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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
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
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.
No, it is your fault, you liberal hippie. If you would stop being lazy, you could get your physician's license and cure your own problems instead of depending on others to help you. Ron Paul 4ever!
I'm fine with society unrolling (so to speak) the genetic dice (to make sure no one misunderstands, I mean that it is a good thing for society to step in and pay for expensive treatments for people that need them from birth), but can we go ahead and call it a tax instead of dancing around pretending that it is insurance?
Nerd rage is the funniest rage.
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.
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.
If you have a bad credit rating, you aren't good at handling your personal finances, so why would you be any better handling your duties at work?
( not that i agree, but that is the thinking, and why they ask )
---- Booth was a patriot ----
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.
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.
---- Booth was a patriot ----
It's been done.
General Relativity: Space-time tells matter where to go; Matter tells space-time what shape to be.
No they won't. The best anyone can hope for, barring radical policy change on the part of the U.S. government, is that their costs won't go up too much for them to afford.
Good health? Costs go up. Bad health? Costs go up more.
"[Regarding the 'cloud,'] ownership was what made America different than Russia." -- Woz
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.
Strippers don't usually screw random people, so I would say the stripper is MUCH more innocent than Big Bubba Insurance, Inc.
For large sets, this will be our guide even unto death, for the LORD will work for each type of data it is applied to...
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.
Nothing wrong with a little selective breading. Make that part of the insurance policy. We'll treat you for your known, genetic conditions that will most likely be passed on to any children, if you agree to be sterilized. It's either that or start repopulating major cities with large carnivors to take care of the slow and the week.
It would take care of the obsesity problem and protect endangered species all at the same time!
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.
...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.
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?
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.
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.
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.
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.
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...
Your employer is not agreeing to buy your labor for the rest of your life. In just about every US state, an individual is an "at will" employee. So the timeframe an employer is committing for is something between maybe 1 and 80 hours of labor. You don't really need detailed files to determine if someone is likely to live through the day or the week. Now if an employer were to sign an iron-clad contract to pay you for your labors at a year or ten at a time, then your health might be a legitimate issue.
I am not a crackpot.
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.
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 :)
It's either that or start repopulating major cities with large carnivors to take care of the slow and the week...it would take care of the obsesity problem
Good idea. I propose we begin the mass euthanization by getting rid of the societal dead weight who confuse simple homonyms and can't spell.
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.
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?
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)
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!
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
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
And on slashdot, the insane sometimes get modded Insightful too!!