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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.
I'd hate to live in a country where basic medical care isn't free.
Sounds like a third world undeveloped nation, where the government can't afford to run hospitals.
Herbert foresaw this.
These bastards will soon decide we are just uninsurable and tell us all to die.
No other 1st world nation treats it's own citizens as badly as the USA does. Notable areas are health care, education and the private prison system.
The sooner we let go of the idea that America is 1st world, the better. It no longer shares the western liberalism ideals that have driven much of humans forward over the last 200 years. Specifically, it's lost site of "equality" and replaced it with rampant capitalism.
It wasn't always this way. America 1950 - 1970 was decidedly better for it's citizens than the late stage capitalism technological dystopia that is now before us.
When used it wards off all liability from discriminatory practices.
"Such questions would be moot in Europe..."
True. But not only for privacy reasons. Most European countries have either public or heavily regulated private insurance markets. Paying through the nose for insurance with sky-high deductibles, like many Americans do, would be unheard of.
In the US, having a child costs thousands to tens of thousands. In most of Europe, it's covered, and out-of-pocket is equivalent to a few hundred dollars, if not less.
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.
Compare medical costs for common procedures between the US and the rest of the world, and you'll be singing a different tune. Yeah, yeah, it's tax-supported in many places. What do WE get for our tax dollars? Expensive healthcare, bad schools, mass incarceration, and a military juggernaut that hasn't truly won a war in decades.
Too many of you say "oh, well, privacy is dead and nobody cares, so why bother even trying?". Well, now it may cost people more money, or get them booted out of their medical coverage entirely, or who knows, get them fired from their job because they'll (potentially) raise the group rates too much? People will suddenly start caring about their privacy and who has access to all the data about their lives. Hit people in the pocketbook and they'll suddenly pay attention to all sorts of things that they said they didn't care about.
What was the cost of your insurance per month (either to yourself or your employer)? What did you pay out of pocket?
So this would mean my very healthy lifestyle would reduce my insurance costs and pump up those who live on junk food, never exercise and other unhealthy choices? Great lets get this happening. That is apart from what squiggleslash said.
Unless they misread you, interpreting whatever you think you look like to them differently from the way you THINK you look to them, or unless they think that whatever you think is a very healthy lifestyle... simply isn't.
... you name it, is good for you or not? Also, you know how there are different camps all certain at any given moment, that THEIR beliefs, based of course, on SOLID... SCIENTIFIC... unimpeachable research, done by people wearing real, actual lab coats and everything, are the only ones that are valid? Yeah... if your insurer whom you're convinced KNOWS you're living a healthy "lifestyle," thinks Paleo is BAD and Atkins was right, and you're doing Paleo... or vice-versa, or you're a vegetarian and your insurer thinks Paleo is the way to go, or maybe they think ALL that is wrong and everyone should be eating what the people in that one remote Japanese village are eating, where people routinely live well past 100... and you're doing WHAT? Eating MEDITERRANEAN?!? OMG... SO unhealthy!
.4783 more humans than it would take to replace you and hold the population stable... point is, NO, this is NOT a good thing, despite what you may have been lulled into thinking. It's rather like "if you have nothing to hide, you have nothing to fear," except instead of someone potentially throwing you in a cage as a result of someone thinking you did something wrong, it's someone deciding to allow you to die because a different someone thinks you did something else wrong. Allowing this kind of thing is like letting the cops be judges, juries, and executioners.
If you think there's such a thing as a single healthy lifestyle, let alone a single VERY healthy one, then I have some bad news for you. You know how every 6 months or so the whole "fitness" world changes its mind on whether eggs, or milk, or wine, or chocolate, or beer, or
Or... do you take your dietary and lifestyle guidance from your health-insurance agent? Actually... they're the ones with the actuarial tables... screw the doctors, maybe we SHOULD be asking the INSURANCE guys how to be healthy! Or maybe not... since they have a vested interest in you dying young, while you're still healthy, before the unavoidable health care costs of advancing age make you a less and less profitable person to insure.
Unless they're also selling you your life insurance, in which case, maybe I'm wrong.
But even then, what happens when you ask your insurance agent, "how should I live my life," and then you do it, and then the company gets bought out by another company, who look in your file, see that you've been following the agent's advice to the letter, but they think your agent was a moron who didn't know what he was talking about? Or what if you've been living a healthy lifestyle, but you had three kids, and the insurer thinks you should only have had two, and that you've just placed a massive burden on the environment by producing
Letting the insurance pigs decide you're too expensive to insure, because you expressed an opinion he thinks is correlated with a reduced life-expectancy or increased costs of coverage, is a bad, stupid, wrong-headed idea. Still not convinced? Okay, so what happens if you think you're living a healthy lifestyle, but you're doing so somewhere your insurer knows is near a cluster of cases of a rare and aggressive form of cancer, and so cancels your insurance, because the premiums you pay aren't worth the risk given the cost of treatment and how much more likely it is for someone who lives where you do?
Still think this doesn't affect you?
Our reign has gone on long enough. Indeed. Summon the meteors.
You know, I really hate it when I just burned mod points on a trite subject. Consolation prize is that you're already maxed out.
They are already doing this, not only for medical reasons, but: should you get locked up; sent to a re-education camp; denied travel, even on trains; get a job; rent an apartment; etc. We're getting there.
The insurance companies will simply get sued for discrimination*. They can claim that sick / unhealthy people cost more to insure, but that's the point of insurance. You rake in a huge pool of cash from both the healthy and unhealthy to cover the costs. In related news, if the healthcare and pharmaceutical industries were regulated, we wouldn't need insurance because the aforementioned industries wouldn't be allowed to charge anything they wanted simply because they can. Get that under control and healthcare for everyone might even be doable.
*Especially when they start charging elderly folks or folks with inherited / genetic diseases more for the same coverage.
It's cheaper to fly to another country and pay cash for a procedure than it is to get it done here in the US.
Yep, let's discriminate against people who choose to cohabit, who don't feel they need some schmuck in a frock (judge or priest, same thing) to tell them that their love is legitimate.
the problem is pre-existing conditions. The current administration is allowing Texas' challenge to the ACA's pre-existing condition mandate to proceed unchallenged. It is very likely to end with the law being declared unconstitutional (elections have consequences and all that rot).
Prior to the ACA there were multiple instances of people in their 40s, 50s and 60s getting skin cancer and being denied care because they had acne medication when they were teenagers. The justification was that the the "acne" was in fact cancerous lesions.
If you think there's something wrong with that you're right. The only solution is to vote people who support single payer in. The hodge podge system we have now is going to collapse because it is being _made_ to collapse. So long as we don't have healthcare as a basic right someone will take it away for profit..
But the single payer folks now need overwhelming power thanks to our current SCOTUS, which is likely to cry the 10th Amendment on any legislation. We'll need to first get Medicare for All passed and then follow it up with a constitutional amendment guaranteeing all Americans healthcare. Otherwise we'll have to wait 40 years for the SCOTUS to change hands. We've got 45,000 people dying every year for lack of health care. If you're reading this you might be next. We can't wait that long.
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n 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")
How do you think insurers come up with group pricing...?
I don't respond to AC's.
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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If you have a healthy lifestyle, this data could lower your rates.
The question is whether being a lazy slob is a pre-existing condition...
the US could conclusively defeat an enemy with the GDP of Appleton, WI
GDP only if you include Green Bay and all the little towns in between.
Not everyone is like you.
If you knew they were looking up information about your habits and interest. Couldn't you just game it to your advantage. Some stuff you can't control like age, ethnicity, basic health info. But your hobbies and interest are in your control. You merely need to look like you are a marathon run health nut who is into health and well being and travel around the world. Hell you can lie about your education and job on social media. Is this possible?
Is honesty a virtue when dealing with thieves?
they're just _paying_ for it. No matter what anybody is telling you nobody is suggesting we nationalize healthcare. We're nationalizing _insurance_; e.g. the paying part. Hence the name "single payer".
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well, not many. What we have are corporatists. People who do whatever the mega-corps want. Similar to what we had when the robber barons were in power.
To be fair, I say not many because Hilary was very, very conservative. Hell, she opposed gay marriage & TPP until Bernie dragged her to the left to secure the nomination. But I'll say this for her, she would have kept everything as is. Stayed the course. It's one of the many, many reasons she lost. If you take the stock market out of the equation the US economy is doing crap. Wages have fallen about 20-30% in the last 40 years. People want change, they just don't know how to get it.
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What a ridiculously backward country is the US. No Western country lets companies screw up their customers as much as the US. In no Western country, not even in the Netherlands and Great Britain, is politics so focused on helping companies make (more) money than in the US. No Western country screws up its citizens more than the US.
-- Cheers!
Yes.
I'm prepared to accept that a degree of moral flexibility may be acceptable, but this example falls far short.
The legal system deals honestly with thieves, for example.
Being honest to honest people is easy. Maintaining that standard in the face of those who will abuse it is when that is tested.
In the example given of an employer who offers a discount for those who promise not to smoke, trust is being extended. Most will rise to that trust and recognise that their integrity is expected and respected. The morale that that trust generates and the strength it adds to the existing employer/employee relationship can offset a degree of abuse by the dishonest. Most systems can continue to be useful with a degree of parasitism, so even the existence of those who may abuse the system don't, in themselves, eliminate the utility of the trust in the example.
I'm arguing utility because it tends to be a reasonable common denominator.
No not an "oxymorn". An "unfair" system is the US system that consigns humans to the scrapheap of poverty and sickness just because an exploitive private health system put its own shitty profits above human dignity and health.
Theres nothing "fair" about an unregulated capitalist healthcare system and the overwhelming weight of experience and history attests to that.
Why does the United States, ostensibly one of the richest per-capita countries in the world have to continue to endure a third world health system just because some rich guys want even more yachts and have the money to buy politicians to ensure that.
In a fair world. we'd hang those people. In this world, we elect them to power.
Excuse the Unicode crap in my posts. That's an apostrophe, and slashdot is busted.
I'm not sure the GDPR bans trading in personal data.
- if users give permission (which not has to be more explicit), you can still do a lot.
- You can try to claim that it would be in the valid interest of the person to share the data, even if they haven't given permission.
Well I'd hope they also would be looking at the information from my Garmin watch and all the running, workouts, etc that I track too then.
(Or better yet, how about you don't look at all?)
Too many of you say "oh, well, privacy is dead and nobody cares, so why bother even trying?". Well, now it may cost people more money, or get them booted out of their medical coverage entirely, or who knows, get them fired from their job because they'll (potentially) raise the group rates too much? People will suddenly start caring about their privacy and who has access to all the data about their lives. Hit people in the pocketbook and they'll suddenly pay attention to all sorts of things that they said they didn't care about.
Yep, and nice that all the paying attention has done great things to fix the cable monopolies... sorry, slightly bitter here.
America based it's entire healthcare system on two unsubstantiated anecdotes.
FWIW I've had much worse from the US system. My Type I diabetic friend was short on insulin until Obamacare and the medicare expansion kicked in. I had a close family member fail a "Wallet Biopsy" and not get an MRI on her hip while on steroids and it did permanent damage, all because the doctor didn't want to order a test he wasn't sure if he'd get paid for.
Anecdotes aside 45,000 Americans die every year for lack of care.
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That is a lie....
Married men DON'T live longer......
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
Most people in the US get their health insurance either from their employer, or from the Obamacare exchanges.
You seem to have forgotten Medicare and Medicaid which cover just over 1/3 of all Americans including basically everyone over the age of 65. About half get their coverage through their work and the remainder with coverage get it through private individual health plans. Then there are several million who lack coverage altogether which should (but doesn't seem to) embarrass the hell out of us.
Tests usually are scheduled immediately. I had a same-day MRI several years ago, so even MRIs can be done fairly fast.
And when that happens you (or your insurance company) pays through the nose for that capability. It's not different than any manufacturing production system. You can have it fast, cheap, or good. Pick two. If you want fast turnaround you can get it but the staff and equipment to do that doesn't come cheaply.
Think about the economics of it. MRI machines cost millions of dollars and have roughly fixed operating costs meaning they cost roughly the same amount no matter how many patients actually utilize the machine. If you can get in tomorrow that means the machine has excess capacity. That means to recoup their money that have to charge a larger amount of money per procedure - fixed $ divided by number of patients. The larger the denominator the lower the costs. If you have fewer machines that are fully utilized then you don't have to charge as much per patient but the average wait time is going to be longer. Keeping quality constant, you can have lower costs and longer wait times or faster turnaround at higher cost. Canada has chosen longer wait times in exchange for lower costs. The US has chosen substantially higher costs in exchange for shorter wait times.
I've never heard of anybody waiting weeks for any test around here, but a friend of mine in Canada waited three months for an MRI.
Depends on the test but generally you are right. And we pay through the nose for that capability even when we don't actually need it. We have too many MRI machines so everyone has to charge more because we aren't fully utilizing very many of them. Then of course there is the fact that because we don't have a single payer system which can enforce reasonable rates the hospitals tend to try to rip the eyes out of patients because they can.
People avoid the ER because of the long wait and the sketchy characters who frequent the place.
The long wait in the ED directly contradicts that statement. It's like Yogi Berra's old saying "nobody goes there anymore because it's too crowded".
Insurers don't actually care about your health. They just want to be sure the premiums are more than what they pay out in claims.
While keeping insured healthy is one way to reduce claims, they have other strategies they use regularly that are easier and more effective: denying claims, dragging their feet on pre-approvals, limiting care available, removing drug choices, requiring high co-pays and cost sharing, and so on.
they can buy on the heavily subsidized exchanges unless they've got employer sponsored insurance. If they've got the latter though they're often screwed because the employer has to cover them by law but their sickness kills the employers rates. But that was happening before the mandates.
Either way ACA is still a bad system. It was bad when Mitt Rhomney put it in place in Massachusetts and it was bad when we did it nationally. The entire thing was a compromise to get coverage for pre-existing conditions out of the insurance companies because Americans got spooked by "Death Panels" when those companies blew $500 million on adverts to convince people of that.
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ideologue we've done pretty well with judges. They gave us Roe v Wade, shot down segregation and upheld those protections against denying pre-existing conditions. The EPA does well too so long as you're not putting the Fox in charge of the hen house like we are now. Stop trolling and wake up before you end up dying of cancer from a toxic spill and can't get treatment for your pre-existing condition.
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Hopefully it could lower my rates, too. I have a gadget in my car that has resulted in my auto insurance lowering of my rates.
Obligatory: "A person is smart. People are dumb, panicky dangerous animals and you know it."
Obligatory: "A person is smart. People are dumb, panicky dangerous animals and you know it."
One of the campy sci fi movie quotes I find truly applicable to nearly everything in life... for better or worse.
Actually... they're the ones with the actuarial tables... screw the doctors, maybe we SHOULD be asking the INSURANCE guys how to be healthy!
If your goal is to minimize the amount you're spending on health care, then yes, insurance companies are exactly the right people to ask. You're likely to get better real-world advice from them than from the actual health care providers. Insurers have the best incentives to discover exactly what factors increase or decrease the cost of health care. The ones that get it wrong will either overestimate the expected cost and set their prices too high, in which case people flock to other insurance providers, or else set their prices too low and get driven out of business when the bills come in.
Or maybe not... since they have a vested interest in you dying young, while you're still healthy, before the unavoidable health care costs of advancing age make you a less and less profitable person to insure.
This makes zero sense unless insurance premiums remain fixed as you age and cannot be updated to reflect the increasing expected cost of care. As long as the deal remains fair to both sides, as it would without outside intervention, insurers have no vested interest in clients dying young. Perverse incentives such as this one are a consequence of politicians trying to turn insurance into something else entirely.
Still not convinced? Okay, so what happens if you think you're living a healthy lifestyle, but you're doing so somewhere your insurer knows is near a cluster of cases of a rare and aggressive form of cancer, and so cancels your insurance, because the premiums you pay aren't worth the risk given the cost of treatment and how much more likely it is for someone who lives where you do?
In that case I would really want to know about this environmental factor which is probably going to give me a heightened risk of cancer, and what I may be able to do to avoid it or at least mitigate the damage. They've actually just done me a huge favor by uncovering this issue. Of course, they aren't going to cancel the policy, just raise the premiums—which is perfectly fair, since we both know those premiums are now covering a higher expected cost. It's no longer the same product which was being offered before, so why should the amount I pay remain the same?
"The state is that great fiction by which everyone tries to live at the expense of everyone else." - Bastiat