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Your Medical Treatment History Is For Sale
Posted by
kdawson
on Tue Aug 05, 2008 02:32 PM
from the slippery-cliff dept.
from the slippery-cliff dept.
PizzaFace writes "The Washington Post reports on the booming business of selling your medical treatment records. Today these are mainly records of your prescriptions, but the data warehouses will soon have records of your lab tests, too. The companies selling these records make it easy for insurance companies to avoid risk by assigning each person a health score, similar to a credit score, or by flagging items in each person's history that suggest chronic or potentially expensive health problems. It's not just for insurers, either; employers who check applicants' credit scores will surely be interested in their health scores as well."
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Health care, what health care? (Score:4, Insightful)
Here you can RTFA all on one page [washingtonpost.com].
Re:Health care, what health care? (Score:5, Interesting)
Maybe I'm missing something and there's a loop-hole, but AFAIK In Canada selling this information is illegal, and I thought that medical records were confidential in the US as well (apparently not). In Canada patients and health care professionals have client/doctor confidentiality similar to client / lawyer confidentiality. A doctor's office would lose it's practice if it handed over information to anyone without the patient's consent.
Of course there's downsides to our system too. Since health care is public doctor's can only charge so much and thus the only way to increase their income is to get more and more patients so doctors are over-worked and the waiting rooms are always packed with huge waits. Plus more and more of our top doctors move to the US where they can earn more. There's gotta be some kind of happy medium where everyone wins.
Parent
Re: (Score:3, Informative)
AFAIK In Canada selling this information is illegal
That it is... well, unless you sign a disclosure, which the article claims is required if you want to get insurance in the first place. So you're basically boned in the US if you want health care coverage *and* your personal privacy.
Re:Health care, what health care? (Score:4, Insightful)
The reason why health care providers ask for medical records is so they can rate your risk, it's the same reason car insurance companies look at your driving record.
Except, it's easy to alter the cost of your car insurance (don't drive, or buy a smaller car, or go on an advanced driving course).
But you can't avoid being ill, or cure an uncureable illness.
(And because that's not fair, in my country the entire country takes on the 'risk' of anyone getting ill.)
Parent
"thus the only way to increase their income [...]" (Score:5, Informative)
"thus the only way to increase their income is to get more and more patients"
Not really.. they can go work in a private clinic, or they can work in another country (as you already pointed out). Thank goodness there's many doctors who don't particularly care about increasing their income - who got into the job because they can genuinely help fellow man and all that sort of altruistic stuff that we, as a society, are far too eager to write off and laugh at. These are doctors who will give treatment for free if needed (and sometimes if not*), instead of some doctors only giving free treatment while on a P.R. trip to a poor country (not dissing the gesture, just dissing the motives).
And, let's be honest, they don't really -need- the higher income because they don't have to worry about multi-million dollar malpractice suits looming around every single corner and the insurance that goes with it.
I'm not saying that 'socialized' healthcare is panacea.. far from it.. but that "happy medium where everyone wins" should not be led by the desire to make more money - focus instead on reducing or eliminating the negatives you mentioned.
* I had a nasty bruised-looking toe - walked (well, semi-hopped) straight into the hospital (hadn't registered for a GP yet after moving), got to see a doc in 10 minutes who had an x-ray made 5 minutes later 'just to be safe', determined that it was indeed broken as he suspected, got me a splint, had a nurse put it on while he moved on to another patient, came back to do a quick check to make sure it was on right, and sent me on my way. That's it. Didn't send me past administration for my insurance info on my way out, and certainly not on my way in.. I was a guy with a nasty bruised-looking toe who needed to have a look at it done by a doc and that's all they cared about. Thanks, MCH. I know this is anecdotal, and I'm all too familiar with waiting lists as well, but it's not nearly as bad as some make it out to be. Being on a waiting list for an organ, however, does suck - but that seems to be the case regardless of medical system; short of countries where there's a lively 'grey'/black market in organs. Yikes.
Parent
Re:Health care, what health care? (Score:5, Informative)
"Since health care is public doctor's can only charge so much and thus the only way to increase their income is to get more and more patients so doctors are over-worked and the waiting rooms are always packed with huge waits. Plus more and more of our top doctors move to the US where they can earn more."
I see you bought into the propaganda. The governments allocate a certain portion of the budget to GP expenses (ie: Doctors office visits). Which means, Doctors can only see so many patients before the budget is blown. Waiting room times have severely diminished thanks to Alberta led procedures. And because of caps, they can't hire more Doctors.
The Provincial Governments don't increase this funding when population grows - hence they kept saying it was 'unsustainable' (and run Provincial surpluses cause they can't count!). And people bought the BS. Too bad Slashdot doesn't allow attachments, because the Conference Board of Canada has some eye opening reports that contradict your memes. And links are useless, as the CBoC is a for-pay site.
Parent
Re: (Score:3, Funny)
Have you considered immigration to Canada as an alternative treatment method?
Re: (Score:3, Insightful)
For instance, if MedPoint produces a report that an individual has been on the highest dose of the cholesterol-reducing drug Zocor for 18 monts, the insurer "would be able to know that you have a very high, near-intractable cholesterol problem," Dick said, and could avoid a costly blood test.
Well, if they actually used this sort of information to "avoid a costly blood test" to measure cholesterol instead of as proof of a pre-existing condition they don't have to cover, and undoubtedly a fantastic reason to increase premiums, it wouldn't be barbaric at all.
Re: (Score:3, Insightful)
Re:Health care, what health care? (Score:4, Insightful)
...something other than anecdotal?
I seriously hope that you don't come down with argyria.
Parent
Re: (Score:3, Insightful)
Arygyria is used for FUD a lot. It mainly happens when people use ionic silver, not colloidal, especially when they make it at home incorrectly and up with a contaminated product. Unfortunately, due to the fact that Big Pharma needs everyone to believe in the fiction that only synthetic patent meds can help you be well, colloidal silver (like many more natural methods) has been discredited through a combination of FUD and fscked up FDA "legal definitions", such as allowing ionic silver to be labeled as coll
Re:Health care, what health care? (Score:5, Insightful)
Business and medicine are a terrible combination. Many herbal and traditional treatments do work. Many don't. How can we possibly figure out which is which?
Through the honest and open application of the Scientific Method! Big Business became clearly deleterious to health care when it became evident (many years ago) that they actively discouraged the investigation of treatments that were not convenient for their profits.
Parent
Re:Health care, what health care? (Score:5, Interesting)
Generally, if something claims to cure EVERYTHING, it really can't. And quite often cures nothing.
My problem with "colloidal silver" is that the proponents of it claim it cures everything... prostate enlargement... cystic fibrosis.... lukemia, depression, skin rash.... cataracts, uhm.. what else have I heard....
Oh and it will bring your grandma back to life, right, I forgot that one.
The problem with claims like that is that they're completely and utterly absurd.
What, exactly does it do?
Has there ever been a double-blind study done by an unbiased research organization (such as a publicly funded university laboratory) that you can cite?
I'm curious...
Parent
Re:Health care, what health care? (Score:4, Funny)
My grandma was a werewolf, and colloidal silver *killed* her, you insensitive clod.
Parent
Re:Health care, what health care? (Score:4, Insightful)
And your evidence is...?
Our evidence comes from double-blind scientific studies not anecdotes.
Parent
Re:Health care, what health care? (Score:4, Funny)
[citation needed]
Parent
Re:Health care, what health care? (Score:4, Informative)
I developed debilitating (and somewhat unusual) asthma that went undiagnosed for too many years. I wound up taking drugs (two corticosteroids and a beta agonist) prescribed by a good pulmonologist. The drugs reduced my asthma to a mere annoyance. Believe me when I tell you that I don't miss the smell of blood when I cough. You might be tempted to call that treatment a success of modern medicine.
Unfortunately, from my perspective it was a failure. The side effects I experienced included insomnia and anxiety severe enough to affect my life nearly as much as the asthma did. Think the afternoon after flunking a test you stayed up all night studying for. Well, not quite that bad, but you get the idea. Drugs to treat those conditions were either highly addictive and sedating or made matters worse (e.g. ambien resulted in nightmarish daytime anxiety).
Eventually, I took the advice of a friend and saw a practitioner of traditional chinese medicine. Though skeptical, I figured I had nothing to lose and went in for treatment with an open mind. The guy prescribed medicinal tea (roots, bark, fruit, dried worms, insect shells, etc.) and performed acupuncture weekly. Three months later, I feel much, much better, having eliminated two of the drugs and greatly lowered the dose of the third. I sleep at night. I can breath. Life is good. This after years of trying to cope.
Now I'll be the first in line to agree with you that personal testimonials are notoriously unreliable. And I don't recommend that anyone cite my story as proof positive of anything. But I'll tell you that I am personally convinced of two things: First, that the drug companies effectively mislead doctors and patients to underestimate side effects of their wares; and second, that something in this alternative therapy is working, and working dramatically well.
If indeed my recovery is due to the placebo effect - which I strongly doubt because I have a far stronger belief in conventional medicine - it has been worth every penny.
P.S. I still don't believe that sticking needles into my skin has anything to do with curing my asthma, but I put up with it rather than challenging either my beliefs or the chinese medical approach that seems to be working. For what its worth, my primary care physician (medical doctor) seems to beileve somewhat strongly in the effectiveness of acupuncture for some things.
Parent
Re:Health care, what health care? (Score:4, Insightful)
Parent
Re:Health care, what health care? (Score:5, Insightful)
Because on a long enough timeline, the chance that you won't get sick approaches 0.
Parent
What Natural Selection Selects (Score:5, Insightful)
If our society were based on blugeoning each other with clubs, this would be a relevant argument. We'd need the specific quality of physical strength and resilience to survive. But the fact is that people who are "sickly" (to use your word) can make important contributions to society exactly because the aspects of the person that is required to make those contributions is often unrelated to the health issue they may confront. Look at Stephen Hawking for example. Nothing wrong with his brain, so as long as the essential aspects of his body are functionally maintained, he can continue to make his contribution. And even when reasoning in some sort of cold/mercenary way, the cost of maintaining such a person may be much less than the cost of losing such a person's potential contribution.
Besides, natural selection is intensely focused on the high order bit--whether people survive to breeding age at all. It's not very concerned with selecting for good writers, philosphers, mathematicians, teachers, etc. Nor does it appear to care a whole lot about diseases that come up after breeding age. So the argument about the gene pool being affected by caring for the so-called "sickly" seems bogus given that a lot of people who we care for are older than breeding age and do not, at that point, contribute to the gene pool.
Natural selection isn't creating some noble super-race. It favors the strong, but also the violent and the crafty. It looks only at outcome; it doesn't moralize about tactics. And its measure of outcome seems, by modern theory, limited narrowly to "has offspring ready to play the game anew". That's a possible theory of "good", but not the only possible theory. It seems just a little limiting, in fact. Which is why society tries to circumvent it through conscious thought and group policy, for better or worse.
Parent
Re:Health care, what health care? (Score:4, Informative)
And to play devil's advocate to your devil's advocate what happens to you if your good health turns out not to be as good as you think it is?
I don't think someone should be made to pay higher healthcare costs for stuff that isn't his fault. But I think it should be fair game on lifestyle choices. If you smoke or drink then I think you should pay more in to the "system."
The really sad part I see is people seem to think the healthcare in general sucks. Which I don't see as true. Medicine in general is the best it has ever been. What sucks is the bureaucracy and the bullshit that as built up around it.
Parent
Re:Health care, what health care? (Score:4, Funny)
Even people in good health would really rather not let additional people know they had a vasectemy, eh?
Are you kidding? I wish the doctor's office gave me a t-shirt and a tattoo to advertise that my baby batter has been replaced with "I Can't Believe It's Not Sperm".
Parent
Re:Health care, what health care? (Score:4, Insightful)
well look at it this way - for more than 10 years i have had to pay my own health insurance .. 120$ a month.. not to bad but i paied it - i didn't go to the doctor i didn't go to the ER.. just spent 120$ a month for a warm fuzzy feeling.. well abouth a year ago i got sick.. i am currently on meds that cost me (after insurance) about 8$ a day - ontop of the 120$ a month i pay for insurance.. if i switch or have any laps they can say pre existing condition.. and who knows what i would be paying a month if i could even get insurance..
for the first 9 years i had the same feeling as you - it is only after you have to switch boats you realize why you do it. If i didn't have insurance when i got sick i would not be able to afford the medication. without meds i can't move in the mornings due to the pain - with them i can be productive and work with minor pain.
pray you don't have to - but if you ever switch boats - you will understand
Parent
Re:Health care, what health care? (Score:5, Interesting)
It's immediately possible to equate your devil's advocacy to the inability to have empathy for others.
Your good health is nice, and it is also likely to be transient for reasons other than good actions you have taken yourself. Even if you've been a bit of a slut and got HIV (or an other STD), or let yourself become obese (with incumbent diabetes and arteriosclerosis), or have smoked like a fiend, you're still a human, and we still want you to live. Really. Those that don't, having no empathy, are in fact sociopathic and by a component of its definition.
So, Satan, fsck off.
Parent
Re:Health care, what health care? (Score:4, Insightful)
Right. Empathy==not using my funds.
You are alive because others had empathy for you and were willing to share your costs and help build you to whom you are today. Your obligation is to other humanity. Common insurance and civic maintenance isn't your obligation, of course.
Therefore, stop paying the insurance as in your perfected state, you won't need it. Beelzebub.
Parent
Why socialized health care should be implemented (Score:5, Insightful)
As someone with a very painful, debilitating chronic health condition (very active Crohn's Disease), you should assist in paying for my health care because you're part of a society that has made euthanasia illegal and severely demonized suicide (indeed, were I to attempt it, I would likely be institutionalized). Hence, as society has taken away my only alternatives, it has an obligation to provide me with access to the requisite medical procedures and drugs.
Parent
Re:Health care, what health care? (Score:5, Insightful)
We also need to remove the requirements for surgeons to have to go through extensive training to be doctors.
This, quite possibly, is the stupidest thing I've ever read on Slashdot. And that's saying quite a lot.
Parent
HIPPA (Score:5, Informative)
Sell my medical records and my lawyer will be in touch with your lawyer. See Health Insurance Portability and Accountability Act [wikipedia.org]
Re:HIPPA (Score:5, Informative)
Parent
A Non-Issue. (Score:5, Insightful)
Car insurance knows how many accidents you've had. Home insurance knows what claims you've made. All the insurance companies know your criminal record.
Health records may be private - you don't particularly want your neighbors to know about it. But the company that is insuring you certainly has a right to know what type of risk they're insuring - and just like auto insurance your cost should reflect it.
At the same time, health care is something that is a necessity. So if they price it out of range, how do you protect yourself? Removing preventive care due to cost and substituting emergency care in it's place is a horrible solution, but if it's priced out of range, that is what may happen.
This is why the government is going to have to step into health care in some way. It's in the Health Insurance company's best interests to not insurance people that are high risk. In a free market, those people will end up being uninsured.
I hate government intervention in any market, but I don't see any way around it. You can walk to the store and work. You can't perform an appendectomy on yourself.
but but... (Score:5, Interesting)
Healthcare rationing! Long waiting lists! Socialism!
Of course, healthcare in the US is already rationed (just according to your ability to pay for it) and you already have to wait for procedures and tests (like the week and a half it took my wife to get the insurance company and various doctors involved to schedule an MRI that everyone agreed she needed).
Insurance companies are probably the worst type of organization to have making healthcare decisions.
Parent
Re: (Score:3, Informative)
You can walk to the store and work. You can't perform an appendectomy on yourself.
Interestingly, a little searching found this:
http://en.wikipedia.org/wiki/Self-surgery [wikipedia.org]
Take a look at the first bullet under the heading "Abdominal."
So there you have it...*shudders*
-G
Re:A Non-Issue. (Score:5, Insightful)
Parent
Re:A Non-Issue. (Score:5, Insightful)
At the same time, health care is something that is a necessity. So if they price it out of range, how do you protect yourself?
That's why the civilized world has universal health care.
I hate government intervention in any market
The health care "market" is not a free market, as I found out in April after my vitrectomy (link may not be sfw) [slashdot.org]. The prescription eye drops I had to take after the surgery varied widely in price from pharmacy to pharmacy, but my co-pay was the same no matter where I boiught it. In the end I got it at the closest drug store, which turned out to be the second most expensive.
I can only get insurance my employer provides. When the market isn't free, government SHOULD intervene.
My best friend died from lack of insurance. RIP Jim Dawson, 1952-1992.
Parent
Re:A Non-Issue. (Score:4, Insightful)
Sorry, but I don't follow your logic at all. Income tax has absolutely nothing whatever to do with health insurance in the US. I'm locked into my employer's insurance plan because he has a shitload of employees and can therefore get a good rate; a rate I can't get on my own, or a small business can get either.
Parent
Re:A Non-Issue. (Score:4, Insightful)
I'm one of the uninsured, and preexisting conditions ensure I'm insurable. It's not possible to pay for your health care (unless you're a multi-millionaire). Here's what that means literally: I've been left for dead. I'm not alone either. There are millions of Americans suffering illness who cannot pay for care, and cannot get insurance. They are left in limbo until they either die, or become sick enough to qualify for disability benefits (in the governments eyes - they've denied people I know in quarantine... )
At that point all you dear readers get to pay my medical bills anyway. Only now they are my inflated medical bills. Prevention is far cheaper than disease management. If you need an example - Had I received something like treatment over the last ten years I may not have neuropathy on top of my primary diagnosis. Now I do. Now the cost of treatment rises exponentially.
They do not care how much costs rise. We are the ones paying.
Parent
Re: (Score:3, Informative)
It's been done [imdb.com].
Re:mod parent up (Score:4, Informative)
wrong.
wrong, wrong, wrong, wrong, wrong.
repeat after me; wrong.
why, you wonder, are you wrong? in a system where market participants place performance, or more properly, are bound by law to place performance, above all other measures of success it is plain that the welfare of the consumer is not considered unless also mandated by law, and even then will be considered less important than the business's performance if there are not sufficiently dissuasive penalties.
for further reference see RailTrack [wikipedia.org].
Parent
Great (Score:3, Interesting)
And I'm busting my ass encrypting laptops for HIPAA compliance so stupid med students don't lose an anonymous list of patient encounter notes.
oh gee what a surprise (Score:5, Insightful)
I don't know why anyone would be surprised that an organization the goal of which is to maximize profits would do its best to cut costs (paying for your medical care) and maximize income (acquiring the money of you, your employer and the government i.e. other taxpayers as health-care premiums). You'd have to fail Logic 101 to think things would be otherwise.
On the other hand, what the Washington Post will suggest is the "solution" to this nonsense is even more illogical: you should give all your health-care money to another organization, Congress, which is also most interested in something other than your health -- namely, keeping political power. What do you suppose will influence Congressmen when they decide what to do with your health-care money, and how to provide you with health-care? Altruism? Your actual happiness? Using your money most efficiently? Hmmm. Is that how it works now, when Congress debates how copyright should work in the Digital Age, or whether it makes sense to subsidize turning corn into ethanol (instead of food)?
Once again, we're confronted with the nasty little fact o' life that the only agent that will ever have only your interests at heart is you. Given that, which of these three options makes sense?
(A) Give your money to a big insurance company, run by strangers with Harvard MBAs seeking to maximize profits for shareholders, then ask for some of it back when you want some health care.
(B) Give your money to Congress, run by smooth-talking lawyers seeking to maximize their terms in office through maintaining access to the massive amounts of cash necessary for perennial re-election, then ask for some of it back when you want some health care.
(C) Keep your money, and spend it on health care when and where you choose.
Strangely enough, people keep choosing (A) and (B), under the amazing delusion that somehow if you make all the transactions really complicated -- shuffle the dollar bills around fast enough -- we can receive more value in health care than we pay out in actual money. Proof that the bitter lesson of TANSTAAFL has not been learned by most adults.
Re:oh gee what a surprise (Score:5, Insightful)
(C) Keep your money, and spend it on health care when and where you choose.
(D) Build a quality, government-run universal health care system, like those found in virtually the entire western world, and watch quality of life rise while health care costs plummet.
But I can see why you wouldn't want that...
Parent
Us health insurance companies - perfect argument (Score:5, Insightful)
Well sounds great except (Score:5, Insightful)
Sounds reasonable at first, but think for a minute: why would your doctor order a blood test to see if you have cholesterol problems if he or she had already put you on cholesterol medication because he or she knew you had cholesterol problems? Even if you switched doctors, your new doctor should know the results of that test, and at the very least you need to tell him you're on the medication. In other words: your doctor is going to know already.
At best this is a flimsy excuse to invade your privacy and raise your insurance premiums: "By reducing wasteful testing your doctor orders because he/she is an idiot, we save you money, so don't worry about invasions of privacy or your rates going up
But there's another issue that this seems to raise: accountants at your HMO second guessing your doctors. Lets say in the example above your doctor wants to test your cholesterol to see how effective it is or if you actually should still be taking it. Your HMO says "Hey, no, we're not paying for that, we know he has high cholesterol because he's on cholesterol medication, we don't need a test!"
It seems like this could be sorted out with common sense, and like the insurance agencies would have some idea of what's reasonable and what's wasteful, but they don't always. The article mentions that often medications that can be perscribed for two or more different purposes, and the insurance agencies often have a hard time understanding something that simple, denying the woman life insurance because they were convinced she was depressed, when she was actually taking prozac for hot flashes.
If they don't belive the doctor that she was postmenopausal instead of depressed, can we really expect them to use information NOT coming from the doctor correctly, in our best interests?
Re: (Score:3, Funny)
No, it is your fault, you liberal hippie. If you would stop being lazy, you could get your physician's license and cure your own problems instead of depending on others to help you. Ron Paul 4ever!
Re:This is stupid (Score:4, Funny)
Nothing wrong with a little selective breading. Make that part of the insurance policy. We'll treat you for your known, genetic conditions that will most likely be passed on to any children, if you agree to be sterilized. It's either that or start repopulating major cities with large carnivors to take care of the slow and the week.
It would take care of the obsesity problem and protect endangered species all at the same time!
Parent
Re: (Score:3, Insightful)
If you have a bad credit rating, you aren't good at handling your personal finances, so why would you be any better handling your duties at work?
( not that i agree, but that is the thinking, and why they ask )
Re: (Score:3, Insightful)
The problem is proving that the employer used the data against you. Its so easy to find other reasons that are hard to fight to do what ever they want that its all a big joke.
Re: (Score:3, Insightful)
No they won't. The best anyone can hope for, barring radical policy change on the part of the U.S. government, is that their costs won't go up too much for them to afford.
Good health? Costs go up. Bad health? Costs go up more.
Re: (Score:3, Insightful)
Strippers don't usually screw random people, so I would say the stripper is MUCH more innocent than Big Bubba Insurance, Inc.
Re:Alarmism (Score:5, Insightful)
Alarmism
Far from it, look at the credit score mess and where it has gotten us.
What's a credit score? It's a score about how much you love being in debt, you get in debt and pay to get more debt and pay on time to get even more debt, etc. How is that relevant to you being able to get a job? It's beyond me.
What makes you think this system won't be abused exactly like the FICO score if not even worse?
Can you imagine identity theft in this scenario? Oh boy oh boy, someone steals your identity and all of the sudden you lose your life insurance, the doctor _won't_ see you now because you lost your health insurance, and all of that is because someone bought a heart medication with your info and your insurers dropped you immediately.
Isn't that similar to how credit scores work? Someone steals your identity messing up your score and all of the sudden _you_ are the criminal, universal default [wikipedia.org] on all of your accounts, collector calls who won't believe you, etc.
The whole "insurance" thing is a form of measured "gambling"/risk industry, that is: "I bet you won't die in 30 years", "I bet you won't get sick so much this year" or "I bet you won't get in a car accident".
Things like this health score significantly reduces that gambling element and turns it almost into "I'll insure you if and only if you don't need the insurance", which just smells bad.
Finally, on a privacy stand point, the idea of even more of my information being thrown about out there doesn't sound that appealing to me.
What's the solution? I don't know. Maybe one day the system will collapse on its own weight or someone will come up with a better idea, but until that day comes, we'll be in this weird relationship with these middle-men characters.
Parent