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"Monitoring patients also helps insurance companies advise doctors about the best treatment for patients" Since when did insurance companies become doctor advi

"Monitoring patients also helps insurance companies advise doctors about the best treatment for patients" Since when did insurance companies become doctor advisors? That's very alarming. The whole concept of unsuspecting data sharing is wrong, disturbing and should have everyone concerned.

OliverM 8y ago
Hence the EU's GDPR legislation. To forestall exactly this.
- ubernostrum 8y ago
  A patient sees two doctors for different conditions. The doctors prescribe different medications. The patient goes to two different pharmacists to pick them up. In a victory for privacy, the patient dies from a fatal interaction of the prescribed medications. In the US there is a strong medical privacy law. And it includes an exception for providers of medical care to share treatment information with each other, for precisely this reason. Even so, every single time you see a doctor in the US, you are handed a notice saying they'll share information for permitted purposes (the triad of "TPO" -- Treatment, Payment, and Operations), and given a form to sign saying you have been made aware of this.
  - Hasknewbie 8y ago
    EU resident here. I am reasonably sure that your doctor has access to your medical records when you hand them your smartcard, regardless of which doctor(s) previously updated said records.
    - sebiol 8y ago
      As far as I know, the answer is no. There was an article in "Die Datenschleuder" #98 [1] about it. [1] https://ds.ccc.de/download.html https://ds.ccc.de/download.html (german)
    - carlmr 8y ago
      At least in Germany they don't. You have to take your medical records in paper form from your old to your new doctor. I think it's non-ideal, but the health insurance should never need to know whether you're using your CPAP. They should only know if the doctor prescribed it. Information should be shared with the pharmacy and other doctors. That would be helpful and would save lives.
    - oarsinsync 8y ago
      EU resident here. We're not like distinct states in the USA, we're independent countries and each country has it's own systems. Healthcare systems vary dramatically between them. In one country, I visit any doctor and they have my full medical history, despite not living there. In another country, every time I visit the same doctor, they somehow don't have any files for me and I have to sign up as a new patient, despite being born and resident there. It's all shambles, but in both cases, I get healthcare for free so it could be a lot worse.
  - simion314 8y ago
    Your current system is still broken if say I go to a second doctor and pay with cash, no insurance involved, so it still preferable the doctor and pharmacist to ask you if you have known allergies, other treatment or suffer for some specific illnesses . You could extend your argument that insurance companies should get access to what food and drinks you buy so they prevent side effects(and not at all tax you more because you drink beer or eat cheap food a lot)
  - Angostura 8y ago
    In the UK, the doctor and pharmacist will ask you if you are on existing medication. I know this because a pharmacist refused to sell me Ibuprofen when I told him that was on Ramapril for high blood pressure.
    - ubernostrum 8y ago
      And you can deliberately or accidentally leave something out, yes, or go to other lengths to hide information. The point was to be an illustrative example of why it can be useful for health-care providers to share information. HN, predictably, took it as a challenge to try to work around and find as many possible ways to hide the information as they could.
  - fucking_tragedy 8y ago
    Part of the ACA was the consolidation of electronic medical records such that situations like this won't happen.
  - znpy 8y ago
    It's clearly the patient's fault here. Every adult knows that in general, drugs cannot be mixed as easily as candy. Also if you're seeing multiple doctors (like, for example, a general practitioner and a specialist) you should be transparent on what prescriptions you're already taking.
  - pbhjpbhj 8y ago
    Your doctor is not a third party to your medical information; perhaps you could exclude them from accessing it, but then you'd be the one forcing them to do something dangerous. Being an idiot and getting yourself killed is not the doctors fault.
lotsofpulp 8y ago
Insurance companies employ tons of doctors and pharmacists that double check chart notes and treatment plans, especially for expensive treatments and medicines. It’s overall good to have some type of checks and balance system when dealing with market you (I.e. patients) know nothing about, in case the doctor or provider makes a mistake or is compromised in some way.
ubernostrum 8y ago
Since when did insurance companies become doctor advisors? That's very alarming. If you want to, you can make this sound sinister. But it's pretty common, and the reason behind it is simple. Many people who need medical care do not see a single doctor for all of their needs. They have a primary doctor, but also see one or more specialists, perhaps have occasional visits with a nurse, deal with a pharmacist, may sometimes need to go to a clinic that's open on a day they can't get an appointment with their regular primary doctor, etc. etc. Out of that potentially large pool of providers, how many do you think are automatically and quickly sharing full records with the primary doctor? How many others of them receive that level of records from the primary doctor and from all the other providers? How many of them even know about all the others' existence? This is a genuine problem, because it means that none of them see the full picture of the patient's health. They see isolated bits and pieces of it. And that's dangerous. Pharmacists get a reputation as the last line of defense for many people against different doctors -- ignorant of each others' existence -- unknowingly prescribing badly-interacting and possibly fatal combinations of medications to a single patient, for example. In the US system (and this is not an endorsement of it), there is exactly one entity that sees everything: the payer (i.e., insurance). All of those providers want to get paid for their services, so every one of them submits claims to the payer, including details of diagnoses, procedures, and so on. Given this status as the only entity which actually sees the whole picture, it makes a lot of sense to be sharing that information with the medical providers who see the patient. This is part of the original idea behind the HMO model of health insurance (where all the providers are a single super-entity coordinating with each other), though it comes with the widely-hated downside of being unable to see a doctor who isn't part of the HMO. And for many years, even PPO-model insurance plans have introduced more and more active collaboration with providers.
- mrhappyunhappy 8y ago
  That makes sense though I still feel there is a huge conflict of interest and the system is broken. I do see your point regarding insurance being the all seeing eye so to speak. Thank you.
torpfactory 8y ago
Here’s a ‘fun’ anecdote to illustrate this point. A friend of ours was diagnosed with non-Hodgkins lymphoma a few years ago at 25. Before she was diagnosed, she had gone to the hospital feeling sick and achy. After a full, 12+ hours at the hospital, it was clear she had some kind of cancer. Imaging showed she had a baseball sized tumor in her chest. One more test was needed to confirm which variety so a course of treatment could be prescribed. It was already quite late (after 11pm) and the hospital staff said she could just come back in the morning to finish the one remaining test. The next morning, she went back to the hospital and was denied the test. Apparently, some inhuman garbage at her insurance company had decided in the middle of the night that they could save a little money by forcing her to do the test in a clinic setting. Since she hadn’t officially received her cancer diagnosis, she had to wait another four weeks to get the required test. Every day the tumor growing a little bigger. She’s doing fine now by the way! She lost her insurance after turning 26, but did benefit from impeccable timing - she got one of the first Obamacare plans, it probably saved her life.

OliverM 8y ago

Hence the EU's GDPR legislation. To forestall exactly this.

ubernostrum 8y ago
A patient sees two doctors for different conditions. The doctors prescribe different medications. The patient goes to two different pharmacists to pick them up. In a victory for privacy, the patient dies from a fatal interaction of the prescribed medications. In the US there is a strong medical privacy law. And it includes an exception for providers of medical care to share treatment information with each other, for precisely this reason. Even so, every single time you see a doctor in the US, you are handed a notice saying they'll share information for permitted purposes (the triad of "TPO" -- Treatment, Payment, and Operations), and given a form to sign saying you have been made aware of this.
- Hasknewbie 8y ago
  EU resident here. I am reasonably sure that your doctor has access to your medical records when you hand them your smartcard, regardless of which doctor(s) previously updated said records.
  - sebiol 8y ago
    As far as I know, the answer is no. There was an article in "Die Datenschleuder" #98 [1] about it. [1] https://ds.ccc.de/download.html https://ds.ccc.de/download.html (german)
  - carlmr 8y ago
    At least in Germany they don't. You have to take your medical records in paper form from your old to your new doctor. I think it's non-ideal, but the health insurance should never need to know whether you're using your CPAP. They should only know if the doctor prescribed it. Information should be shared with the pharmacy and other doctors. That would be helpful and would save lives.
  - oarsinsync 8y ago
    EU resident here. We're not like distinct states in the USA, we're independent countries and each country has it's own systems. Healthcare systems vary dramatically between them. In one country, I visit any doctor and they have my full medical history, despite not living there. In another country, every time I visit the same doctor, they somehow don't have any files for me and I have to sign up as a new patient, despite being born and resident there. It's all shambles, but in both cases, I get healthcare for free so it could be a lot worse.
- simion314 8y ago
  Your current system is still broken if say I go to a second doctor and pay with cash, no insurance involved, so it still preferable the doctor and pharmacist to ask you if you have known allergies, other treatment or suffer for some specific illnesses . You could extend your argument that insurance companies should get access to what food and drinks you buy so they prevent side effects(and not at all tax you more because you drink beer or eat cheap food a lot)
- Angostura 8y ago
  In the UK, the doctor and pharmacist will ask you if you are on existing medication. I know this because a pharmacist refused to sell me Ibuprofen when I told him that was on Ramapril for high blood pressure.
  - ubernostrum 8y ago
    And you can deliberately or accidentally leave something out, yes, or go to other lengths to hide information. The point was to be an illustrative example of why it can be useful for health-care providers to share information. HN, predictably, took it as a challenge to try to work around and find as many possible ways to hide the information as they could.
- fucking_tragedy 8y ago
  Part of the ACA was the consolidation of electronic medical records such that situations like this won't happen.
- znpy 8y ago
  It's clearly the patient's fault here. Every adult knows that in general, drugs cannot be mixed as easily as candy. Also if you're seeing multiple doctors (like, for example, a general practitioner and a specialist) you should be transparent on what prescriptions you're already taking.
- pbhjpbhj 8y ago
  Your doctor is not a third party to your medical information; perhaps you could exclude them from accessing it, but then you'd be the one forcing them to do something dangerous. Being an idiot and getting yourself killed is not the doctors fault.

lotsofpulp 8y ago

Insurance companies employ tons of doctors and pharmacists that double check chart notes and treatment plans, especially for expensive treatments and medicines. It’s overall good to have some type of checks and balance system when dealing with market you (I.e. patients) know nothing about, in case the doctor or provider makes a mistake or is compromised in some way.

ubernostrum 8y ago

Since when did insurance companies become doctor advisors? That's very alarming. If you want to, you can make this sound sinister. But it's pretty common, and the reason behind it is simple. Many people who need medical care do not see a single doctor for all of their needs. They have a primary doctor, but also see one or more specialists, perhaps have occasional visits with a nurse, deal with a pharmacist, may sometimes need to go to a clinic that's open on a day they can't get an appointment with their regular primary doctor, etc. etc. Out of that potentially large pool of providers, how many do you think are automatically and quickly sharing full records with the primary doctor? How many others of them receive that level of records from the primary doctor and from all the other providers? How many of them even know about all the others' existence? This is a genuine problem, because it means that none of them see the full picture of the patient's health. They see isolated bits and pieces of it. And that's dangerous. Pharmacists get a reputation as the last line of defense for many people against different doctors -- ignorant of each others' existence -- unknowingly prescribing badly-interacting and possibly fatal combinations of medications to a single patient, for example. In the US system (and this is not an endorsement of it), there is exactly one entity that sees everything: the payer (i.e., insurance). All of those providers want to get paid for their services, so every one of them submits claims to the payer, including details of diagnoses, procedures, and so on. Given this status as the only entity which actually sees the whole picture, it makes a lot of sense to be sharing that information with the medical providers who see the patient. This is part of the original idea behind the HMO model of health insurance (where all the providers are a single super-entity coordinating with each other), though it comes with the widely-hated downside of being unable to see a doctor who isn't part of the HMO. And for many years, even PPO-model insurance plans have introduced more and more active collaboration with providers.

mrhappyunhappy 8y ago
That makes sense though I still feel there is a huge conflict of interest and the system is broken. I do see your point regarding insurance being the all seeing eye so to speak. Thank you.

torpfactory 8y ago

Here’s a ‘fun’ anecdote to illustrate this point. A friend of ours was diagnosed with non-Hodgkins lymphoma a few years ago at 25. Before she was diagnosed, she had gone to the hospital feeling sick and achy. After a full, 12+ hours at the hospital, it was clear she had some kind of cancer. Imaging showed she had a baseball sized tumor in her chest. One more test was needed to confirm which variety so a course of treatment could be prescribed. It was already quite late (after 11pm) and the hospital staff said she could just come back in the morning to finish the one remaining test. The next morning, she went back to the hospital and was denied the test. Apparently, some inhuman garbage at her insurance company had decided in the middle of the night that they could save a little money by forcing her to do the test in a clinic setting. Since she hadn’t officially received her cancer diagnosis, she had to wait another four weeks to get the required test. Every day the tumor growing a little bigger. She’s doing fine now by the way! She lost her insurance after turning 26, but did benefit from impeccable timing - she got one of the first Obamacare plans, it probably saved her life.