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."
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.
mod parent up (Score:2, Interesting)
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.
Re:Health care, what health care? (Score:2, Interesting)
To play devil's advocate, why should those of us with good health have to pay extra for your problems? We still need heath insurance in case an accident happens (if we develop a condition, then we would be in the 'bad' health boat with you), but paying higher rates because 80% of the population has more problems (or visits the doctor more frequently because they think they do) isn't exactly fair either.
This is a very complex issue that I don't even remotely pretend to have the answer to, and US helth costs are quite high for a variety of reasons and something needs done about it. I just want to make sure both sides of the coin get presented.
And this health score thing is definately NOT the answer. Even people in good health would really rather not let additional people know they had a vasectemy, eh?
your presciption drug history is also for sale (Score:2, Interesting)
Just a week ago BusinessWeek had a piece about health care insurance companies buying your prescription drug history onto which they base your insurance premium.
http://www.businessweek.com/magazine/content/08_31/b4094000643943.htm [businessweek.com]
Health care probably needs more an element of solidarity. Insurance is a business and as such it is legitimate for them to aspire for higher profits. Cynically, it is also legitimate for an insurance company to deny services to higher risk individuals. It is legitimate for a business but it points to deep deficiencies in how health care finances are set up in US.
In contrast, Germany's system (and probably others in Europe) has an element of solidarity. Healthier people subsidize sicker people. American system is an insurance, set up for calamity but actually used as pre-paid service.
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.
Re:oh gee what a surprise (Score:1, Interesting)
Right, and if you want prescription drugs just drive down to Mexico or up to Canada and get them for 10% of the price. That's the reason most people visit the doc anyway.....
I see those cheap minute clinics in pharmacies really taking off. Why do you think CVS and Walgreens put up so many stores? They intend to have clinics in there, for people to get diagnosed for common illness, like colds, lung and ear infections, warts, etc, that typically involve only medication and little if any actual medical work.
If it's only $25 bucks plus your prescription costs, why would you even need insurance? For catastrophes, and in that case it is legitimate for them to know your claim history. However, they don't need to know the details, just as a credit report doesn't list details. A credit report just says "you have this balance, this monthly payment, here's your payment history". Likewise a medical report could have the dollar amount of claims, whether or not they were paid, etc. It's not important what the actual medical care was to the insurance company, but rather how MUCH was it.
That's where I see medical insurance going wrong. They are trying to determine medical necessity and they aren't "on the ground" with the patient. What they should be concerned about is costs, NOT what the docs are doing. You yourself should be concerned what the doc is doing, and questioning if they are over-charging.
I have been overcharged on numerous occasions and if you ask them to explain, usually they blame the insurance for not paying. A lot of times the people at the doctor who are submitting the claims do it incorrectly. It pays to know this stuff yourself, so you can make a logical and factual argument.
Read more about the 1500 and UB04 forms if you can find it. A lot of these people get into "medical billing" right out of high school and have NO CLUE what they are doing. If you care about your health at all, you should have a lot of knowledge about this process. Unfortunately, a lot of it is not written out, and has never been examined publically by the media.
But, get this, the providers NEGOTIATE RATES with the HMOs and PPOs so you will end up paying more FOR THE SAME SERVICE if you pay cash. Then the difference is actually "written off" and the company gets a tax break for charging "less".
It's really an amazing cluster-f*ck; I wouldn't worry about it. Get an HSA/MSA as soon as you can--it's pre-tax AND you never pay taxes on the interest (only the principal you deposit) if you use it for medical expenses. And you will.
Re:Health care, what health care? (Score:2, Interesting)
Re:HIPPA (Score:3, Interesting)
And the grantparent-references wikipedia seems to state the HIPAA just makes them give you their privacy statement, but doesn't seem to force them to have a privacy policy that excludes sharing info.
I don't know if it's standard practice everywhere, but my mom works in the radiology department of a hospital and they're explicitly forbidden to give out any information to anyone who doesn't need to know. That is, if you're getting an x-ray, the x-ray tech, the supervising doctor and the doctor who ordered it (along with necessary staff like the secretaries that handle everything) are the only ones allowed to see anything, barring something like a court order. There have been people reprimanded (with a 3 strikes policy) for simply saying to another staffer "oh, did you see so and so was in and has X?"
McCain wants the market to help insurance costs, but it never will, because it's much cheaper for insurance companies to simply avoid insuring sick people than try to drive down costs. Obama has all but dropped healthcare as an issue, and wanted to let people opt out anyway.
I'm a single male without kids, 31 and in great health. I dropped my insurance provider back in 2005 when the 3 month premium went from $900 to $1400 in one fell swoop due to new state mandates on what the insurance company has to provide.
I don't want a package with all the frills, all I want is something to cover catastrophic needs. I can't buy it. New York State refuses to let me have it. I either need to pay for things like child birth, which I obviously have no anatomy to participate in and thus will never require, or else pay directly out of my pocket for everything. I've spent a grand total of $112 on my health care, and didn't miss out on anything, compared to the ~$24,000 I've saved in premiums. I'd gladly pay $200 a month for catastrophic care to cover any accidents, sudden problems like a cardiac arrest, etc, but the state won't let me... probably because they get to count me as a member of the uninsured, so they can leverage it to try to create a socialized system where they control everything.
It's worth noting that the whole HMO industry was created by an act of Congress introduced by Ted Kennedy as a freshman Senator looking to make his mark in 1973 as a response to regular people suddenly being left out of health care after the creation of Medicare/Medicaid increased demand and drove up costs. Government created the situation by interfering in the market, they deliberately keep the market from correcting itself by preventing companies from providing the plans people want, and their "solution" is to allow the government full control. I'll pass, thanks.
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.
It could be worse (Score:3, Interesting)
While it is popular to slag American health care, it is also vastly superior in terms of medical results across the population by a wide range of metrics. Take cancer survival rates, where the U.S. has long been the best in the world, as once again confirmed in a recent Lancet Oncology study:
"American men have a five-year survival rate of 66 percent -- compared to only 47 percent for European men." (http://www.ncpa.org/pub/ba/ba596/)
That is no small difference -- almost 20 points! -- in medical outcomes for one of the leading causes of death in the industrialized world, and a lot of other medical metrics look like this. For all the talk of preventative medicine not being available to Americans, they are actually more likely to receive it than in other industrialized countries in many cases. There is a disconnect between popular perception and the medical literature.
Clearly insurance companies are accidentally doing something right, though perhaps because dead people do not pay premiums. However, this is less of an endorsement of the current byzantine system and more a recognition that we do not want to throw out the baby with the bathwater.
Re:Health care, what health care? (Score:3, Interesting)
>No, in theory, you can choose to not sign it, and go somewhere else. (however, pretty much everywere requires it).
Indeed they do not. They will allow you to sign, they will present it as though it is routine, and they will accept it.
They will not require it. And if they push for it hard enough, it can lead to bankrupting civil fines, prison time for the executives, and restitution to the victims.
It is much easier to challenge authority, especially when it comes to confidentiality issues in healthcare, than many people seem to believe.
Have you had a different experience? My employer and my insurance (through my employer) are entirely separate, disinterested parties. My insurer has never asked for any kind of disclosure, nor asked for any access to my medical history, and to the contrary, has made the policy on privacy and disclosure very clear.
Re:Natural selection is unjust (Score:3, Interesting)
You know what really "weakens our gene pool"? Allowing the children of the rich to inherit money or positions of power. It stifles innovation and clogs the top spots so the serfs don't even try to excel. The only solution is shooting the little snots when they reach, say, 16.
At a minimum, these are the first kids we should send to Iraq, et seq.
Re:Health care, what health care? (Score:2, Interesting)
Milton Friedman is pretty smart. I am guessing smarter than you!
Why does anyone need to go to school for 8 years to learn to operate and suture.
Re:Health care, what health care? (Score:1, Interesting)
It may be amusing to pass around FUD, but in a case like this one it is no laughing matter. Do yourself a favor and learn the truth about health care issues if you plan to speak on them, otherwise you are simply a part of the problem. I only posted what I did out of a genuine desire to help others who may have endured the kind of horrific suffering I did. If you prefer to believe something else, fine. But don't preach about things you don't understand.
Its not Gambling (Score:3, Interesting)
I am not an Actuary... but my first programming job (COBOL!) was for a health insurer.
From the American Academy of Actuaries:
Principles of Insurance -- Gambling vs. Insurance
- Gambling creates a risk that did not previously exist
- Insurance transfers the financial consequences of an existing risk for a known dollar amount (premium)
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...
Re:Its not Gambling (Score:2, Interesting)
Semantics. Ask any underwriter. We gamble.
I will grant that traditionally there has been the concept of an "insurable interest." The hair between insurance and gambling was split by saying you couldn't insure a property or a life unless you had an insurable interest. So, for example, I couldn't buy a policy on my neighbor's house just to speculate because that was considered against public policy (aside from the moral hazard issues).
But that concept is harder to apply to newer lines of insurance. Take credit default swaps. You can buy CDS "insurance" against default on bonds you don't own. Sounds like a good way to speculate, eh? That example makes the reality more obvious, but it doesn't have to be so clear cut. If you're playing with probabilities, you're gambling. You're making a bet that your view of the future will be at least close to the actual future experience on your book (yes, we call them our books, we're just bookies) if you place enough bets (law of large numbers). Of course, as we humans keep learning and forgetting over and over again, the law of large numbers doesn't work so well when policies are correlated, but that's a whole 'nother story. So, yes, insurance is gambling. The Academy of Actuaries can spout whatever nonsense they want to justify or prettify what they do (which is not quite but very close to pulling numbers from thin air). Reserves for insurance companies are plug numbers. They decide what they want their profit to be, then figure out the required change in reserves based on that. The actuaries, whether they know it or not (the higher-level ones do) are just backing into those numbers. Later, when actual results are known, the differences are trued up and taken in a big bath.
Any sort of gamble, if it offsets an exposure you already have, can be considered risk transfer or hedging. If you're a pro athlete, you could make an argument that betting against your team is the financially prudent thing to do. It offsets your long exposure, similar to an exec with stock options buying puts. But you probably wouldn't get very far with that argument. Some types of speculation/risk transfer/whatever you want to call it make sense for both insured and underwriter; some don't. My opinion is that most of modern risk management is a scam and a massive waste of resources. All contracts total up to a a zero-sum game. Compensation costs and transaction costs are huge. Models are inductive and woefully inadequate compared to a thinking, skeptical human brain seeking out trend reversals and seeking to protect against truly catastrophic, goal-breaking events. The athlete doesn't bet against his team because (1) we arbitrarily consider it gambling and don't allow it and, more importantly, (2) he doesn't want to transfer the risk. Duh. He's shooting for the moon. But wait... isn't that gambling? If you fail to transfer a known risk, is that gambling?
We live in a world of probabilities. Risk transfer versus gambling... mostly semantics.