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.

Comments

Who is affected?

[squiggleslash]

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?

Re:Who is affected?

[decep]

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.

Re:Who is affected?

[b0s0z0ku]

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.

Re:Who is affected?

[Anonymous Coward]

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'

Re: Who is affected?

[b0s0z0ku]

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.

Re:Who is affected?

[Alypius]

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

That stucks

[viperidaenz]

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.

Re:That stucks

[b0s0z0ku]

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.

Re: That stucks

[toadlife]

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.

Re:That stucks

[b0s0z0ku]

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.

Re: That stucks

[judoguy]

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.

Re:That stucks

[b0s0z0ku]

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.

Re:That stucks

[b0s0z0ku]

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.

Re: That stucks

[ceoyoyo]

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.

Re: That stucks

[youngone]

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

Re:That stucks

[ceoyoyo]

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.

Re:That stucks

[NeoTubNinja]

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!

Re:That stucks

[GrimSavant]

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.

This is the point of community rating

[GrimSavant]

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.

Re:Oxymoron Alert

[b0s0z0ku]

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.

This is the shit that will get peoples' attention

[Rick Schumann]

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.

Rates aren't the problem

[rsilvergun]

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.

We could pay off the national debt

[rsilvergun]

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.

Which is why we're not letting them do it

[rsilvergun]

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".

We don't have conservatives

[rsilvergun]

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.