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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.

67 of 299 comments (clear)

  1. Who is affected? by squiggleslash · · Score: 4, Interesting

    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.
    1. Re:Who is affected? by Anonymous Coward · · Score: 2, Insightful

      Unless they also factor in your arrogance, which drastically increases your chances of being harmed by other humans.

    2. Re:Who is affected? by Ichijo · · Score: 2, Informative

      My employer offers a discount on health insurance for anyone who promises not to smoke, and another discount for anyone who logs their workouts. So we don't all pay the same rate even though we're all in the same pool.

      --
      Any sufficiently unpopular but cohesive argument is indistinguishable from trolling.
    3. Re:Who is affected? by decep · · Score: 5, Insightful

      Except that one time you searched for Little Debbie snack cakes to prove to your friends how unhealthy they are for you. The data aggregator just lumps you in with the rest of the "unhealthy eaters" out there.

      Now your insurance premiums go up by $200/mo with no explanation and no way to dispute the data.

    4. Re:Who is affected? by b0s0z0ku · · Score: 5, Insightful

      This is also shit -- not everyone wants to be tagged with a GPS tracker like some weird migratory bird experiment. The sooner the private insurers are kicked to the curb and replaced with a fair system of public insurance, paid for by a per-cent tax on income, the better. And by kicked to the curb, I mean expropriated and ideally jailed for a few years in general prison population.

    5. Re:Who is affected? by aaarrrgggh · · Score: 2

      They can still be evaluating the group plans.

      I just doubt the effectiveness of the information for the stated purpose. This seems like another BigData Garbage Dump.

    6. Re: Who is affected? by fuzzyfuzzyfungus · · Score: 2

      Among other possible cases, hiring and firing decisions are an obvious candidate: employer-pooled insurance doesn't remove the impact of high or low cost individuals; just average it across a bunch of employees.

      This creates a fairly obvious incentive to call the sickies, unless making an exception for some total rockstar. Which has the obvious consequences in both risk of being dismissed for some trumped up reason and in terms of reduced mobility(among those whose employers aren't actively cullingthe uneugenic: but who know that any prospective employer probably won't go for someone who ruins the average cost of the employee plan).

    7. Re:Who is affected? by Anonymous Coward · · Score: 5, Insightful

      The current trend about insurance is a Mormon idea (Google :: Medical Information Bureau),
      started a _long_ time ago under the guise of "fraud protection." If the U.S. would finally adopt
      single payer, none of this BS would be relevant any more. Dunno what it's gonna take, though...

      CAP === 'fathoms'

    8. Re:Who is affected? by b0s0z0ku · · Score: 2

      Generally, they're a percent of your income, so they're more likely to be affordable than the US system.

    9. Re:Who is affected? by taustin · · Score: 2, Insightful

      Plus all the various other taxes that are used to subsidize it, of course.

    10. Re: Who is affected? by b0s0z0ku · · Score: 5, Interesting

      The problem that the idea of a "perfectly healthy lifestyle" changes every few years or so. Is fat the demon? Or is is sugar? Or maybe carbs?

      Is a glass of wine with dinner good for you, or should we all be hopping on the wagon with Carrie Nation? How much exercise is too much?

      The goalposts keep shifting, and no one has any real idea of what's "healthy." In fact, it may vary by body type and genetics.

    11. Re:Who is affected? by jedidiah · · Score: 2, Insightful

      > Here in BC, Canada it's a whopping $75/month per family, assuming two adults.

      I would rather not have to wait 6 weeks for an MRI, or have trouble even getting a family doctor, or have to go to the ER on the weekend instead of one of the several quick care clinics within easy walking distance even in my sorry post-cancer condition.

      The idea you think you can get away with paying only $75 per family is why I want NOTHING to do with people like you having monopoly control over my cancer treatment.

      --
      A Pirate and a Puritan look the same on a balance sheet.
    12. Re: Who is affected? by fuzzyfuzzyfungus · · Score: 3, Interesting

      Only if you can take on the(generally sharply uphill) battle of demonstrating that you were rightsized and/or not hired because you were bad for health insurance rates; rather than for essentially any other reason.

      If your former or prospective employers are foolish enough to gloat somewhere discoverable about ditching the uneugenic, and you are able to make it through a long, punishing, probably expensive, case that will stamp a radioactive "NOT A TEAM PLAYER" on you whether you win or lose, perhaps you'll obtain a settlement of some sort.

      That's definitely not scary enough to discourage something so eminently cost effective.

    13. Re:Who is affected? by b0s0z0ku · · Score: 2, Insightful

      Better a state of decent mediocrity when no one goes hungry than a country where people have to slave to avoid hunger. Innovation and hunger == constant stress == lower life expectancies, less enjoyment from life, more illness.

    14. Re:Who is affected? by Alypius · · Score: 5, Funny

      a blind man throwing darts at a voodoo doll tied to a dartboard summed with the output of a random number generator.

      Following the airline ticket model, I see

    15. Re:Who is affected? by GerryGilmore · · Score: 2

      Total 100% Organic, Dolphin-Free Bullshit!!!
      We are already paying MUCH more than any other "civilized"* country, and yet not only we do not cover EVERYONE, as the other "civilized" countries, we have worse outcomes.
      This Bullshit about cost totally ignores what we are ALREADY paying for shit-sandwich outcomes.
      Grow the fuck up.
      * = To call yourself civilized, you kind of have to act that way, even if it hurts a little in some tiny way.

    16. Re:Who is affected? by dryeo · · Score: 2

      And taxes are relatively low and the budget is balanced.

      --
      https://en.wikipedia.org/wiki/Inverted_totalitarianism
    17. Re:Who is affected? by dryeo · · Score: 2

      People I know in BC who have needed an emergency MRI get it within 24 hours (it is a bit slow on Sunday). There's lots of clinics so you don't have to go to the emergency and when I had to take a friend to emergency a couple of times last year, he'd be in by the time I parked and walked back to the emergency. Did have to wait till morning to get operated on though.
      Same with my sister who made the mistake of needing bypass surgery on the weekend, took 12 hours before she was in the OR.
      Where things get slow is if you need a new knee or hip, could be months of waiting.
      Same if you live in the middle of nowhere, it can be a hassle getting care. BC is big, California is closer then the north.

      One thing most Americans don't know about Canada is that the Provinces (and Territories) each handle their own medical system with the feds just saying the minimum so you can't generalize too much.

      --
      https://en.wikipedia.org/wiki/Inverted_totalitarianism
    18. Re: Who is affected? by Pascoea · · Score: 2

      I understand where you are coming from when you approach the median, it gets hard to differentiate between healthy and unhealthy. But really, who's the higher health risk? The guy that has an Amazon subscription for twinkies and Mountain Dew or the guy who spends 15 hours a week at health.com? (mea culpa, I have no idea if you can subscribe to twinkies on Amazon, or what value health.com provides. But you get the idea.)

    19. Re: Who is affected? by thegarbz · · Score: 2

      Not really. You just think it does because the media jumps on the fads. There's been very consistent views about what a healthy lifestyle is and it doesn't involve cutting out any demons or exercising too much. Even while the news was telling us fat was bad the science kept saying eat a balanced meal. Even while the news was saying OMG eggs! cholesterol! scientists were saying eat a balanced meal.

      Same with exercise. Short of physical injury the message has been quite consistent too little exercise is bad. Don't exercise to the point where you hurt yourself. Sure the media will say use this wonderful 7min workout, runing is the best for you, no swimming is, actually you should be HITTing, no you should be going slow and steady, the science was still saying: do whatever you want just get off your arse and move your body a bit.

    20. Re:Who is affected? by reboot246 · · Score: 2

      Tests usually are scheduled immediately. I had a same-day MRI several years ago, so even MRIs can be done fairly fast. X-rays are always same day, as are blood tests. Of course, a 24 hour urine test takes at least 24 hours. 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.

      My doctor is in practice with a group of about 8 doctors, and in their one building there's an X-ray machine and an MRI. They also have a facility for physical therapy under the same roof. The lab is just across the highway. All of that is only 11 miles from my house and I pass one hospital, several clinics and two "doc-in-a-box" places on my way there.

      People avoid the ER because of the long wait and the sketchy characters who frequent the place.

    21. Re:Who is affected? by Joce640k · · Score: 2, Insightful

      Before Obamacare, the state private markets were based strictly on age.

      So?

      After Trumpcare they might be based on age and your online habits.

      It's only far that your insurance company knows as much about you as possible, right? That way the rich people with easy jobs and healthy living conditions can pay less.

      --
      No sig today...
    22. Re:Who is affected? by Applehu+Akbar · · Score: 2

      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")

      The point of the article is that although individual lifestyle rating is not being done yet, today's data mining could be used to implement such a scheme whenever insurance companies find such data lucrative enough to justify putting in the IT infrastructure to monitor it.

    23. Re: Who is affected? by Applehu+Akbar · · Score: 2

      The problem that the idea of a "perfectly healthy lifestyle" changes every few years or so. Is fat the demon? Or is is sugar? Or maybe carbs?

      Eat a fad-free diet and get lots of exercise, and you will stay in the best of health. No matter what happens in the world of fashion, that core recommendation never changes.

    24. Re:Who is affected? by west · · Score: 3, Insightful

      Indeed, there are reasons why the US system is so much more expensive than its Canadian counterparts. The US has a Lexus style system (for those lucky enough to have good insurance) and Lexus prices. The Canadian system, is more Corolla style with Corolla price.

      But like two cars, the interesting thing is that the health outcomes for identical conditions are nearly identical.

      What you purchase for an expensive health-care system is a much more pleasant system (no lines, lots of tests that occasionally catch something, but mostly make the patient feel better, etc.) and marginally better outcomes.

      The downside is, of course, that costs are so high that there's really no way of providing fairly comprehensive medical service to the entire population.

      As a Canadian, naturally, I prefer a system that allows all Canadians to be covered (with difficulties, of course, there are lines, and in some areas, primary care doctors are harder to find - natural outcomes of a much more economical system) over a more pleasant system with similar outcomes, where a substantial portion of my fellow citizens access to health-care is a major source of stress and concern (to put it mildly).

      Psychologically, I think our health-care system helps bind us together - it is a concrete and ever-present example that as a people, we have expressed a sentiment that the lives of all Canadians are equally important, from the richest to the poorest. It's an ideal, and we certainly don't meet that ideal, but we spend considerable resources attempting to do so, and I think that makes a great deal of difference to who we are as a people.

      I'll take the fact that my taxes are buying Corollas for four rather than a Lexus just for myself. It's not a trade-off I'd necessarily make individually, but it's one that I'm happy to have the government make on my behalf.

    25. Re:Who is affected? by cayenne8 · · Score: 2

      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 do if you're self employed, and there are quite a few of us out there, not everyone works W2 jobs my friend.

      --
      Light travels faster than sound. This is why some people appear bright until you hear them speak.........
    26. Re:Who is affected? by cayenne8 · · Score: 2, Informative

      Who do you think was most impacted by Obamacare? The people who were already getting insurance via their employers? Or, you know, the self employed, and others who previously had to buy insurance individually but now had the option of using the Obamacare exchanges.

      Obamacare did NOT help the self-employed, if anything it hurt MANY of us.

      I previously was able to get insurance with a "high deductible" policy, I think it was maybe $1200 a few years back, and only cost me maybe $75-$100 a month or so. With the "high deductible" coverage I was also qualified to set myself up a HSA (Health savings Account) and fund it to a max of over $3K.

      The coverage was quite comprehensive, had low cost meds etc.

      After Obama care? I can't afford that type policy, as that it barely exhists, and has been deteriorating each year. I had to drop down in coverage a bit to afford this last one....I pay about $780/mo, for a $1700 deductible....covers not quite as many meds, office fees have increased on what I have to pay for co-pay....but the one saving thing is I can still max out my HSA year after year (unlike FSA's, mine isn't used or lose it, I roll it over every year).

      But not only is it more $$...fewer of my Drs on on the network. There are fewer choices in plans....those exchanges don't do fuck-all for anyone making over poverty level...they just aren't there, and it is getting worse.

      Obama care was one of the worst things I"ve ever seen happen to healthcare for middle to upper middle income people.....the quicker it is done away with, the better.

      IMHO, the ONLY positive thing the federal govt could do for health care, is make it so that medical insurance can be sold over state lines, like car insurance is....let the market back in and make things competitive again.

      The only positive things Obamacare did, was remove the pre-existing condition parts that could exclude you from any insurance. That was a positive....but hell, even back before, I had some preexisting conditions, and it didn't make my medical insurance NEARLY as $$$$ as it currently is.....

      --
      Light travels faster than sound. This is why some people appear bright until you hear them speak.........
  2. That stucks by viperidaenz · · Score: 5, Insightful

    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.

    1. Re:That stucks by b0s0z0ku · · Score: 5, Insightful

      Enough to protect themselves without breaking the bank and worshiping their militaries like some kind of false idols. (While quietly mistreating their veterans.)

      If the US truly wanted to merely "defend" itself, it wouldn't be expensive -- a few ICBM silos and missile subs are an ample deterrent against invasion. The problem is US bullying of other countries to support obsolete industries like Saudi oil, their pet theocracies in the Middle East, and an unwinnable war on (some) drugs.

    2. Re: That stucks by toadlife · · Score: 5, Insightful

      you'd rather have the government make the rules.

      Yes.

      You want that heart bypass surgery? No problem, we'll pencil you in for July 6th, 2028.

      An absurd exaggeration that flies in the face of actual data from countries with socialized healthcare systems, but absurdity is guaranteed when your argument has nothing of substance to stand on.

      --
      I don't always use unix-like operating systems; but when I do, I prefer FreeBSD.
    3. Re:That stucks by b0s0z0ku · · Score: 5, Informative

      Go to much of Europe outside the UK, and it's like a breath of fresh air.
      (1) No warning signs everywhere, and no attempt to protect people from themselves. 10 year olds walk or take transit to school. Train windows open -- if you stick a hand out, it's your own problem
      (2) Fewer nannying restrictions on alcohol
      (3) Widely ignored and/or lax drug laws in many countries
      (4) Fewer sexual taboos. Nudity/toplessness are much more accepted
      (5) Stricter privacy laws. More restrictions on employers -- employers aren't allowed to meddle in private lives outside of work as much.

    4. Re: That stucks by judoguy · · Score: 5, Informative

      you'd rather have the government make the rules.

      Yes.

      You want that heart bypass surgery? No problem, we'll pencil you in for July 6th, 2028.

      An absurd exaggeration that flies in the face of actual data from countries with socialized healthcare systems, but absurdity is guaranteed when your argument has nothing of substance to stand on.

      Not at all. I worked for several years on a medical office management system that ran in 12 or so countries. My team had members from Canada and the U.K. and they both had horror stories about the "free healthcare" involving their mothers. For the Canadian mom, she was diagnosed with a heart problem and was told to stay in bed until money was available for treatment. She was told that it shouldn't more than six months. The U.K. mom had breast lumps discovered in a checkup and was scheduled for a biopsy. In six months coincidentally. Both moms were brought to the U.S. right away for treatment even though it wasn't "free".

      Regarding the medical office system we were working on, as much as a pain in the ass it was dealing with 50 states worth of insurance companies, the Canadian "single payer" system was A LOT harder to deal with. Unbelievably complex rules about who could get what at what age and in what Province depending on the time of year. This was a while back so maybe it's all rainbow farting unicorns now.

      --
      Peace is easy to achieve, just surrender. Liberty is much harder get/keep.
    5. Re:That stucks by b0s0z0ku · · Score: 4, Informative

      No, the babies were beyond hope. "Treatment" would have at best created a brain-dead vegetable. Better to let their bodies die than offer false hope to the parents.

    6. Re:That stucks by Solandri · · Score: 3, Insightful

      No country has free medical care. The only difference is in how it's managed and paid for. The U.S. uses a combination of government programs, private insurance, and personal funding. A lot of countries use government programs and personal funding. So in countries with "free" health care, it's not free, you are paying for it via your taxes.

      As for the hypothesis that it's the lack of government-funded health care which drives up prices in the U.S., in 2009 prior to Obamacare passing, the U.S. government was already spending more per capita on health care than any country except Norway, Luxembourg, and the Netherlands. If government-funded health care were truly the solution, the U.S. government was already spending enough to copy Canada's health care system wholesale before Obamacare was even proposed. The problems with the U.S. health care system are deeper and more complex than "it's because you don't have a government-funded system."

    7. Re:That stucks by b0s0z0ku · · Score: 5, Insightful

      Problem is that an entirely government system might actually be cheaper. It wouldn't need parallel systems like Medicare, Medicaid, and the VA. It wouldn't need layers of bureaucrats to determine who's eligible for which services and which subsidies. The US has layers upon layers of inefficiency, both in private and public insurance.

    8. Re: That stucks by Anonymous Coward · · Score: 3, Interesting

      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).

    9. Re: That stucks by ceoyoyo · · Score: 5, Insightful

      The plural of anecdote is not data. Proper health outcome studies consistently show that the US is middle of the road in the world, and lags behind the modern social democracies.

      The UK and Canadian systems definitely aren't perfect, but they're better, both in outcome and efficiency, than the US system.

    10. Re: That stucks by youngone · · Score: 5, Interesting

      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

    11. Re:That stucks by ceoyoyo · · Score: 4, Insightful

      Not sure I understand your reasoning. You're saying that because the US mostly private system is very, very expensive, the problem is not that the system is mostly private?

      No, the US isn't going to be able to fix it's system with a little bit of legislation. Powerful interests, from physicians to pharma are going to be pissed off. But data from the whole world agrees that some sort of socialized system is both most efficient and most effective.

    12. Re: That stucks by phantomfive · · Score: 2

      Proper health outcome studies consistently show that the US is middle of the road in the world, and lags behind the modern social democracies.

      The last 'proper' study I saw attributed the differences to smoking rates in the countries. Overall measuring the quality of a healthcare system is not easy because there are so many factors involved in outcomes besides just the system. What 'proper' health outcome study are you talking about? Did it adjust for lifestyle of the participants? It's not an easy question, but we can say that people from the US sometimes prefer to visit Canada for treatment, and sometimes people from Canada prefer to visit the US for treatment. It's not straightforward, it's complex.

      --
      "First they came for the slanderers and i said nothing."
    13. Re:That stucks by b0s0z0ku · · Score: 2

      The US has relatively high taxes when property tax, sales tax, and all income taxes are taken into account. They just pay for subsidies to military contractors and mass incarceration. Unless you're a military contractor or a jailer, how does that benefit you more than using the money to provide healthcare for persons such as yourself? It's not only taxation, but what you get back from it.

    14. Re: That stucks by b0s0z0ku · · Score: 2

      The French and Germans smoke like steam locomotives compared to Americans, yet still live longer on average...

    15. Re:That stucks by NeoTubNinja · · Score: 4, Interesting

      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!

    16. Re:That stucks by GrimSavant · · Score: 4, Interesting

      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.

    17. Re:That stucks by another_twilight · · Score: 3, Informative

      Had they been in the US the tragedy would have unfolded in the same way. An experimental treatment that _may_ have offered an extension on life but which cost most of $1.5 million (in one example that I found).

      That the NHS cannot and will not cover every treatment should be obvious. Where that line is drawn will always be tragic.

      That these are the worst examples you can find either points to a deliberate attempt to appeal to emotion or the shallowness of your argument.

    18. Re:That stucks by cayenne8 · · Score: 2

      Problem is that an entirely government system might actually be cheaper. It wouldn't need parallel systems like Medicare, Medicaid, and the VA.

      Hmm...well, looking at the federal govt's track record for efficiency, cost savings, and high standard of care with those existing programs (Medicare, Medicaid, and the VA)....I don't think they've proved themselves qualified to handle the care for ALL of us yet.

      Horrible costs, horrible management and poor standard of care.....that's all they've shown us they can do to date in the US.

      --
      Light travels faster than sound. This is why some people appear bright until you hear them speak.........
    19. Re:That stucks by apoc.famine · · Score: 3, Insightful

      and entrenched interests who get their gravy train from the wide variety of inefficiencies

      And when you dig into the health care system in the US to any appreciable extent you realize that it's not just a gravy train of inefficiencies, it's inefficiencies all the way down. Inefficiency is a core structural component of the US healthcare system.

      --
      Velociraptor = Distiraptor / Timeraptor
  3. The 1st world is getting smaller by the day by Anonymous Coward · · Score: 3, Insightful

    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.

    1. Re: The 1st world is getting smaller by the day by another_twilight · · Score: 2

      Your 'duress' is a golden age in history. No other people have had so much, nor lived so well.

      You have been raised in a community and a society. By the time you were able to make decisions for yourself you've already benefited directly from things society has provided, like education and medicine and indirectly by living in a country with rule of law and relative peace. These were offered as part of a social contract. part of that contract includes limitations to your absolute freedom - a requirement to abide by the laws of society and to make some kind of contribution to the maintenance and upkeep of some of the very things you've already enjoyed.

      If you find that implicit contract something that you disagree with, then what do you propose? Why should society continue to provide you with active and passive benefit if you refuse to accept the obligations that implies? Where is the duress? You can leave and find a society more to your choosing at any point. There are even a few places left where you can leave all society behind. Live without obligation and with total freedom.

      I'm really struggling to understand this idea of 'duress'.

  4. Europe... by b0s0z0ku · · Score: 2

    "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.

  5. This is the point of community rating by GrimSavant · · Score: 5, Interesting

    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.

    1. Re:This is the point of community rating by lgw · · Score: 2

      If you have auto insurance, it's going up after you have a wreck - but they'll pay for the wreck. Heck, you can even buy a rider that insures your insurance rate (forgiveness for an accident).

      You also have a max you can be charged for your auto insurance - the way that works varies from state to state, but insurers are required to lose money on the highest-risk drivers in order to enter the market. Seems like that would work just fine for health insurance. If you're a fat lazy slob like me, you'll pay more - but not infinitely more.

      --
      Socialism: a lie told by totalitarians and believed by fools.
  6. Re:Oxymoron Alert by b0s0z0ku · · Score: 5, Insightful

    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.

  7. This is the shit that will get peoples' attention by Rick+Schumann · · Score: 5, Insightful

    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.

  8. You are. Surprise. by Hallux-F-Sinister · · Score: 2

    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.

    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 ... 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!

    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 .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.

    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.
  9. Yet again, China is leading the way by GerryGilmore · · Score: 2

    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.

  10. In the end by nehumanuscrede · · Score: 2

    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.

    1. Re:In the end by nehumanuscrede · · Score: 2

      " 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 "

      As an example:

      A recent MRI ( of which I spent exactly ten minutes in the machine ) cost me $800 USD. EIGHT HUNDRED FUCKING DOLLARS for ten God Damn minutes.

      This kind of shit is why the whole system needs to be regulated.

    2. Re:In the end by omnichad · · Score: 2

      You have to split up the cost of the $1.5 - 3.0 million machine across everyone who uses it. Not to mention the cost of keeping the liquid helium cold or replacing it if the machine has to be shut down. $800 is probably still too high, but I wouldn't imagine it being cheap either.

  11. Rates aren't the problem by rsilvergun · · Score: 5, Informative

    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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  12. We could pay off the national debt by rsilvergun · · Score: 5, Interesting

    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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    1. Re:We could pay off the national debt by Pascoea · · Score: 2

      If you're a fiscal conservative single payer just makes sense

      The problem is we don't have the fiscal variety of conservatives anymore. All we have is the moral type. I consider myself a lefty, only because the "conservatives" are more interested in who I'm having sex with rather that what they are spending my money on.

  13. Which is why we're not letting them do it by rsilvergun · · Score: 4, Insightful

    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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  14. We don't have conservatives by rsilvergun · · Score: 4

    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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  15. Re:Couldn't you game what they looked by tsa · · Score: 2

    It is, but think about it. You have to pretend to be interested in something you are not, and act as if it makes up a big part of your life. And you have to keep that up for a long time. That is hard. And then there is the added problem that people often get interested in things if they are forced to spend time on them, for instance because it's part of their job.

    --

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  16. Re:Oxymoron Alert by sg_oneill · · Score: 2

    fair system of public insurance

    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.

    --
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  17. Re:You are. Surprise. by fropenn · · Score: 2

    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.