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Health Insurers Are Vacuuming Up Details About You -- And It Could Raise Your Rates (propublica.org)
schwit1 shares an excerpt from an in-depth report via ProPublica and NPR, which have been investigating for the past year the various tactics the health insurance industry uses to maximize its profits: A future in which everything you do -- the things you buy, the food you eat, the time you spend watching TV -- may help determine how much you pay for health insurance. With little public scrutiny, the health insurance industry has joined forces with data brokers to vacuum up personal details about hundreds of millions of Americans, including, odds are, many readers of this story. The companies are tracking your race, education level, TV habits, marital status, net worth. They're collecting what you post on social media, whether you're behind on your bills, what you order online. Then they feed this information into complicated computer algorithms that spit out predictions about how much your health care could cost them. Patient advocates warn that using unverified, error-prone "lifestyle" data to make medical assumptions could lead insurers to improperly price plans -- for instance raising rates based on false information -- or discriminate against anyone tagged as high cost. And, they say, the use of the data raises thorny questions that should be debated publicly, such as: Should a person's rates be raised because algorithms say they are more likely to run up medical bills? Such questions would be moot in Europe, where a strict law took effect in May that bans trading in personal data.
Most people in the US get their health insurance either from their employer, or from the Obamacare exchanges. In both cases they're not treated as individuals (from a buying point of view) by the health insurance industry, instead they're treated as part of a group (on the exchanges this is called "community rating")
So where is this information actually being used? How often, post-AHCA, do people buy insurance directly from the insurer in such a form that the insurer can actually benefit from having this level of information about their potential customer?
You are not alone. This is not normal. None of this is normal.
Community rating, charging the same premium across a cohort, is intended to prevent this sort of thing. Unregulated health insurance markets will use whatever data they can to underwrite potential policy holders, and try to isolate uninsurable individuals and either charge them unaffordable rates or deny them coverage. This is much more socially acceptable in other insurance contexts, such as an uninsurable risk for car insurance being unable to get coverage (due to many collisions or drunk driving convictions or whatever) and thus being unable to drive legally is acceptable. In the case of being unable to health coverage due to prior illness, the consequence can easily be death.
So when there is the talk about repealing Obamacare or single payer or free market maximalism for health insurance, this is very much what is at stake. Unregulated private insurers maximize their profit by isolating high risk individuals and either pricing them in or kicking them off the rolls. The money and resources spent on these deep dives are wasteful and detrimental from the standpoint of society as a whole, but totally rational from the standpoint of the individual insurers because those downsides can be offloaded onto someone else.
Yeah... I dunno. Both my parents had fairly life threatening conditions. My Dad had a quad bypass (and then another just recently), and my Mom had lymphoma. Both got treatment right away, both had their incident over a decade or more ago, both are still alive today, both are from rural areas where access is typically a little worse, but they're fine. And neither had to declare bankruptcy over their medical bills. Thanks but I'll take the Canadian system over the American one any day. To be fair (tooooo beeee fayyyyahhhh) no system is perfect, but a single payer system spreads the risk and keeps premiums the lowest. If you want to punish people for bad genes and poverty (and obviously some of that could be personal choice related) sure, the American system is great, the rich do absolutely get better treatment. But ... no thanks, happy to be Canadian. (plus the world doesn't think we're as much of assholes (like our allies) which is a nice side benefit).
And let me guess, you'd rather have the government make the rules...we'll pencil you in for July 6th, 2028...
Oh, yes, that's exactly how it works in my country, where we have a proper taxpayer funded public health system.
When I got diverticulitis a few years ago and needed a bowel resection, I had to wait 25 years for surgery.
Hang on, no I didn't because the government have nothing to do with scheduling surgery, it's doctors that do it, and I had to wait two weeks. It cost me no dollars at all.
Clueless A/C
You know, as a person who pays into health insurance for others "unhealthy lifestyles" without ever taking out, I'm one of the dumbasses who wants to keep it that way. Insurance, by it's very own nature, is going to have people people who take more and those who give more. There is no way around that.
But you know, if we decided we wanted to care about other people and not just ourselves, universal healthcare would also bring about broader policies to help people get into and maintain "healthy lifestyles". With privatized healthcare, that's just not the case. No health care company is going to get you in the door preemptively to help fight against diabetes before it happens. They're more happy to let it happen and and then charge you out the ass for it because they're in the MONEY business and not the HEALTH business. It's the whole reason why we pay more per person than other nations for our precious privatized health care.
So, why did I put "healthy lifestyle" in quotes? Who's going to determine what is healthy? Certainly not you. I don't need my premiums raised if I'm a non-smoker and non-drinker just because I might be into rock climbing. Should my premiums go up because a healthy activity I find enjoyable could cost an insurance company more money? No. Fuck that noise.
If you want to stick it to the unhealthy, why not just tax the things that make an unhealthy lifestyle? Is it because you don't agree with the regulation or is it because you yourself engage in said unhealthy lifestyle from time-to-time?
What is the correlation between being poor and being unhealthy? Does it make sense that the people with the highest premiums should also be the poorest? I think not. How is a person supposed to pull themselves out of the healthcare-poverty loop? Do you just expect a large swath of the population to just get rich?
Either way, I don't think you really thought this through. I sincerely hope you get financially fucked and get into some shit situation because it seems like that's what it takes these days for people to feel empathy. Maybe you'll get a couple fingers chopped off and then you can decide which one is more important (and cheaper) so they can reattach it. Not like those chumps in Canada who would get ALL of their fingers back just for showing up. Don't they get a choice? Where is THEIR freedom? Who would assume I want all of my fingers back?! That's absurd!
in 15 years with the money we'd save switching to single payer.
If you're a fiscal conservative single payer just makes sense. The only reasons to oppose it are bad ones.
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The reasonable assessment is that the US healthcare system has a lot problems beyond simply the payment system for health services. Which it does, US's health sector is bloated and inefficient in a wide variety of ways beyond private or socialized insurers. But those unnecessary redundancies and the intentionally crippled negotiating power of those payment systems are still a big part of the problem.
Either a heavily regulated and subsidized private system or a more socialized system could work, but what the US has now is a Frankenstein system with various limbs from various systems sewn together, and entrenched interests who get their gravy train from the wide variety of inefficiencies and have sufficient political clout (largely as consequence of that wealth) to block any efforts for genuine reform. If we had a rational, above the board government right now they'd launch an even more aggressive legislative and regulatory assault on the problem than we got with Obamacare. Because we have a corrupt government that represents an ideology that venerates selfishness instead, we'll probably plod along until the system collapses under its own unsustainable weight and causes a massive recession or depression.