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HealthCare.gov Sends Personal Data to Dozens of Tracking Websites
- bagels 12y agoI'm wondering whose doubleclick account those ad dollars are ending up in.
- dangrossman 12y agoI was initially curious why Google/DoubleClick were in there myself, since there aren't ads on the healthcare.gov site. Those requests look to be retargeting tags so they have the ability to do things like show banner ads on CNN only to people who have an incomplete marketplace application, along with conversion tracking so they can see which marketing campaigns led to completed applications or other goals. Presumably whoever controls the rest of the healthcare.gov marketing budget also runs the DoubleClick/AdWords account.
- btian 12y agoNot ad account. I think doubleclick is used for surveys.
- JeremyMorgan 12y agoNope. http://en.wikipedia.org/wiki/DoubleClick http://en.wikipedia.org/wiki/DoubleClick DoubleClick is a subsidiary of Google which develops and provides Internet ad serving services
- btian 12y agoI'm saying in this case. Doubleclick accounts are usually for ads.
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- jayess 12y agoIsn't this a HIPAA violation?
- Kikawala 12y agoNo. I don't see any protected health information.
- markolschesky 12y agoThe user's IP address (which I imagine gets collected by doubleclick) is one of the 18 identifiable attributes which makes data PHI. But, I don't think that healthcare.gov needs to comply by HIPAA.
- honksillet 12y ago# of pregnancies is a violation. One could infer whether the individual is pregnant, has had a miscarriage or even an abortion.
- markolschesky 12y agoWhile the data itself would fit the description of PHI, I don't know if healthcare.gov itself qualifies since it isn't a "health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse". That doesn't mean that it's against best practices. I built an analytics platform for a project with the VA on https://catalyze.io/baas https://catalyze.io/baas (I also work there), so their are some alternatives to analytics when HIPAA is a concern.
- troyastorino 12y agoIt could depend on whether healthcare.gov signed Business Associate Agreements (BAAs) with the insurers that it's connecting to. If it did have to sign BAAs, then heathcare.gov would be covered under the scope of those BAAs, and would likely have to be complying with the security rule and the privacy rule.
- UrMomReadsHN 12y ago
- dkroy 12y agoI heard something awhile back about the us government(NSA) leveraging the cookie in a way that they could use it as a surveillance beacon. I doubt there is any relation, but it makes you think a bit. [1] https://www.eff.org/deeplinks/2013/12/nsa-turns-cookies-and-more-surveillance-beacons https://www.eff.org/deeplinks/2013/12/nsa-turns-cookies-and-...
- bhhaskin 12y agoI am sure the NSA are involved with at least some aspect of all .gov addresses.
- devindotcom 12y agoSpokesman Aaron Albright said outside vendors "are prohibited from using information from these tools on HealthCare.gov for their companies' purposes." The government uses them to measure the performance of HealthCare.gov so consumers get "a simpler, more streamlined and intuitive experience," he added. It's one thing to send session length, general location, usage stuff like that to see where, for example, awareness campaigns might be needed. But really: smoker=1&parent=&pregnant=1&mec=&zip=85601&state=AZ&income=35000 That's a bit much! And I suppose DoubleClick is carefully siloing this information so it doesn't accidentally perform all kinds of analysis on it for comparison with its other huge databases? Perhaps they are barred from selling it wholesale to data brokers but I can't imagine they are unable to use it for plenty of their own purposes.
- Arnor 12y agoI'm sure you're right that the information is getting used by DoubleClick. To the other point about this information not being appropriate for the purposes Albright mentioned: Isn't this exactly the information that a health insurance company wants to know for outreach? If I know that all the pregnant women in Tuscon are signing up but none from Pheonix, I suddenly know where to put my next billboard or field office. If this was a private sector company, nobody would be surprised at collecting this data. It would also be a different story if the data was being stored and analyzed in house or even if the doubleclick request happened on the server side instead of the client. I agree with the general sentiment that this is a privacy violation, but that's because of the way that the data is collected and who processes it, not the collection and use of the data generally.
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- Arnor 12y agoConfused...
- joering2 12y agoI think the analogy would be like opening a Government Bank where the doors are always wide open and there are no locks. Everyone can see everyone account status or simply come in and grab their jewls or gold coins, but they won't because generally [...] citizens "are prohibited by law from stealing other people's belongings"
- zaroth 12y agoThis is pretty shocking. What is PII doing in the query string in the first place? Disclosing pregnancy status from an insurance application sounds like a possible HIPPA violation and runs afoul of various state laws around 'Insurance Information and Privacy Protection'. E.g http://www.leginfo.ca.gov/cgi-bin/displaycode?section=ins&group=00001-01000&file=791-791.29 http://www.leginfo.ca.gov/cgi-bin/displaycode?section=ins&gr.... See Section 791.13(k). That's just CA law but many states followed with their own version. (IANAL) I think the really big penalties come into play when medical information is 'personally identifiable'. Since this data is going to Google, Facebook, and Twitter (really?!) with 3rd party cookies, or even without, it would be hard to argue this data is not personally identifiable. It's not like they didn't know they weren't sending this data out. Or perhaps the highly advanced debugging prowess of "Chrome Inspector" is beyond their pay grade. Edit: Oh it's not even just Referral leak it's actually it the request in some cases, so blatantly intentional. :-(
- threeseed 12y ago> Oh it's not even just Referral leak it's actually it the request in some cases, so blatantly intentional. Be careful about throwing the term intentional around. There is nothing to suggest this is the case. It's just a shocking breakdown in security/testing processes and/or a bug. We see security/privacy issues everyday. They are almost never intentional.
- Alupis 12y ago> They are almost never intentional. Somebody had to specifically code the application to concatenate into the string: > smoker=1&parent=&pregnant=1&mec=&zip=85601&state=AZ&income=35000
- darkerside 12y agoIt could have been passed along as a returnUrl. Never attribute to malice what can be explained by incompetence.
- acdha 12y ago
- mindslight 12y agoWhat else could one possibly expect when an industry has succeeded at convincing the government to make buying their product mandatory?! I know the EFF focuses specifically on informational issues, but stirring outrage over one abuse of a captive market when such abuses are by design is a disservice to general sanity.
- dublinben 12y agoThe entire issue with the ACA and private insurance aside, this particular website does not need to have 18 tracking scripts on it. I'm sure this is just another symptom of the convoluted development process behind the Healthcare.gov mess.
- mindslight 12y agoThat depends entirely on whose perspective you use for the definition of need, which is the point of my original comment.
- threeseed 12y agoNot sure if you've ever worked on an enterprise website before but this would have nothing to do with the development process. This is all the work of the various marketing/product teams wanting to use the tools they are accustomed to. It's ridiculous how many times I've seen this happen before.
- programmarchy 12y agoYeah... this is what happens when the customer is not the end-user of the product. Markets break down because there's no feedback loops. Kind of like those toilet paper dispensers in public bathrooms that require a key to open and make it as difficult as possible to unroll a few sheets of what feels like sandpaper. Georgia Pacific has no reason to care about the person sitting there, powerless, on the toilet. Terrible user experience!
- threeseed 12y agoThe ACA model in the US is very similar to what exists in many places in the world e.g. here in Australia. And it was driven from the needs of the government not the needs of the health care industry. Although they are a beneficiary. That said the model really does work. The fact is that uninsured people has a devastating effect on the economy. It prevents movement of labour, affects productivity, promotion to higher socio-economic levels, prevents people starting businesses, affects crime and countless other social effects. You need to force people who don't think they need it to have it.
- seccess 12y agoThis is certainly scary stuff, but I was a bit annoyed with the line: "...consequences such as when Target notified a woman's family that she was pregnant before she even told them. " I've heard this story referenced time and again with respect to motivating people to care about privacy and tracking. I'm all for privacy, but I feel like: (a) we should have more recent anecdotes about the consequences of tracking than a story from 2012, (b) the mechanism that Target used to infer this is far less intrusive (not making it OK) than what we see here, and (c) its really not strong enough an example. Not that speculation is the way to go, but what about the possibility of someone being turned down for life insurance due to this information?
- protomyth 12y agoWell, it is a simple example and has the virtue of being true instead of the often quoted but misrepresented McDonalds hot coffee story. Simple examples showing a situation are best, and much like iOS bug statistics, the parties who would have the statistics on situations caused by tracking are never going to make them public.
- tedunangst 12y agoDon't blame the browsers for continuing to send Referer headers though. Because browsers take your privacy seriously.
- garazy 12y agoLooks like a few of the tracking companies only just started to appear - http://builtwith.com/detailed/healthcare.gov http://builtwith.com/detailed/healthcare.gov The only non-ad tool they added was the Twitter Platform to their homepage. Lots of data leakage points though.
- EdSharkey 12y agoMore government doing shitty things not in its charter. I'm numb to this abuse. Next up: increased taxes + inflation. I hope I live to see the day that the laws are twisted and shredded such that all corporate-government data about every person is available for purchase. I'd love to have that detailed record of everything I've said, thought, places I've been, etc since ~Y2K. How cool would that be? I've heard it said that future cultural anthropologists of the future will absolutely love mining the rich personal data coming out of this period of time.
- at-fates-hands 12y ago>>> I've heard it said that future cultural anthropologists of the future will absolutely love mining the rich personal data coming out of this period of time. Former Anthropologist here. While culturally speaking it will be interesting, up to a certain point in human history there has always been physical things left behind by cultures to denote their existence. As our whole lives have become digital, once the servers are gone, the pseudo physical evidence will vanish. One of my professors told me in passing in the early aughts that, "This generation (meaning the Y generation) will barely leave a trace of its existence in 200 years." He inferred that once technology has evolved past our current rate of burn, the mechanisms by which we preserve our memories will be forever wiped out. He made a note of saying, "When was the last time you used something physical to create, retain or share your memories?" When was the last time you printed a photograph? Listened to a music album? Once the devices by which we save our memories become obsolete, so does our existence. It caught me off guard, and was. . one of those times where you stop and wonder what people will dig up in 2-300 years from now and discover about our civilization? Will it all just be zero's and one's on a server somewhere?
- EdSharkey 12y agoDelicious 0's and 1's, all indexed and cross-referenced for your convenience.
- paulfurtado 12y agoCouldn't you say that hard drives, SSDs, tape backups, etc are all still physical mediums? While these mediums lose data over time, forensics will still be able to recover partial data, similar to other physical mediums (pen and paper, photos, etc).
- kumarm 12y agoOne of the heavily trafficked sites in India (Railway Booking) has been showing Google adsense ads. Someone is making a Million dollars a month in Government :) https://www.irctc.co.in/eticketing/loginHome.jsf https://www.irctc.co.in/eticketing/loginHome.jsf 536 Global Rank (50 in India): http://www.alexa.com/siteinfo/www.irctc.co.in http://www.alexa.com/siteinfo/www.irctc.co.in
- nathanaldensr 12y agoWhat does this have to do with the topic of this thread?
- stephenhess 12y agoIf you're looking for a better place to go than healthcare.gov, give us a try at stridehealth.com. Bunch of ex-privacy folks and healthcare folks - can shop from your phone. Pretty shocking to see such a novice mistake by an org I think we were all expecting to take it up a level this year.
- drylight 12y agoGive $563M to Accenture and you get some really shoddy work http://www.healthcaredive.com/news/accenture-snags-new-5-year-healthcaregov-contract-for-563m/347935/ http://www.healthcaredive.com/news/accenture-snags-new-5-yea...
- j_s 12y agoPaging HN user brandonb and 'a bunch of other Google, Facebook, and Y Combinator alums' -- did this exist while you worked on the site? > I've been working on healthcare.gov for the last few months https://news.ycombinator.com/item?id=7312442 https://news.ycombinator.com/item?id=7312442
- brandonb 12y agoWe weren't involved with this specific part of the site but folks are on it! (I wrapped up my involvement several months ago, but others helping out with this open enrollment period.)
- bashinator 12y ago> folks are on it! Am I correct in thinking that the cheery use of passive voice means you're under quite a serious NDA?
- brandonb 12y agoThere is an NDA but I used "folks" since I, personally, have returned to the startup world and am not involved in the details of fixing this particular incident. But yes, rest assured that the people who currently work on healthcare.gov are busy testing a fix, which is why they're not posting on HN.
- fubarred 12y agoCurrently, https://disconnect.me/ https://disconnect.me/ browser extension says https://www.healthcare.gov/ https://www.healthcare.gov/ uses: - 0 Facebook, 3 Google, 0 Twitter - 0 Advertising - 6 Analytics: 1 ClickTale, 4 MixPanel, 1 Chartbeat - 0 Social - 6 Content: 3 Google, 3 Optimizely
- declan 12y agoAn additional problem, as I see it, is that the Obama administration made unambiguous assurances that no PII was being collected as part of Healthcare.gov's use of web measurement tools. Here's the excerpt from the privacy policy: HealthCare.gov uses a variety of Web measurement software tools. We use them to collect the information listed in the “Types of information collected” section above. The tools collect information automatically and continuously. No personally identifiable information is collected by these tools. https://www.healthcare.gov/privacy/ https://www.healthcare.gov/privacy/ Note the last sentence is in bold on the actual web page. A Department of Health and Human Services organ called the Centers for Medicare & Medicaid Services is responsible for the site. An enterprising HN reader might want to skim through the CMS (very long) privacy impact assessment to see if there are any other incorrect claims about Healthcare.gov: http://www.hhs.gov/pia/cms-pia-summary-fy12q4.pdf http://www.hhs.gov/pia/cms-pia-summary-fy12q4.pdf It will be interesting to see if anyone gets fired as a result of this particular privacy screwup. The buck should stop somewhere, right?
- jobposter1234 12y ago>A Department of Health and Human Services organ called the Centers for Medicare & Medicaid Services is responsible for the site. An enterprising HN reader might want to skim through the CMS (very long) privacy impact assessment to see if there are any other incorrect claims about Healthcare.gov: http://www.hhs.gov/pia/cms-pia-summary-fy12q4.pdf http://www.hhs.gov/pia/cms-pia-summary-fy12q4.pdf Is there any way to split this up so each person is responsible for a section? you'd miss a lot by missing context... but if the section readers bullet pointed everything, that could be combined into a larger context. Or, in HN speak, we could crowdsource a real-world Map/Reduce job to support big data in the citizen-scientist.
- declan 12y agoI love the idea of a real-world map/reduce job. :) But before spending any time on this, please make sure it's the right PDF. It does mention Healthcare.gov, but only a few times, and I'm no expert on HHS organizational structure. Here's the full directory of PIAs: http://www.hhs.gov/pia/ http://www.hhs.gov/pia/
- natmaster 12y agoDon't worry guys, Obama's friend's companies will use that information to sell you better products. It's for your own good!
- jtheory 12y agoThey don't even get into the repercussions of loading externally-hosted JavaScript into a secure page. We avoid this entirely (also hosting medical data), though it's been a bit of extra work to do so. I'm sure Chartbeat, Mathtag, Mixpanel, Google, etc. are reasonably careful about their security, and of course they would suffer as well if one of the servers/scripts was compromised and the breach was made public. But in short -- healthcare.org's security relies on the idea that none of these many 3rd parties will ever have a CDN server compromised, for example. Or (in other situations) have the NSA demand access. It just takes one -- and then an "improved" script could be delivered to only clients visiting a single targeted site, or even specific targeted clients. The normal customer just sees the lock icon and can verify that there's a secure connection to the main host; but there are actually many other connections going on to other hosts, and any of them may provide a script that can access any sensitive data on the page.