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Health Insurers Are Vacuuming Up Details About Customers

193 点作者 marchenko将近 7 年前

33 条评论

a_d将近 7 年前
Whenever someone says that AI and IoT would automate insurance underwriting, I start to fret — because it very quickly starts to imply more and more data collection. This is like pre-crime but for your health. Meaning, you start paying high premiums right away because later in life you might be at a high risk for a specific condition. (I know this already happens for smoking, but that is declared on a form — not by a company sending a drone to spy on you)<p>Since this is a startup forum — I believe health insurance to be so dark and morbid (with things like companies haggling with living relatives about ventilator care) — there is got to be a better way! (I realize this is more of a lament than a constructive suggestion)
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samfisher83将近 7 年前
While its called its called Health Insurance, it should be called health care costs.<p>The US is the only 1st world country without universal healthcare. The thing is most of us already subsidize the healthcare industry. The hospital has to treat someone in an emergency if they take medicare or medicaid. A lot of times people are using the emergency room as their primary care since they can&#x27;t afford primary care. The hospital increases the rates it charges everyone else to cover this.<p>You can use data to predict who is going to be more sick and charge them more. However do you want them to die or suffer. I wouldn&#x27;t. So why not try to fix the big problem instead of all these little ones about data misuse and just cover everyone since you are paying for them anyway.
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FireBeyond将近 7 年前
&gt; Insurers contend they use the information to spot health issues in their clients — and flag them so they get services they need.<p>Horse shit. And I say that as someone who writes claims management software for the healthcare industry.<p>I challenge ANY health insurer to provide examples of this. Of course, they won&#x27;t, because they&#x27;ll cite &quot;patient confidentiality&quot;, but that just doesn&#x27;t happen.<p>They&#x27;ve wanted to do this for years, though, and try to. Requests to be able mine claim data for familial predispositions to diseases was one that we fended off multiple times.
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turc1656将近 7 年前
<i>&quot;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.&quot;</i><p>The only way they can do this <i>and</i> link it to you as an individual is if we have all been lied to about how everything is &quot;anonymized&quot; data being sent between the data brokers and sold to corporations. I&#x27;ve always assumed that the whole narrative about all this data being anonymized was complete and utter bullshit.<p>Now we know with certainty.
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1996将近 7 年前
&gt; The company, owned by the massive UnitedHealth Group, has collected the medical diagnoses, tests, prescriptions, costs and socioeconomic data of 150 million Americans going back to 1993<p>I think they just use their point of sales (primary care, etc) to collect data from the client and use it against the client. I know because I used to be in a very similar line of business.<p>It is easy because clients give you a permanent unique id for payment purposes (ssn), or other unique id (phone numbers) that varies with time (now less with people porting their number). Of course, the point of sale has a list of previous items, even from competitors (medical history) but that has become harder to use, due to laws. Still, most places ask for &quot;emergency contact&quot;, which you can use to build a social network. Sick people cluster together. I don&#x27;t know why, it just happens, and it is a good workaround.<p>Of course, you need enough data, but it is then a matter of scale (if you have 75% of the market, you have seen everyone in a county at least once) and trade (buy the same data from your competitors).<p>Personally, due to experience, I prefer to forego insurance and get my healthcare abroad. Better prices than paying deductibles, better services. But I can not recommend that for everyone.<p>Still this is a dirty business, and I strongly recommend to adopt basic opsec precautions if you get healthcare in the US: never give your ssn, give a phone number that is not used for anything else even better if it is prepaid so not linked to a ssn, never ever give an emergency contact, only list medical conditions that will not cause you legal issues.
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dhimes将近 7 年前
Exactly why I won&#x27;t do those genetic-sample tests for &quot;ancestry&quot; or anything else. Eventually, those data will be sold, even if the entire company is sold with it. Eventually, we will be much better at decoding the DNA for predispositions to medical problems like heart disease, diabetes, alzheimers, and so on.<p>That information will also be used against our kids and maybe our other relatives even if they don&#x27;t undergo the testing.
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jesseryoung将近 7 年前
Heard about this article on NPR this morning. Thought the concern was valid but a little on the alarmist end of things.<p>Most of the data they need to know if you are going to be an expensive subscriber or a cheap one you&#x27;re required to give them directly: Your age, your gender, your home address and the list of services you received at your doctor&#x27;s visits that they were billed for.<p>Both healthcare providers and insurance providers know that the most efficient way to lower your healthcare costs is to get the patient to go to preventive care visits and keep them out of the ER. It doesn&#x27;t matter how much money you give them each month, if they can prevent you from going to the doctor all together it&#x27;s 100% (roughly) profit.
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hirundo将近 7 年前
&gt; But patient advocates are skeptical health insurers have altruistic designs on people’s personal information.<p>It&#x27;s funny that the article felt this needed to be said. Just how would an altruistic insurance company have survived in such a competitive market?<p>I think I learned the insurance business model early in life. I lived near a horse race track, and used to collect the programs and assemble giant (paper) spreadsheets with various data on horses and their win&#x2F;loss records. Does the jockey make a big difference? Does the wetness of the track? I would have used any measure that gave me an edge in betting, with zero &quot;altruistic&quot; regard for the horse, its owners, or anyone else but me. You know, like an insurance company.<p>It turned out that there was a datum that significantly improved my odds, and converted me from a regular loser to an irregular net winner. And it didn&#x27;t come from a program. I figured out that I could just watch the horses as they paraded to the starting gate, pick the one that I thought looked like it wanted to win, and could, and ran to place a bet on it before the race started. Far from perfect obviously, and I didn&#x27;t win big, but I started winning more than losing.<p>I&#x27;d bet that insurance companies wish they could do something similar: Have experienced medical underwriters examine and interview potential customers and then make gut level decisions, then judge more by underwriter stats than patient stats.<p>But that approach seems to be increasingly prohibited, so they make do with what data they can get. It&#x27;s hard to find that surprising, unless somehow you&#x27;ve confused &quot;insurance&quot; and &quot;altruism&quot; to be related terms.
stakhanov将近 7 年前
I think there&#x27;s something to be said IN FAVOR of the notion that person A&#x27;s health risks don&#x27;t trade off against person B&#x27;s health risks at a 1:1 rate.<p>The crucial thing however, in a data protection sense, is that there are too many people who don&#x27;t realize the implications of giving away data about themselves. A shopper signing up for a loyalty card scheme in a grocery store might sign a blanket waiver allowing the scheme operator to pass the data on to whoever they please to be used in whatever way they want, without thinking about the possibility that it may end up in places where it won&#x27;t serve their best interests.<p>So there should be something similar here to health warning on cigarettes. Kind of like &quot;Warning: Signing up for this loyalty card may make you uninsurable.&quot;<p>Also, I think there should be legal infrastructure in place to ensure that there are certain rights that you can&#x27;t sign away as part of a contract that, in practice, you don&#x27;t have the option not to sign (like Google&#x27;s general terms &amp; conditions).
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clumsysmurf将近 7 年前
A recent-ish book that talks a little about this (surprised the article did not mention QuintilesIMS):<p>&quot;Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records&quot;<p><a href="https:&#x2F;&#x2F;www.amazon.com&#x2F;Our-Bodies-Data-Companies-Billions&#x2F;dp&#x2F;0807059021" rel="nofollow">https:&#x2F;&#x2F;www.amazon.com&#x2F;Our-Bodies-Data-Companies-Billions&#x2F;dp...</a>
ohazi将近 7 年前
Isn&#x27;t this super illegal? Who are the lawyers at these companies who are signing off on these projects?
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mnm1将近 7 年前
I wouldn&#x27;t be surprised if people are denied care and left to die due to exorbitant prices based on random, undoubtedly wrong algorithms. Here&#x27;s where the cost of personal data really becomes huge, at in life or death. Insurers have played god like this since their inception and nothing is going stop them from making more money by shutting out anyone who is a threat to their bottom line. We&#x27;ve only had a law that prevents discrimination on pre-existing conditions for a few years. I&#x27;m sure the insurance companies will lobby hard to get rid of it so they can let the very sick suffer and die rather than be forced to pay for their healthcare. This is an end run to that goal in case lobbying to murder people legally fails.
staticautomatic将近 7 年前
I buy data from LexisNexis. AMA.
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kyrieeschaton将近 7 年前
This is complete nonsense and entirely speculative. They admit as much when they inform you they can find no evidence of any individual underwriting decision being made based on this data, which the companies strongly deny, and would be illegal. Insurance is highly regulated, both on a state and federal level. Pricing algorithms and variables are public in most states (albeit obfuscated).<p>What does seem to be happening is the companies are using third party data providers for marketing and market analysis, as literally every other company from your local HVAC guy to McDonald&#x27;s does.
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stakhanov将近 7 年前
There are certain dimensions that it makes a lot of sense to discriminate around: For example, if you&#x27;re a roofing contractor, I really think you SHOULD be paying higher health insurance rates than I do, as an office worker. You&#x27;ll just price it into whatever you charge to make roofs, which means the price of a house will start getting closer to what it actually costs the economy. Since I rent, I would otherwise end up subsidizing other people to build or buy houses for themselves, and I don&#x27;t think that&#x27;s how an economy should work.
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jschwartzi将近 7 年前
Considering how inaccurate some of Fitbit&#x27;s measurements are( resting heart rate, for example ), I would sue my insurer if I found out they were using that data. My doctor shouldn&#x27;t be using it either.<p>RHR is normally measured within the first 30 minutes of waking while lying in bed, which is something Fitbit can determine. What I&#x27;ve noticed is that on days when my RHR that I&#x27;ve measured using their monitor after waking is 54 BPM, they report up to 61 BPM. There&#x27;s a very long chain on their forum about how inaccurate the measurement is.
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dawhizkid将近 7 年前
Most people who work for medium or large sized companies in the US are working for companies that are self-insured, meaning your company is taking on all the risk, so if anything your own employer is incentivized to do this and not the insurance company itself.<p>When I first heard of the Amazon&#x2F;JP Morgan&#x2F;BH heathcare initiative my thought on what that company would actually do is surveillance on their collective millions of employees to better predict if they are prone to disease and use predictive analytics to lower their own claims cost.
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shiburizu将近 7 年前
As a college student I work taking phone calls for a biz that attends entirely US customer base, my colleague asked why our clients were often leery about sharing things like their photo ID with us, despite being customers with us for many years.<p>As one of the few who lived in the US amongst us I&#x27;d have to say it might have to do with how much companies involved in risk assessment really know about you and how much of it goes to the government -- they have no interest in having us show up in their credit or what have you.
exabrial将近 7 年前
That&#x27;s ok with me? I wish it were like life insurance where they can ask you anything and then you get that rate locked down for the term.<p>I also actually liked the proposal in Congress that got rejected: allow people to make their own groups. So if you are a person who likes to work out and get your fat levels tested once a year, you could join a group of like minded individuals and insurance companies would bid to insure your group.
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u801e将近 7 年前
My employer used to provide additional funding in employees&#x27; HSAs (Health Savings Accounts) if they participated in a health screening. The health screening involved measuring height, weight, blood sugar, cholesterol and other lipids. There was also a questionnaire about lifestyle choices related to health in terms of how physically active you were, smoking, drinking, etc.
madengr将近 7 年前
I&#x27;ve been saying this for years. That discount card you use at the grocery store tells your insurance company how much bacon you eat.
bawana将近 7 年前
LexisNexis said there is no web page to submit a request for info. I tried their chat option and that person said I had to call. 888.497.0011 After 30 min on hold I spoke to someone. They wanted my personal info including SS# and Drivers license# They saifd they would mail out the info in 10 days.<p>I guess this &#x27;personal touch&#x27; is a security measure.
DenisM将近 7 年前
In WA state to price out insurance all you need to provide is your age, gender, and smoking status. I don&#x27;t see how insurance companies can use any other information in setting the price?
394549将近 7 年前
Has anyone done any research to map out the relationships between the different data brokers? E.g. who has what data to sell, and who&#x27;s selling what data to who?
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deegles将近 7 年前
To play devil&#x27;s advocate, I think data should be used to manage rates for things that a consumer can reasonably change, like diet&#x2F;exercise. Smokers are already penalized.<p>e.g. &quot;Our data indicates your average sugar consumption is over Xg per day over the last 6 months. If you commit to reducing this to Yg per day over the next 6 months, your insurance rate will drop by 10%. Otherwise rates will increase by 20% to cover your increased risk for diabetes, heart disease, and stroke.&quot;
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smileysteve将近 7 年前
&gt; And it could raise your rates<p>And it could lower your rates.
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cutler将近 7 年前
Aren&#x27;t there obvious GDPR issues with this unless you&#x27;re limiting the analysis to US insurers?
Cieplak将近 7 年前
Just clicked for me why “healthcare” companies spend so much money on hard discs and data storage.
mixmastamyk将近 7 年前
We desperately need some privacy legislation in the US, years ago.
adrianhel将近 7 年前
Free&#x27;ish healthcare is the only way...
jadedhacker将近 7 年前
Whelp, just one more reason why we need Medicare for All. There&#x27;s no need to enable these people whose business is to find ways to deny people healthcare, just eliminate their industry completely and save money in the process too.
mtgx将近 7 年前
This will ensure the death of the private healthcare system. It won&#x27;t happen overnight, but eventually the private&#x2F;hybrid healthcare system will have <i>no</i> redeeming qualities other than to extract as much profit as possible out of anyone&#x27;s health issues. That&#x27;s when no one will support it anymore (except the politicians taking bribes to support it).
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gascan将近 7 年前
There are surely privacy concerns, but it seems like the evolution of all insurance markets trend towards better risk profiling.<p>This is a good thing IMO. The point of insurance is to <i>pool</i> risk, not get your high risk subsidized by some sap with low risk. The better insurance companies can profile risk, the more fair the pools.<p>Then if we want subsidies for high risk individuals, we can work on that separately.