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Danger, danger: heavily regulated waters ahead! Remember these words well: "This statement has not been evaluated by the Food and Drug Administration. This prod

Danger, danger: heavily regulated waters ahead! Remember these words well: "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

clort 9y ago
“And then you’d guide them through the appropriate final diagnosis, which would be through a blood pressure cuff and then treatment.” so the intention is that this would generate a warning to go to your doctor?
- brandonb 9y ago
  It's a little more nuanced—the exact next step depends on the health condition, co-morbidities, previous tests you've taken, which interventions are covered by your insurance, etc. Think this diagram of how Slack decides to send a notification, but for health: https://twitter.com/codevisuals/status/838881724016787457?lang=en https://twitter.com/codevisuals/status/838881724016787457?la... :)
omginternets 9y ago
I came to say "danger, danger" but for another reason. I think a whole generation of fitbit users are going to be horrified when their insurance premiums go up based on data that was purchased by insurers. If Apple watch starts making a health play, I don't see why it would be any different.
- bertil 9y ago
  Apple has been aggressively branding as the company that does not need to sell your data because their margins on hardware allow them to. It might not always be the case but they can future-proof that claim by keeping that data on your device or protect it using differential privacy. What might happen if health plans become habitually based on tracking (which I expect will be the case) is that having an Apple watch (or nothing) will be considered suspicious and charged a premium.
  - omginternets 9y ago
    Typical PR spin-doctored hogwash. They don't need it, arguably, but they sure as hell want it, as evidenced by: 1. The extremely lucrative market of personal data 2. Their continued collection of such personal data
    - dkonofalski 9y ago
      That's nonsense. The market being lucrative doesn't provide any evidence for your claim and your second point is completely false. Apple doesn't collect any of this data. It's stored completely on the device itself and all processing of health data is done on the device.
    - bertil 9y ago
      The lucrative market is for advertising placement which demands that you don’t sell the data that you have (otherwise the targetting that you provide is no longer unique). Some company do sell the data they have behind the scene (Experian is one of them) but there are few buyers, those buyers can tell their data is of bad quality and they have competitors with similar data, so it is hardly lucrative. As far as I can tell, Apple’s efforts to make articles readable by removing JS-embeds a while ago, encrypt iMessage, fight the FBI about weakening their security or to fight against cross-site cookies more recently, all that seems both real and representative of how they value their product. I have not seen crowds ask for differential privacy and yet they spend precious time in their recent keynotes about it.
- criddell 9y ago
  And those that can't provide that data will see even greater hikes. Insurers hate uncertainty.
- wikibob 9y ago
  Vitality Health has already started down this path [0], and are doing a fantastic job habituating people to accepting sharing this data. They have borrowed an identical copy of the auto insurance industry playbook [1]. Start out by offering "discounts" in exchange for tracking, and then slowly the cost of the insurance ramps up, unless you have the discount. [0] https://www.macrumors.com/2017/10/24/vitality-uk-free-apple-watch-offer/ https://www.macrumors.com/2017/10/24/vitality-uk-free-apple-... [1] https://www.progressive.com/auto/discounts/snapshot/ https://www.progressive.com/auto/discounts/snapshot/
- brlewis 9y ago
  I work for Fitbit, but I don't speak for Fitbit. However, this page does speak for Fitbit: https://www.fitbit.com/legal/privacy https://www.fitbit.com/legal/privacy For insurers to purchase data on Fitbit users, they'll have to purchase it from the users themselves.
  - maxerickson 9y ago
    Is there a legal structure in place that would prevent a new owner from rewriting the privacy policy and doing whatever the hell they wanted?
    - brlewis 9y ago
      I'm not a lawyer. In high school I took a class that covered some aspects of contract law. Want my speculation? I do know something about the financial incentives, though. Fitbit's users are its customers. Insurers and employers are a small part of revenue. The people Fitbit needs to keep happy are users.
      - maxerickson 9y ago
        No need to speculate. Of course it would be reassuring if there was something in the privacy policy that directly addressed the question. There is stuff like If we are involved in a merger, acquisition, or sale of assets, we will continue to take measures to protect the confidentiality of personal information and give affected users notice before transferring any personal information to a new entity. But "measures" and "notice" are pretty weak sauce if they can result in the new entity still doing whatever it wants with the data. How about an explicit opt in policy that would actually impact the sale value of the data?
        brlewis 9y ago
        IMO something that specifically addressed an acquisition wouldn't add anything. Either Fitbit's acquirer is contractually bound by the privacy policy or it isn't. If it isn't, then the specifics about acquisition don't add anything. If it is, then "We pledge...to never sell your personal data" is enough. FWIW, Fitbit's publicly traded stock is non-voting, so hostile takeover is not possible.
- maxerickson 9y ago
  Current law in the US for individual coverage is that they can vary pricing based on age and tobacco use and can't deny coverage to anyone. Short term regressions to that seem likely enough. Long term I think you have to consider whether we even stick to anything resembling the model we have now (with mandatory private insurance being something like the baseline expectation).
- brandonb 9y ago
  (I'm a study author and worked on HealthCare.gov rescue team) The good news is you're protected by the law. Under the Affordable Care Act, insurers can only vary your rate based on your age, location, and whether you smoke. They can't take into account prior health conditions or biomarkers, including novel biomarkers measured on wearables. Every major Republican "repeal & replace" bill has preserved this part of the law, called "rating factor limitations", although sometimes they vary the constants. For example, the Paul Ryan plan let insurers charge the elderly 5x more than the young, compared to the current law of 3x, but otherwise preserved the rule that insurers can only vary rate based on age, location, and whether you smoke. What insurers can do is offer you a 30% (maximum) premium rebate for taking healthy actions, like going for a run, enrolling in a diabetes prevention program, or getting your blood pressure checked. But they can't tie the rebate to the outcome of the test (health status), only your participation. This is a good point, though, and shows a case where regulation helps technology have a positive impact. If people fear their insurance premiums will go up, they'll avoid all forms of diagnosis, not just Apple Watch.
  - moe 9y ago
    They can't take into account prior health conditions or biomarkers, including novel biomarkers measured on wearables. Yet.
- 013a 9y ago
  If you don't see any reason why it would be different, you're not looking. Apple is aggressively privacy focused. Apple is the most valuable company in the world, and none of that money has come from selling users' data despite the fact that they're sitting on probably the second most valuable corporate dataset in the world (behind Google). And while Fitbit might also be very clear about their users' privacy, they don't share one quality Apple has: a virtual guarantee that they won't go under new ownership in the near future.

clort 9y ago

“And then you’d guide them through the appropriate final diagnosis, which would be through a blood pressure cuff and then treatment.” so the intention is that this would generate a warning to go to your doctor?

brandonb 9y ago
It's a little more nuanced—the exact next step depends on the health condition, co-morbidities, previous tests you've taken, which interventions are covered by your insurance, etc. Think this diagram of how Slack decides to send a notification, but for health: https://twitter.com/codevisuals/status/838881724016787457?lang=en https://twitter.com/codevisuals/status/838881724016787457?la... :)

omginternets 9y ago

I came to say "danger, danger" but for another reason. I think a whole generation of fitbit users are going to be horrified when their insurance premiums go up based on data that was purchased by insurers. If Apple watch starts making a health play, I don't see why it would be any different.

bertil 9y ago
Apple has been aggressively branding as the company that does not need to sell your data because their margins on hardware allow them to. It might not always be the case but they can future-proof that claim by keeping that data on your device or protect it using differential privacy. What might happen if health plans become habitually based on tracking (which I expect will be the case) is that having an Apple watch (or nothing) will be considered suspicious and charged a premium.
- omginternets 9y ago
  Typical PR spin-doctored hogwash. They don't need it, arguably, but they sure as hell want it, as evidenced by: 1. The extremely lucrative market of personal data 2. Their continued collection of such personal data
  - dkonofalski 9y ago
    That's nonsense. The market being lucrative doesn't provide any evidence for your claim and your second point is completely false. Apple doesn't collect any of this data. It's stored completely on the device itself and all processing of health data is done on the device.
  - bertil 9y ago
    The lucrative market is for advertising placement which demands that you don’t sell the data that you have (otherwise the targetting that you provide is no longer unique). Some company do sell the data they have behind the scene (Experian is one of them) but there are few buyers, those buyers can tell their data is of bad quality and they have competitors with similar data, so it is hardly lucrative. As far as I can tell, Apple’s efforts to make articles readable by removing JS-embeds a while ago, encrypt iMessage, fight the FBI about weakening their security or to fight against cross-site cookies more recently, all that seems both real and representative of how they value their product. I have not seen crowds ask for differential privacy and yet they spend precious time in their recent keynotes about it.
criddell 9y ago
And those that can't provide that data will see even greater hikes. Insurers hate uncertainty.
wikibob 9y ago
Vitality Health has already started down this path [0], and are doing a fantastic job habituating people to accepting sharing this data. They have borrowed an identical copy of the auto insurance industry playbook [1]. Start out by offering "discounts" in exchange for tracking, and then slowly the cost of the insurance ramps up, unless you have the discount. [0] https://www.macrumors.com/2017/10/24/vitality-uk-free-apple-watch-offer/ https://www.macrumors.com/2017/10/24/vitality-uk-free-apple-... [1] https://www.progressive.com/auto/discounts/snapshot/ https://www.progressive.com/auto/discounts/snapshot/
brlewis 9y ago
I work for Fitbit, but I don't speak for Fitbit. However, this page does speak for Fitbit: https://www.fitbit.com/legal/privacy https://www.fitbit.com/legal/privacy For insurers to purchase data on Fitbit users, they'll have to purchase it from the users themselves.
- maxerickson 9y ago
  Is there a legal structure in place that would prevent a new owner from rewriting the privacy policy and doing whatever the hell they wanted?
  - brlewis 9y ago
    I'm not a lawyer. In high school I took a class that covered some aspects of contract law. Want my speculation? I do know something about the financial incentives, though. Fitbit's users are its customers. Insurers and employers are a small part of revenue. The people Fitbit needs to keep happy are users.
    - maxerickson 9y ago
      No need to speculate. Of course it would be reassuring if there was something in the privacy policy that directly addressed the question. There is stuff like If we are involved in a merger, acquisition, or sale of assets, we will continue to take measures to protect the confidentiality of personal information and give affected users notice before transferring any personal information to a new entity. But "measures" and "notice" are pretty weak sauce if they can result in the new entity still doing whatever it wants with the data. How about an explicit opt in policy that would actually impact the sale value of the data?
      - brlewis 9y ago
        IMO something that specifically addressed an acquisition wouldn't add anything. Either Fitbit's acquirer is contractually bound by the privacy policy or it isn't. If it isn't, then the specifics about acquisition don't add anything. If it is, then "We pledge...to never sell your personal data" is enough. FWIW, Fitbit's publicly traded stock is non-voting, so hostile takeover is not possible.
maxerickson 9y ago
Current law in the US for individual coverage is that they can vary pricing based on age and tobacco use and can't deny coverage to anyone. Short term regressions to that seem likely enough. Long term I think you have to consider whether we even stick to anything resembling the model we have now (with mandatory private insurance being something like the baseline expectation).
brandonb 9y ago
(I'm a study author and worked on HealthCare.gov rescue team) The good news is you're protected by the law. Under the Affordable Care Act, insurers can only vary your rate based on your age, location, and whether you smoke. They can't take into account prior health conditions or biomarkers, including novel biomarkers measured on wearables. Every major Republican "repeal & replace" bill has preserved this part of the law, called "rating factor limitations", although sometimes they vary the constants. For example, the Paul Ryan plan let insurers charge the elderly 5x more than the young, compared to the current law of 3x, but otherwise preserved the rule that insurers can only vary rate based on age, location, and whether you smoke. What insurers can do is offer you a 30% (maximum) premium rebate for taking healthy actions, like going for a run, enrolling in a diabetes prevention program, or getting your blood pressure checked. But they can't tie the rebate to the outcome of the test (health status), only your participation. This is a good point, though, and shows a case where regulation helps technology have a positive impact. If people fear their insurance premiums will go up, they'll avoid all forms of diagnosis, not just Apple Watch.
- moe 9y ago
  They can't take into account prior health conditions or biomarkers, including novel biomarkers measured on wearables. Yet.
013a 9y ago
If you don't see any reason why it would be different, you're not looking. Apple is aggressively privacy focused. Apple is the most valuable company in the world, and none of that money has come from selling users' data despite the fact that they're sitting on probably the second most valuable corporate dataset in the world (behind Google). And while Fitbit might also be very clear about their users' privacy, they don't share one quality Apple has: a virtual guarantee that they won't go under new ownership in the near future.