than the narrowly selfish to the needs of the business quarter.
Mankind right now, through the actions of scientists, not football players, has the self-awareness to recognize that an adaptive algorithm inserted just about now might improve matters for both Nature and ourselves, and brainpower, not musclepower, is what's going to give us our only real chance. It's the only tool man has ever had that allowed it to rise above the other animals, and we dare not at this point suggest that it is of no consequence. There may come a day when indeed we can't save everyone. But when that day comes, what we'll probably need is brains, not muscle. And if that day comes, it will be the rich and the politicians, if that's not redundant, making the choices. So let's hope we keep the world safe for all now to avoid having it safe only for the Dr. Strangelove contingent later.
Obligatory Relevance Comment: What has this to do with medical records being sold? Because they are not being sold to people who are optimizing the outcome of humanity. They are being sold to those who are optimizing their portfolio, a portfolio that is not taxed in proportion to the dissonance between its own size and the good meta-health world. In meta, they are playing out the same survival game in business as we're playing out in the world, with Capitalism substituted for Nature. But they're not equipped to survive the storm if Mankind is wiped out through their follies. So all of these things are interconnected, and Climate Change is, I allege, not as off topic here as one might be tempted to presuppose.
Kent M Pitman
Philosopher, Technologist, Writer
Hey, no need to advocate violence -- though I do like the idea.
We could just as easily increase the inheritance tax, which was intended for precisely this purpose (aside from the nice side effect of increases revenues for the state).
"Trolls they were, but filled with the evil will of their master: a fell race..." -- J.R.R. Tolkien on Olog-hai
Canadian doctors on average make upwards of $200K a year (conservative number).
Quote: (wikipedia with other sources confirming)
"Doctors in Canada make an average of $202,000 a year (2006, before expenses).[31] Alberta has the highest average salary of around $230,000, while Quebec has the lowest average annual salary at $165,000, creating interprovincial competition for doctors and contributing to local shortages.[31]"
Admittedly they have some practice costs (assume 40-60K for office and assistant) they have to pay but they certainly still make well over a hundred thousand a year.
"The Average Household Income for 2006 as estimated by Canadian Demographics- Financial Post was $73,871. The Estimated Average Household Expenditures for 2006 was $70,215." (http://www.reddeer.ca/Connecting+with+Your+City/City+Services+and+Departments/Land+and+Economic+Development/Economic+and+Demographic+Profile/Income+and+Consumer+Statistics/default.htm)
Cry me a river... the poor poor doctors... they only make almost double what most ENTIRE Canadian households make.
Further the number of doctors in Canada per 1000 people is comparable to the states (Canada 2.2 /1000, US 2.4/1000).
Finally if you look at key health indicators, eg. life expectancy and infant mortality rates, Canada has both a better life expectancy and a lower infant mortality rate (Canada, 80.2 years, 5.3 /1000, US 77.8 years, 6.8 / 1000).
And if you look at cost numbers Canada system provides better care, better coverage at a lower cost per person to ALL Canadians.
Canada
3,326 Per capita expenditure on health (USD)
9.8 Healthcare costs as a percent of GDP
16.7 % of government revenue spent on health
70.3 % of health costs paid by government
US
6,401 Per capita expenditure on health (USD)
15.3 Healthcare costs as a percent of GDP
18.5 % of government revenue spent on health
45.1 % of health costs paid by government
More info on the Canadian healthcare system:
http://en.wikipedia.org/wiki/Health_care_in_Canada
The truth is that by not having private health care with private companies that have to pay shareholders, not only are Canadians getting better treatment, but also are paying less.
Yes there have been issues around wait times... but they are being addressed both through equipment purchases and the training of new Doctors, the number of spots at medical school have been increased. However it takes time to train Doctors (about 7-12 years of medical school + residency).
Canadians like to whine... and complain about everything.
That and corporations interested in privatizing health care have been running systematic misinformation campaigns to try and get the opportunity to set up a similar highly profitable (for the shareholders) but poor service (good care costs money) health care system as in the US.
We as Canadian voters won't let them though.
Personally I want a doctor that cares about my well being not about money. Those doctors can go to the States...
What I would suggest though is changing the fee structure for medical school in Canada.. stop subsidizing every domestic student, rather take the subsidy money and divide it up amongst the students willing to commit to practicing in Canada for 5 years after graduation. The rest can go to the US if they wish but not while getting government (ie taxpayer) tuition subsidies.
For example domestic students at U of T pay $18,169 per year (still expensive)
and international students pay $48,031 per year
That means there is a subsidy of $30K per year!
my two cents.
Try the paleo diet. Looks like they have been having some success with chronic diseases by going to to our ancestor's foods.
You think so? $1000 (for a big screen TV) saved at 3% for 18 months gives you $45.97 assuming monthly compounding.
I'm not disagreeing with you, per se, but you are underestimating the value of interest. And if you think 3% is hard to get in a savings account, plenty of online banks offer that (and it's not an introductory rate).
Of course, the business also knows the value of interest and that's why they might be willing to give you a discount for cash (that and avoiding credit card transaction fees). Why do you think you could possibly get a better deal by taking *their* estimate of the interest savings (minus some for profit, of course), versus having the freedom to put your money wherever you want to maximize that interest?
I'll leave it to you to tell Dick Cheney he shouldn't get any more health care for his genetically feeble heart condition. I like not being shot in the face.
I'm not tense. I'm just terribly, terribly, alert.
According to a recent PBS special, some countries health systems are based on private insurance, but regulations allow them to offer only one price to everyone regardless of age, gender,or pre-existing conditions. This what private US employers usually offer their employees.
Banker: I cannot lend you the $50,000 you want be you really do need that money. We only make loans to people that don't REALLY need money.
But that makes sense. You wouldn't loan $50k to someone who is completely broke, but you would loan it to someone who is rich and has demonstrated the ability to handle money very well. Society would completely collapse if homeless people could start taking out $1 million loans because they "REALLY need" the money.
We will only insure healthy people who don't need medical treatments.
No, it's more like:
Oh fuck, healthy people are purposely becoming uninsured because they don't need health insurance. We have to start charging more to people who have health problems because there's nobody to balance the risk. OR we could charge healthy people less so they stay on, and charge sick people more but still not as much as their true cost.
With health, medical and drugs, you have NO market place.
You have a captive (and increasing with the aging of Americans and the wounded in the oil wars on the far side of the world,) 15% of the population which is disabled to some degree and with some permanence.
You don't have a marketplace.
You have Health-DON'T-Care.
You don't have a marketplace.
You have HMOs who are responsible strictly, within the letter of fiduciary responsibility, only to their bottom line. If you're sick, you're an expense as long as you're alive. (And that YOUR problem.)
McCain has no fucking idea of which end is up.
He's dangling his schmangles and coughing in some govt. HMO doctor's office, (not very likely since he married money.)
He's NOT struggling to pay a doctor bill because he's unemployed, uninsured or just under-insured (and trying to keep it quiet so the HMOs don't find out.)
America's got a system of health-DON'T-care and its not going to get any better with the band-aids that the candidates are proposing, when you can even get them to say anything about it.
MSBPodcast.com The opinions expressed here are my own. If you don't like 'em... Think up your own stuff.
What's a credit score? It's a score about how much you love being in debt, you get in debt and pay to get more debt and pay on time to get even more debt, etc. How is that relevant to you being able to get a job? It's beyond me.
It's a score about how often you miss payments, default on debt, etc, as well. You can be in a lot of debt but have a lot of collateral (house) and a good payment history, and thus have a good credit record. Sadly the credit agencies like to distill that down into a single number which is pretty meaningless, but decent loan processors, etc, will actually analyse your per-credit-item history to make a decision.
If you're in significant debt, then you might not be the best person to hire in a situation which involves money or expensive systems. For a factory worker or postman or store worker it is an irrelevance of course.
You don't make that much more in the US than in Canada as a doctor. Sure, your gross pay is MUCH higher, but then come all the negatives with it as well. The largest, is the malpractice insurance. No need for such thing in Canada. And if you get sued once or twice by some people, your net pay can end up a lot less than in Canada.
...and charge sick people more but still not as much as their true cost....
Much sickness is due to lifestyle. How is a poor lifestyle compensated for? MUST those who have a healthier lifestyle subsidize those who choose to abuse their bodies with drugs, poor diet and lack of exercise?
How is healthcare anymore my responsibility than other necessities of life, such as food, clothing and shelter? Should society insure these also? Everybody gets these also through some sort of "insurance"?
For most of human history, it has been an individual pursuit to secure one's own livelihood, which includes health. If I can volunteer to help someone who has had some misfortune, that is one thing, but if my neighbors (society) FORCE me to take care of some who refuse to make an effort on their own, that is quite another thing and totally unacceptable.
We have some close friends living near by, whose house burned to the ground due to a faulty appliance about a month ago. They lost everything but their life. Neither they nor their landlord had any sort of insurance. We and many others in our community helped and are continuing to help them financially and with life's essentials. However, we are doing this voluntarily, not under coercion of a government decree.
Insurance is a good thing ONLY if it is voluntary, just as it is voluntary whether I go to a casino or not. Would you like it if your neighbors (society) decreed that you had to go to and gamble your money away every so often?
The fact that doctors often give substantial discounts to those who pay with cash on the barrelhead, proves that insurance increases medical costs. This sometimes also true of car repair after a fender-bender accident. The attitude: "Oh it's OK, after all it is insured" is fairly common these days.
All theory is gray
Reported crimes are verified crimes.
Not all crimes are solved, so using "solved crimes," as you suggest, as the measurement would artificially lower it.
I don't think I'm creating anything other than a less trusting view of the world. I am not fostering an environment that suggests The Man is hostile; on the other hand, I'm suggesting the real truth that most people fear:
The problem is humanity itself, and cannot be handled by institutional changes.
Now THAT is a challenging thought, one which goes against centuries of dominant theories which have turned out to be error. What if instead of trying to fix the problem on the SURFACE, we had to actually look INSIDE of ourselves for valuation?
The people who make disaster on this planet are the ones who tell us that easy solutions exist by transferring power to central goverments, religious authorities, celebrities, etc. I'm telling you the opposite.
Anti-Globalism, Traditionalism, and FreeBSD.
What about countries with "socially just" health care system that have decided that certain organ transplants are not economically feasible? Then it really sucks!
The same thing happens in the U.S. system as well, it's just that instead of being decided by elected officials, it's decided by un-named execs who declare the procedure "experimental".
Of course, there's nothing intrinsic to socialized medicine that says you can't get supplemental insurance that covers extraordinary treatment if that's a concern to you.
Of course, I point out that it's better to have most medical conditions covered by a system more interested in restoring health than in what insurance you have than to have none covered that way.
Once again, there is some valid reasoning behind your "trolley car" choice. I'm not trying to dispute that.
What I'm saying is that there's a big difference between "two people/groups are in immediate, deadly danger and only one can be saved" and "we as a society think this group is useless, therefore let's starve or sterilize them."
The first is a choice that must be made. The latter values money and convenience over human life.
Well, the Blue Man Group is supposedly hiring.
So the more information your insurer has about you, the more each person is bearing his own risk, and the less he is bearing the risks of those around him. Literally, society is bearing less of the cost of individuals who behave dangerously.
Republicans love that kind of thing. They like the idea of personal responsibility
One month back in 1999, my stomach hurt like someone was running it through the "puree" setting on your average blender for that entire month. (it continues on and off to this day, and severely affects my nutrition uptake)
I went in, was put through testing, and diagnosed by one of the regions most eminent experts in the field with Crohns disease.
In addition, I was born with a chemical imbalance called bipolar disorder.
Neither of these was my choice. I didn't "live dangerously". In fact, i've been one of the straightest shooters out there.
Now i'm being penalized. I "can't get arrested" in my quest to get insured, so i can get treatment, so i can get this kind of thing under enough control to pursue a stable career.
Believe me, when you suffer from chronic pain and nutrition issues of this nature AND have bipolar, you don't get a much more perfect storm than that.
Insurance companies are supposed to be about SPREADING risk, not about discriminating against people, and yes, when they demand anything more than your name, phone number, and social security number to make their decision, it is discrimination.
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Much sickness is due to lifestyle.
bullshit.
Most of it is due to hereditary factors. Generally we call denying people services or charging more based on hereditary factors "discrimination".
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To play devil's advocate, why should those of us with good health have to pay extra for your problems?
Because on a long enough timeline, the chance that you won't get sick approaches 0.
If you happen to be the greedy psychopathic type that drives our economy.. if qualified or potentially qualified people who could or may already work for you are incapacitated because they were denied treatment, you lose productivity, ergo money
a healthy workforce is a productive workforce.
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pass "medical insurance neutrality" laws.
"all medical insurance companies are hereby compelled to provide insurance at a flat rate across the board to anyone who seeks coverage"
They will optimize for profits, but without gouging and/or denying coverage to select groups.
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There are several neutral, non-profit organizations which provide social services to america at large.
They were founded by the government, but are otherwise independent, and appointed directors either keep them solvent or they die.
This works for numerous organizations, and it could work for a federal, TRULY equal opportunity, insurance company. Of course, a very powerful middle-man who has been gouging us for several centuries will be cut out: the other insurance companies, who will either go kaput or be forced to reap "not-obscene" amounts of profit.
What you are spouting is their propaganda, no less so than the way the MAFIAA spews fud about the internet, p2p, the DMCA, fair use rights, and competition.
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Enable stock holders to share data about corporate executives, their health records, their private lives, credit scores of their companies, etc.
Build a website that allows people to post photos of wandering executives, health histories so that shareholders can then approach the board to remove a CEO.
Do it especially on a large corporate scale. Incorporate a company to do this, and operate under the corporate shell. If they sue you, they need to sue your corporate and not bankrupt you.
Make the records public, for sale, and provide detailed analysis of banks, especially based on credit ratings, customer satisfaction, etc.
This is the perfect analogy to what these scumbags are doing to us. May as well just slap the barcodes on us so we can be "scanned" for interviews.
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The largest, is the malpractice insurance. No need for such thing in Canada.
Where did you get that idea? While you're not likely to get millions of dollars when you spill coffee on yourself, it is mandatory to have insurance to practice medicine. The Canadian Medical Protective Association is the largest provider.
You leave out two important factors in that big screen TV scenario:
1) Taxes, (assuming a 25% tax bracket) that's $11.49 to Uncle Sam leaving you with $34.48
2) Risk! If you read the fine print on almost all of these credit card agreements it simply says "We have the right to change the rules of the game or trigger universal default whenever we feel like it".
When you also factor in that if they charge you a 20% interest in any given month (typical for department store cards after the introductory 0%) for _any_ reason (missed payment, mind slip, job loss) before you could pay the card off, I can guarantee you that it will be more than the _$35_ you will be making in __a year and a half__.
I personally would feel better paying cash for the big screen TV and go work to make that $35 in a fraction of a fraction of the year and a half, while investing what would have been my monthly payment in a mutual fund or just saving it in a money market account.
If you can't mod them join them.