4 ms·

To play devil's advocate, I think data should be used to manage rates for things that a consumer can reasonably change, like diet/exercise. Smokers are already

To play devil's advocate, I think data should be used to manage rates for things that a consumer can reasonably change, like diet/exercise. Smokers are already penalized. e.g. "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."

dsfyu404ed 8y ago
That'll end well. "our data indicates you're probably a women and therefore have an above average risk of having kids, if you commit to gender reassignment surgery your insurance rate will drop by 30%" Or if that's not allowed they'll just use other things that are a rough proxy for a protected class.
jschwartzi 8y ago
On that note, my insurer helpfully put a note in my file that the doctor should tell me about being more physically active based on my BMI. When I listed everything I do, he turned to his intern and said "this is an example of how BMI doesn't tell the whole story." Then he deleted the note. So it has to be the right data and the doctor needs to be the final arbiter of whether it's meaningful or not.
supertrope 8y ago
The 2010 ACA law considers employee wellness discounts of 30% or more coercive and potentially a way to get around the ban on individual medical underwriting. While monetary incentives are powerful, people are not completely or even close to rational actors. If poor health and prematurely dying (often painfully) aren’t motivators to take care of your health, what will? Health promoting culture like teaching all kids to cook and eat healthier, encouraging fitness through less car centric infrastructure, etc. are needed to address the metabolic syndrome epidemic. Frequent reminders, small sub-goals, reinforcement, role models are probably more effective than a four figure fine for being unhealthy. Some people can overcome big problems on their own because they are committed, but once you get out into the wider population a lot of marketing, hand-holding, and gimmicks are needed to get everyone to make significant permanent change.

dsfyu404ed 8y ago

That'll end well. "our data indicates you're probably a women and therefore have an above average risk of having kids, if you commit to gender reassignment surgery your insurance rate will drop by 30%" Or if that's not allowed they'll just use other things that are a rough proxy for a protected class.

jschwartzi 8y ago

On that note, my insurer helpfully put a note in my file that the doctor should tell me about being more physically active based on my BMI. When I listed everything I do, he turned to his intern and said "this is an example of how BMI doesn't tell the whole story." Then he deleted the note. So it has to be the right data and the doctor needs to be the final arbiter of whether it's meaningful or not.

supertrope 8y ago

The 2010 ACA law considers employee wellness discounts of 30% or more coercive and potentially a way to get around the ban on individual medical underwriting. While monetary incentives are powerful, people are not completely or even close to rational actors. If poor health and prematurely dying (often painfully) aren’t motivators to take care of your health, what will? Health promoting culture like teaching all kids to cook and eat healthier, encouraging fitness through less car centric infrastructure, etc. are needed to address the metabolic syndrome epidemic. Frequent reminders, small sub-goals, reinforcement, role models are probably more effective than a four figure fine for being unhealthy. Some people can overcome big problems on their own because they are committed, but once you get out into the wider population a lot of marketing, hand-holding, and gimmicks are needed to get everyone to make significant permanent change.