Your Medical Treatment History Is For Sale 607
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."
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:1, Insightful)
Looks to me like this is an excellent time to read up on alternative treatment methods, as the barabaric, for-profit
US "healthcare system" appears hell-bent on becoming less and less available to those of us with imperfect health
and fewer than several gazillions of dollars.
Here you can RTFA all on
one page.
Alternative treatment methods? Like what? Magic and superstition? The US healthcare system has major issues, but it isn't bad enough that placebo healing works better.
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.
Re:Health care, what health care? (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:This is stupid (Score:2, Insightful)
I'm fine with society unrolling (so to speak) the genetic dice (to make sure no one misunderstands, I mean that it is a good thing for society to step in and pay for expensive treatments for people that need them from birth), but can we go ahead and call it a tax instead of dancing around pretending that it is insurance?
Re:Health care, what health care? (Score:3, Insightful)
The Sick and The Dead (Score:2, Insightful)
This is just another way in which the insurance industry works to defeat access to preventative medicine. You want the screening for early detection, but it might lead to you losing your insurance, or getting dropped from an employer plan and having to go it alone.
The insurance industry knows three things: Sick people cost money Healthy people cost less money Dead people cost even less money
Guess which they want the most of? The faster you move from sick to dead, the better their bottom line looks.
Re:Health care, what health care? (Score:4, Insightful)
...something other than anecdotal?
I seriously hope that you don't come down with argyria.
Re:I must be missing something.. (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 )
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:American Disabilities Act (ADA) (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:On the other side of the coin (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:Health care, what health care? (Score:5, Insightful)
Because on a long enough timeline, the chance that you won't get sick approaches 0.
Re:Fsck Insurance Companies! (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.
"Health Care" (Score:2, Insightful)
No "health care" involved. The companies are worried about how much they will spend if they take you on as a client.
Also, they have had access to physicians records for some time—again for the same reasons. And guess what (RTFA, or the "Privacy Rule" in HIPAA): HIPAA doesn't apply. When you apply for insurance, read the fine-print, because there are clauses in there about allowing them access to your medical billing records. These days they are just electronic, ergo easier to access. This is why they want access to prescription info as well, because then they can use this to more finely tune their systems of prescription drug co-pay scenarios.
I don't think that it was ever up for debate that the United States "health care" system has nothing to do with health, but another good indicator would be that insurance plans typically don't cover anything that can be deemed preventative, including basic physical examinations, and routine diagnostic testing such as STD/HIV tests, cancer-screenings, etc. Those tests are only paid for if they are deemed "necessary" for the diagnosis of a condition, rather than the prevention of a condition.
There has never been a better time for a national health-care system in the US. Also, there has never been a worse time: we don't have any more money.
Re:oh gee what a surprise (Score:1, Insightful)
The problem is you don't have enough money to get solve your own health care problems if you get some chronic disease or serious injury unless you are very very rich. So either you (a) choose to just die or (b) spread the risk over many people and have the majority of healthy pay for the minority sick.
Re:Health care, what health care? (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 colloidal silver. It takes conscientious research to deduce the truth, and to find honest products. And obviously it's far easier to believe the FUD, until it's your life hanging in the balance.
Us health insurance companies - perfect argument (Score:5, Insightful)
Re:mod parent up (Score:1, Insightful)
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
All I want from these records companies... (Score:2, Insightful)
Re:A Non-Issue. (Score:5, Insightful)
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.
Re:Health care, what health care? (Score:4, Insightful)
And your evidence is...?
Our evidence comes from double-blind scientific studies not anecdotes.
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: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...
The government is already the problem (Score:3, Insightful)
and introducing more of it into health care will only decrease the quality of what we do have.
You can't shop across state lines because of federal regulations. Every damn state and the feds introduce must carry rules. It is because of government intervention that health care is such a mess. We spend nearly TWO trillion dollars if all levels of government are represented and what are we getting for it? Oh, that's right, somehow its private corporations that are at fault for so many uninsured. Yet when solutions are offered some in Congress go out of their way to limit your ability to choose. One recent attempt was to remove the ability of seniors to shop around. Apparently it was too popular and less people needed government which means politicians had less ways to preserve their power.
Don't run out with the tired examples of what a mecca Canada or Britain are. I have relatives and family friends who have all been subject to that. My father had to fly back to the states for knee surgery while in Germany because it wasn't life threatening unless you call not being able to walk ok. One day here and he was back on a plane to Germany the next. Heaven forbid your over sixty and need something major. Our family friend's doctor's solution was to fly to the Mayo clinic to get his surgery NOW instead of waiting for the necessary regulatory requirements to be met in BC.
Yeah, you can cite examples on either side of the argument but all you have to do is read the news around the world to see that government controlled health care has its own set of problems and some of them are worse. Perhaps having the government help cover extreme cases would be best, no one should go bankrupt because of a medical emergency but at the same time they should not sacrifice.
My local doctor is on the verge of refusing all but private payers because the government is worse than all but one of the HMOs that he has to deal with. The government imposes treatment costs and requirements that go beyond what he feels is reasonable. He has been practicing nearly forty years, you would think he knows what is appropriate.
These fools can't run our schools, can't run airport security, and certainly cannot seem to protect our information, yet it never amazes me how many people want them to handle their health care. All it will do is create a new and more entrenched political group which will suddenly unionize and spend their money influencing elections as long as it further entrenches them and gives them power. People think the national teachers unions are out of control won't believe what will happen when the same occurs in the medical profession. Worse will be all the new bureaucrats that will be needed. The one area of employment which has never stopped growing is government. There are close to twenty five million people being paid to work in our governments. TWENTY FIVE MILLION! Think about it. Now you want more and you want them into a even more personal part of your life.
Then again I keep forgetting, the very same throw their most valuable and important parts of their life into public schools without batting an eye. After all their school, politician, local government, etc, isn't the bad one. I guess we can convince ourselves of anything if it means we don't have to look behind the door
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.
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.
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.
Re:mod parent up (Score:2, Insightful)
Re:Health care, what health care? (Score:3, Insightful)
You're saying health care shouldn't be about social justice? Seriously?? Wow... you really are a cold-hearted bastard, aren't you? I assume you feel the same way about, say, the third world food crisis?
Re:Health care, what health care? (Score:3, Insightful)
No, not unless you hire and pay for a lawyer to sue the health insurer in court for the right to pay them while retaining your medical privacy (and win).
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.
Re:Health care, what health care? (Score:3, Insightful)
Alternative treatments like 'toxins cause all illnesses, including the genetic ones, and especially cancer'?. Yeah, let's all jump on that bandwagon.
I went to my doctor today and he wrote me a prescription. I went and paid all of $14 for the medicine (that's the uninsured price). Mind you I live in Canada, so the doctor's visit was free. But honestly, when I watch those drug commercials you have in the States for sinus medication with side effects that include sinus infection and nose bleeds, and on top of that it costs you lots of money to see a doctor in the first place I can honestly understand *why* alt-meds seem so appealing. The sad fact of the matter is the proprietors of alt-meds are worse swindlers than the pharmaceutical companies people like to rail against.
http://whatstheharm.net/ [whatstheharm.net]
You conveniently sidestepped the issue... (Score:3, Insightful)
How are uninsurable people suppose to obtain healthcare? And not just emergency or major surgery healthcare, but preventative healthcare?
If you don't want government involvement, then health insurance must be non-discriminatory, or else there will be no choice but to have public-funded programs to treat those who cannot afford private insurance. Or they can just get sick and die, I guess. Hey, as long as your ass is covered, right?
Re:HIPPA (Score:3, Insightful)
You can't get out of the doctor's office without signing a HIPAA waiver so the doctor can share your health information with their partners.
I guess assuming that this partner would be the radiologist, neurologist ... involved in my case was foolish. Plus, they obviously have to disclose to the insurance company to get paid. And the insurance company runs the database from which they sell your information. Great!
This statement scares me even more: It's not just for insurers, either; employers who check applicants' credit scores will surely be interested in their health scores as well.
I don't really see how this is legal. I'm sure most companies would love to be able to cherry pick employees based on health risk. But, whatever happened to the risk sharing aspect of insurance?
If insurance companies will only insure people who don't need it, they have no reason to exist. Oh, excuse me, I totally forgot about those poor stock holders :->
It sounds like the people who will get hurt the most by this are once again the individuals buying their own health insurance and also small businesses.
There has to be a better way.
Re:Health care, what health care? (Score:4, Insightful)
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.)
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.
Re:You are selling your labor (Score:3, Insightful)
There is nothing wrong with the employer checking up the quality of your health before buying. If you make that illegal, you should outlaw Consumer Reports and, in particular, their repair-history database...
Your employer is not agreeing to buy your labor for the rest of your life. In just about every US state, an individual is an "at will" employee. So the timeframe an employer is committing for is something between maybe 1 and 80 hours of labor. You don't really need detailed files to determine if someone is likely to live through the day or the week. Now if an employer were to sign an iron-clad contract to pay you for your labors at a year or ten at a time, then your health might be a legitimate issue.
Re:Alarmism (Score:3, Insightful)
But if you're so good with money that you never use credit cards or take loans, then you have no credit score at all, and this is considered 'bad' credit.
Re:It could be worse (Score:3, Insightful)
An interesting point, but it's only a view with respect to a single aspect of medical care.
Taking a less narrow focus, consider the overall life expectancy at birth for the US vs. other countries - you'll find that a number of European nations are ahead, including France, the UK, Sweden, Germany, the Netherlands, Italy, among others.
I don't know that you can draw that conclusion from the site you cite. It might be a matter of medical training, drug availability, or other factors.
Re:Health care, what health care? (Score:3, Insightful)
I don't think someone should be made to pay higher healthcare costs for stuff that isn't his fault.
That statement is a double-edged sword. Why should you pay higher healthcare costs if it isn't your fault AND it's not even happening to you?
Because by making a tiny individual sacrifice (the increase in healthcare costs) we improve the lives of those unfortunate enough to have a long-term medical problem.
If you don't care for other people, then economically a healthy population is also more productive than an unhealthy one.
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.
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.
Re:Health care, what health care? (Score:3, Insightful)
Re:You conveniently sidestepped the issue... (Score:3, Insightful)
You think someone else is paying for all of this, don't you? Sorry, but it is you (and the rest of us).
Yes, it's called a social covenant. I accept it as a price for living in a society. If you want to live without any social obligations, then live as a hermit. Those of us who willingly accept our social responsibilities will continue to care for each other as we would expect others to care for us (you excepted).
If you feel that you can live selfishly, without any obligation or regard to your community or the world at large, and care only of yourself and perhaps few of your family and friends, then I feel sorry for you. You are not part of humanity, because you are not humane.
Re:Health care, what health care? (Score:3, Insightful)
Don't be a closed minded fool and rule out alternative therapies, like I did for too long.
I always love how skeptics are accused of being closed minded, when all they really want is quality evidence. Most skeptics would readily embrace any medical treatment if there was sufficient, and good, evidence (i.e., the trend in the literature showed an affect above that of random noise). Unfortunately there is no "alternative" modality which proffers any decent evidence. In reality, the true believer is the most closed minded, for they are willing to accept the bogus claims of quacks on face value, rather than exercise their critical faculties and rely on more than anecdote.
Re:Insurance and Socialism (Score:1, Insightful)
So the more information your insurer has about you, the more each person is bearing his own risk
And the more they push it, the more the customers realize they're being ripped off. If I'm bearing my own risk, what the hell am I paying the CEO and the accountants for?
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.
Re:Health care, what health care? (Score:2, Insightful)
Herbs contain active compounds. If you have a herb that treats a disease, then you fraction the herb, and test the compounds you isolate on either live cells, or in a biochemical assay to determine if they have an effect.
This is exactly how many drugs are found. Artemisinin is the most recent one I can think of.
You decide what evidence you need before you even start to work.
Re:Doctors and Hospitals? (Score:3, Insightful)
And on slashdot, the insane sometimes get modded Insightful too!!