8 ms·

How Do Insurance Companies Know My Health History? (2017)

fathead_glacier 8y ago
Collating a private database of health history is an extremely dangerous practice and I will just drop this article from rms which has further links to other systems [0]. The article in this post, however, is lacking an explanation of how MIB gathers the medical records. It is therefore unclear if the users gave their consent to share the information even if it was through vague fine print. On the other hand the story would be very different if the data was gathered and shared without consent and I might wonder if a legal case can be made here. [0] https://stallman.org/ancestry.html https://stallman.org/ancestry.html
- Latteland 8y ago
  That article has no sense of irony, they don't even consider that someone might not want that. How was my info sent to that MIB group? I don't want that. Can you opt out? How is this even legal?
- dvfjsdhgfv 8y ago
  It's ironic how every now and again I read a piece by RMS that I find exaggerated only to come back to it a few years later just to find he was right. Come on, offering people DNA testing only to sell it to insurance companies? That's a new low to me.
- zrail 8y ago
  When you apply for life and disability insurance you consent to two things: the insurer may collect medical data about anything you mention on the application AND any or all of that may be shared with MIB. Approval is conditional on that consent and omitting anything on the app can lead to denials in the first two years and is technically insurance fraud. So basically, if you don’t want your information in MIB don’t apply for insurance that requires a medical history.
- Spooky23 8y ago
  Your health data isn’t really private. Various third parties have real-time access to your hospital admissions and prescriptions, in some cases before your insurer. As an example, when my wife was admitted to the hospital at 8 weeks for a miscarriage that almost killed her, the level of detail provided to data brokers allowed Enfamil to Fedex a big sample box of formula to us on what would have been the due date of the baby. No consent was given or needed.
blackflame7000 8y ago
Going out on a limb here, but if they are paying the bill, don't you think they have a pretty good idea what things cost? At the end of the day there are not that many things that cost $59,324.49 at Hospital X for example. So with a little deduction you could begin to ballpark the severity of illness
denzil_correa 8y ago
Along with the GDPR, the EU also bought "Right to Explanation" for algorithmic decision making. Basically, a user has the right to ask for an explanation on an algorithmic decision. This regulation has been mostly buried in the deluge of GDPR content but it's an important shift in decision making. There's a nice paper which outlines the implications and HN too had a discussion on it couple of years ago [0, 1]. [0] https://arxiv.org/abs/1606.08813 https://arxiv.org/abs/1606.08813 [1] https://news.ycombinator.com/item?id=12048223 https://news.ycombinator.com/item?id=12048223
- emilsedgh 8y ago
  That's actually really interesting! I think it really is a good law, although it may render some things really difficult for engineers. I remember when Alphago was beating the go master, we couldn't really tell why it made certain moves. But it certain makes sense to require an explanation for things that affect us in our lives.
  - moate 8y ago
    Yea, I think showing your work is substantially more important when people's lives and finances are on the line as opposed to the thrill of victory for a go master. If you're making algos for that directly affect another human's basic needs, I think it's really important to be able to back up why the algo did what it did. I feel like you're probably opening yourself up to massive liability (regardless of region your operating in) if you can't explain to a court why your system did X to a person that resulted in them suing your company.
- gruez 8y ago
  how does this work with neural networks when the "explanation" is going to be a list of weights?
  - AstralStorm 8y ago
    You cannot then use such a network to make a questionable decision. In other words, they better be robust or you might drown in lawsuits or face a big fat one. Which is the exact result people want. We want explanations that are valid and understandable in relatively plain language, using postulate logic.
pjc50 8y ago
Rather like the old joke about a banker who will lend you an umbrella while it's sunny but wants it back when it's raining, it seems that the health insurance business thrives on trying to avoid as far as possible giving healthcare to people once they're sick.
- TeMPOraL 8y ago
  I haven't heard the original joke in full, but the way you wrote it, it very much applies - umbrellas are somewhat useful when it's sunny too, so you get some benefit from lending one. Similarly, health insurance isn't useless, but it definitely tries to not be there when needed most.
  - microcolonel 8y ago
    Well, knowing you'll need to pay (and roughly how much) kinda defeats the purpose of insurance altogether.
  - jaclaz 8y ago
    JFYI: https://quoteinvestigator.com/2011/04/07/banker-umbrella/ https://quoteinvestigator.com/2011/04/07/banker-umbrella/ I personally like the 1949 version: >Definition of a banker: A man who loans you an umbrella when the sun is shining, asks for it back at the first sprinkle of rain, and doesn’t own the umbrella in the first place.
- dsfyu404ed 8y ago
  > it seems that the health insurance business thrives on trying to avoid as far as possible giving healthcare to people once they're sick. That's not just health insurance. All insurance wants to take your money and then avoid paying in any way possible.
tinkerteller 8y ago
Tip: If you are very casual smoker and see a form asking you "Have you ever smoked?" or "Do you smoke any tobacco?" then say no. If you say yes then you will see it getting reported to your health insurance and even life insurance and your premiums will go up as if you were chain smoker.
- sitepodmatt 8y ago
  I'm not sure that's a good tip, presumably if you get lung cancer they can still detect if you are or have been a casual smoker for a non-trivial amount of time. In addition, you might put 'No' on signup and be accepted, but a lot of due diligence (uncovering your real history) is done at the time of claim i.e. they contact any past doctors and all surrounding hospitals for medical reports related to your past. Admittedly there is a lot more leeway for insurance companies in Asia to pursue their denials any way they see fit since we don't have a first world grasp of privacy or anything remotely like GDPR.
  - tinkerteller 8y ago
    Hope that's obvious. If you are going in for something related to smoking always talk to your doctor. I'm talking about simple stuff where they give you large forms on what you have. They form end up at insurance companies and your rates would reflect that.
  - Retric 8y ago
    Second hand smoke and casual smoking (one per week) are indistinguishable.
    - sitepodmatt 8y ago
      Today, maybe. Btw, a side line to the point as do qualify your defintion, other peoples'' definition of casual and very casual vary a lot, I know people that if a pack lasts more than one day they consider that casual.
      - 8y ago
dzdt 8y ago
From the article: This allows the insurance companies to keep insurance costs down for both the insured and the insurers. No! Mathematically the insurance business works the same as long as the average premiums cover the average costs for the pool. Identifying higher risk individuals and charging them more does nothing to lower the average cost as long as they continue to buy insurance. It only spreads the costs around differently. That is, unless the idea is to make the cost so high for risky patients as to force them not to participate in the pool. Which is I guess what they are saying. It does lower average premiums in the pool the only way mathematically possible, by forcing at-risk or sick patients out of coverage. This raises average costs for the original pool (from before some patients were priced out) because those patients forced out will show up later at emergency rooms with expensive problems and no coverage. But that is no longer the insurance company's problem, so who cares. Well at a society level there is no forcing people out other than death. So unless we can get enough sick people to die quickly and cheaply this system just forces higher costs on everyone. Or maybe we could just cover everyone in one national pool without keeping a secret database of everyone's health history to use against them and gouge them more?
- netcan 8y ago
  I think of it this way: Say insurers know nothing about customers, just an anonymous number. In this world they would have to charge everyone the same, the average cost of insuring a person. Everyone pays the same premium, and has all their medical bills paid. In a parallel world, insurers have perfect information. They know your medical future, not just the history. In this world, insurers will price your premium at exactly the cost of paying your medical costs. If you won't have to go to the doctor this year (this is a world where insurers know the future), you won't be charged anything. If you're going to be in a car accident, you will be charged for surgery and rehab. In world no. 2 where insurers have maximum knowledge, insurance basically doesn't exist. Insurance is exactly the same as just paying your bills directly. In world 1, insurance works fine, but a 19 y/o pays a little more than they do today and sick or elderly people pay less than in the real world. As data/information becomes more ubiquitous, we travel down this continuum.
  - 8y ago
nwatson 8y ago
The article doesn't address whether an individual can request a full report of their own records and those of their dependents from this MIB. I can get a copy of my credit report for free, same should apply here. Hmmm ... might be able to get a copy here: https://www.mib.com/request_your_record.html https://www.mib.com/request_your_record.html
retailloans 8y ago
thanks for sharing excellent post and Compare Rates for Business Loans in Chandigarh and Get Best of Deals. Get Best of EMI per Lacs on Business Loans in Chandigarh. Compare and choose from Top Business Loan providers in Chandigarh read more http://www.retailloans.in/business-loan-in-chandigarh http://www.retailloans.in/business-loan-in-chandigarh
kalekold 8y ago
In the UK, health insurance companies buy data from supermarkets like Tesco (gathered from loyalty cards) to understand your lifestyle and potential risk by viewing what you eat and drink over a period of years.
- pflanze 8y ago
  Do you have references about this?

Collating a private database of health history is an extremely dangerous practice and I will just drop this article from rms which has further links to other systems [0]. The article in this post, however, is lacking an explanation of how MIB gathers the medical records. It is therefore unclear if the users gave their consent to share the information even if it was through vague fine print. On the other hand the story would be very different if the data was gathered and shared without consent and I might wonder if a legal case can be made here. [0] https://stallman.org/ancestry.html https://stallman.org/ancestry.html

Latteland 8y ago
That article has no sense of irony, they don't even consider that someone might not want that. How was my info sent to that MIB group? I don't want that. Can you opt out? How is this even legal?
dvfjsdhgfv 8y ago
It's ironic how every now and again I read a piece by RMS that I find exaggerated only to come back to it a few years later just to find he was right. Come on, offering people DNA testing only to sell it to insurance companies? That's a new low to me.
zrail 8y ago
When you apply for life and disability insurance you consent to two things: the insurer may collect medical data about anything you mention on the application AND any or all of that may be shared with MIB. Approval is conditional on that consent and omitting anything on the app can lead to denials in the first two years and is technically insurance fraud. So basically, if you don’t want your information in MIB don’t apply for insurance that requires a medical history.
Spooky23 8y ago
Your health data isn’t really private. Various third parties have real-time access to your hospital admissions and prescriptions, in some cases before your insurer. As an example, when my wife was admitted to the hospital at 8 weeks for a miscarriage that almost killed her, the level of detail provided to data brokers allowed Enfamil to Fedex a big sample box of formula to us on what would have been the due date of the baby. No consent was given or needed.

blackflame7000 8y ago

Going out on a limb here, but if they are paying the bill, don't you think they have a pretty good idea what things cost? At the end of the day there are not that many things that cost $59,324.49 at Hospital X for example. So with a little deduction you could begin to ballpark the severity of illness

denzil_correa 8y ago

Along with the GDPR, the EU also bought "Right to Explanation" for algorithmic decision making. Basically, a user has the right to ask for an explanation on an algorithmic decision. This regulation has been mostly buried in the deluge of GDPR content but it's an important shift in decision making. There's a nice paper which outlines the implications and HN too had a discussion on it couple of years ago [0, 1]. [0] https://arxiv.org/abs/1606.08813 https://arxiv.org/abs/1606.08813 [1] https://news.ycombinator.com/item?id=12048223 https://news.ycombinator.com/item?id=12048223

emilsedgh 8y ago
That's actually really interesting! I think it really is a good law, although it may render some things really difficult for engineers. I remember when Alphago was beating the go master, we couldn't really tell why it made certain moves. But it certain makes sense to require an explanation for things that affect us in our lives.
- moate 8y ago
  Yea, I think showing your work is substantially more important when people's lives and finances are on the line as opposed to the thrill of victory for a go master. If you're making algos for that directly affect another human's basic needs, I think it's really important to be able to back up why the algo did what it did. I feel like you're probably opening yourself up to massive liability (regardless of region your operating in) if you can't explain to a court why your system did X to a person that resulted in them suing your company.
gruez 8y ago
how does this work with neural networks when the "explanation" is going to be a list of weights?
- AstralStorm 8y ago
  You cannot then use such a network to make a questionable decision. In other words, they better be robust or you might drown in lawsuits or face a big fat one. Which is the exact result people want. We want explanations that are valid and understandable in relatively plain language, using postulate logic.

pjc50 8y ago

Rather like the old joke about a banker who will lend you an umbrella while it's sunny but wants it back when it's raining, it seems that the health insurance business thrives on trying to avoid as far as possible giving healthcare to people once they're sick.

TeMPOraL 8y ago
I haven't heard the original joke in full, but the way you wrote it, it very much applies - umbrellas are somewhat useful when it's sunny too, so you get some benefit from lending one. Similarly, health insurance isn't useless, but it definitely tries to not be there when needed most.
- microcolonel 8y ago
  Well, knowing you'll need to pay (and roughly how much) kinda defeats the purpose of insurance altogether.
- jaclaz 8y ago
  JFYI: https://quoteinvestigator.com/2011/04/07/banker-umbrella/ https://quoteinvestigator.com/2011/04/07/banker-umbrella/ I personally like the 1949 version: >Definition of a banker: A man who loans you an umbrella when the sun is shining, asks for it back at the first sprinkle of rain, and doesn’t own the umbrella in the first place.
dsfyu404ed 8y ago
> it seems that the health insurance business thrives on trying to avoid as far as possible giving healthcare to people once they're sick. That's not just health insurance. All insurance wants to take your money and then avoid paying in any way possible.

tinkerteller 8y ago

Tip: If you are very casual smoker and see a form asking you "Have you ever smoked?" or "Do you smoke any tobacco?" then say no. If you say yes then you will see it getting reported to your health insurance and even life insurance and your premiums will go up as if you were chain smoker.

sitepodmatt 8y ago
I'm not sure that's a good tip, presumably if you get lung cancer they can still detect if you are or have been a casual smoker for a non-trivial amount of time. In addition, you might put 'No' on signup and be accepted, but a lot of due diligence (uncovering your real history) is done at the time of claim i.e. they contact any past doctors and all surrounding hospitals for medical reports related to your past. Admittedly there is a lot more leeway for insurance companies in Asia to pursue their denials any way they see fit since we don't have a first world grasp of privacy or anything remotely like GDPR.
- tinkerteller 8y ago
  Hope that's obvious. If you are going in for something related to smoking always talk to your doctor. I'm talking about simple stuff where they give you large forms on what you have. They form end up at insurance companies and your rates would reflect that.
- Retric 8y ago
  Second hand smoke and casual smoking (one per week) are indistinguishable.
  - sitepodmatt 8y ago
    Today, maybe. Btw, a side line to the point as do qualify your defintion, other peoples'' definition of casual and very casual vary a lot, I know people that if a pack lasts more than one day they consider that casual.
    - 8y ago

dzdt 8y ago

From the article: This allows the insurance companies to keep insurance costs down for both the insured and the insurers. No! Mathematically the insurance business works the same as long as the average premiums cover the average costs for the pool. Identifying higher risk individuals and charging them more does nothing to lower the average cost as long as they continue to buy insurance. It only spreads the costs around differently. That is, unless the idea is to make the cost so high for risky patients as to force them not to participate in the pool. Which is I guess what they are saying. It does lower average premiums in the pool the only way mathematically possible, by forcing at-risk or sick patients out of coverage. This raises average costs for the original pool (from before some patients were priced out) because those patients forced out will show up later at emergency rooms with expensive problems and no coverage. But that is no longer the insurance company's problem, so who cares. Well at a society level there is no forcing people out other than death. So unless we can get enough sick people to die quickly and cheaply this system just forces higher costs on everyone. Or maybe we could just cover everyone in one national pool without keeping a secret database of everyone's health history to use against them and gouge them more?

netcan 8y ago
I think of it this way: Say insurers know nothing about customers, just an anonymous number. In this world they would have to charge everyone the same, the average cost of insuring a person. Everyone pays the same premium, and has all their medical bills paid. In a parallel world, insurers have perfect information. They know your medical future, not just the history. In this world, insurers will price your premium at exactly the cost of paying your medical costs. If you won't have to go to the doctor this year (this is a world where insurers know the future), you won't be charged anything. If you're going to be in a car accident, you will be charged for surgery and rehab. In world no. 2 where insurers have maximum knowledge, insurance basically doesn't exist. Insurance is exactly the same as just paying your bills directly. In world 1, insurance works fine, but a 19 y/o pays a little more than they do today and sick or elderly people pay less than in the real world. As data/information becomes more ubiquitous, we travel down this continuum.
- 8y ago

nwatson 8y ago

The article doesn't address whether an individual can request a full report of their own records and those of their dependents from this MIB. I can get a copy of my credit report for free, same should apply here. Hmmm ... might be able to get a copy here: https://www.mib.com/request_your_record.html https://www.mib.com/request_your_record.html

retailloans 8y ago

thanks for sharing excellent post and Compare Rates for Business Loans in Chandigarh and Get Best of Deals. Get Best of EMI per Lacs on Business Loans in Chandigarh. Compare and choose from Top Business Loan providers in Chandigarh read more http://www.retailloans.in/business-loan-in-chandigarh http://www.retailloans.in/business-loan-in-chandigarh

kalekold 8y ago

In the UK, health insurance companies buy data from supermarkets like Tesco (gathered from loyalty cards) to understand your lifestyle and potential risk by viewing what you eat and drink over a period of years.

pflanze 8y ago
Do you have references about this?