Your Medical Data Is Shared. Be Informed

[lollipop]

@haidut This is an article about Sleep Apnea, BUT interesting reveals about data. A few paragraphs highlighting the problem:

“In an email, a Blue Cross Blue Shield spokesperson said that it’s standard practice for insurers to monitor sleep apnea patients and deny payment if they aren’t using the machine. And privacy experts said that sharing the data with insurance companies is allowed under federal privacy laws. A ResMed representative said once patients have given consent, it may share the data it gathers, which is encrypted, with the patients’ doctors, insurers, and supply companies.”


“Luke Petty, the operations manager for Medigy, said a lot of CPAP users direct their ire at companies like his. The complaints online number in the thousands. But insurance companies set the prices and make the rules, he said, and suppliers follow them so they can get paid.

“Every year it’s a new hurdle, a new trick, a new game for the patients,” Petty said.”


You snooze, you lose: Insurers make the old adage literally true

 

[Queequeg]

Interesting, I read a while ago that HIPAA, instead of protecting you privacy, mandates the electronic collection and sharing of your data with the government and any other provider including your insurance.

Almost every bill passed today does the exact opposite of what its title would suggest- Affordable Healthcare, Patriot Act etc

 

[tankasnowgod]

When you get down the to the core of it, this is the real problem with any third party payment system in medicine. This holds true whether it's a company, government, non profit org, or an individual. If one of those entities is using their money (even if only by custodianship), don't they have the "right and responsibility" to make sure it is used appropriately? It's hard to argue that they don't. Otherwise, fraud could be rampant and widespread.

As soon as this happens..... treatment is no longer discussed simply between doctor and patient. It's between doctor, patient, and payer.... and probably other layers of middlemen. The person receiving treatment is oftentimes unaware of the cost. The payer is unaware of the effects, good or bad. Was it worth the money spent? The side effects? Do any of the parties even truly know? Cancer treatments, for example, can cost the payer as much as a luxury car, maybe much more. Ask a cancer patient about the details of their treatment. Then ask someone who purchased a car for details of their purchase. Who can tell you more? Which purchase is more important?

Even when a lot of us buy our labs direct....... there are still more than simply patient and doctor in that scenario. The company that you pay directly isn't the same company that draws your blood, which still opens the door originally mentioned. Although it does cut out a few middlemen.

It's sad that most people don't question treatments if they aren't the ones paying the bill. Can your life or health really be boiled down simply to dollars or other currency? I'm happy to be here among people that at least question that concept.

 

[DrJ]

Heh, not really surprised I guess. If they don't get some sort of control in place, I suspect with quite a bit of certainty that within a decade they'll be able to run data mining algorithms on all the medical image data that contains a surprising amount of medical history info in addition to huge amounts of identifying patient information plus the image data and diagnosis to accurately predict how expensive a person is going to turn out to be in the near- and far-term. Of course that wouldn't be used to deny coverage. No way.

 

[tankasnowgod]

Heh, not really surprised I guess. If they don't get some sort of control in place, I suspect with quite a bit of certainty that within a decade they'll be able to run data mining algorithms on all the medical image data that contains a surprising amount of medical history info in addition to huge amounts of identifying patient information plus the image data and diagnosis to accurately predict how expensive a person is going to turn out to be in the near- and far-term. Of course that wouldn't be used to deny coverage. No way.

Again to the point.... why did you want a third party payer in the first place?

 

[Such_Saturation]

Cancer treatments, for example, can cost the payer as much as a luxury car, maybe much more. Ask a cancer patient about the details of their treatment. Then ask someone who purchased a car for details of their purchase. Who can tell you more? Which purchase is more important?

Very good example. We are in a bad situation...

 

[Amazoniac]

Cancer treatments, for example, can cost the payer as much as a luxury car, maybe much more. Ask a cancer patient about the details of their treatment. Then ask someone who purchased a car for details of their purchase. Who can tell you more? Which purchase is more important?

..this part that Such quoted. People that are diagnosed with a disease are bombarded with conventional and alternative opinions, they're already shaken from the diagnosis and there's pressure on them to decide what to do as fast as possible (similar to visiting an online store that has the panic countdown). Believing that they don't have enough time to evaluate both, it's healthier from a mindset perspective to choose one or the other without knowing only half of the story because it's precisely this that will cut their faith in the process. If they embark on a treatment knowing that there's something shady about it, it's much more difficult to believe in its success. It seems an unconscious decision and not a neglect for their lives.

 

[haidut]

@haidut This is an article about Sleep Apnea, BUT interesting reveals about data. A few paragraphs highlighting the problem:

“In an email, a Blue Cross Blue Shield spokesperson said that it’s standard practice for insurers to monitor sleep apnea patients and deny payment if they aren’t using the machine. And privacy experts said that sharing the data with insurance companies is allowed under federal privacy laws. A ResMed representative said once patients have given consent, it may share the data it gathers, which is encrypted, with the patients’ doctors, insurers, and supply companies.”


“Luke Petty, the operations manager for Medigy, said a lot of CPAP users direct their ire at companies like his. The complaints online number in the thousands. But insurance companies set the prices and make the rules, he said, and suppliers follow them so they can get paid.

“Every year it’s a new hurdle, a new trick, a new game for the patients,” Petty said.”


You snooze, you lose: Insurers make the old adage literally true

Thanks! Is this only about CPAP machines or any medical data in general? I suspect it is the latter but just curious what you have seen/heard. As I mentioned in other posts, considering LabCorp and Quest have biomarker (and thus DNA) data on majority of US people, often going back decades, I would be surprised if they do not share it with data mining companies like Google and Amazon. Of course, it is "properly" anonymized, so nothing to worry about folks. /s
To me, LabCorp and Quest are a much bigger threat to privacy than any insurance company or even DNA outfits like Ancestry.com

 

[Queequeg]

Again to the point.... why did you want a third party payer in the first place?

Why do you think a single payer system would solve any of these problems? Last I checked most veterans subject to the VA's single payer system aren't very happy with it.

The truth is that the ACA from the start was designed to fail; to then be replaced by a single payer system. This has been openly admitted to by its architects. It's the oldest trick in running a country, Order out of Chaos. What's amazing is how they can consistently get us to end up asking for our own enslavement.

 

[tankasnowgod]

Why do you think a single payer system would solve any of these problems. Last I checked most veterans subject to the VA's single payer system aren't very happy with it.

The truth is that the ACA from the start was designed to fail to then be replaced by single payer. It's the oldest trick in running a country, Order out of Chaos. What's amazing is how they can consistently get us to end up asking for our own enslavement.

I absolutely do NOT want a single payer system. Not in the slightest. "Single Payer" means there is only ONE third party paying for everything. A system like that would not solve anything, simply give that single payer a monopoly on people's health. That is insanely scary. At least with the current system, we have a choice of which third party we use to pay for treatment.

Ideally, I think the only people involved in such decisions should be doctor and patient. In that model, the patient directly pays the doctor.

 

[Queequeg]

I absolutely do NOT want a single payer system. Not in the slightest. "Single Payer" means there is only ONE third party paying for everything. A system like that would not solve anything, simply give that single payer a monopoly on people's health. That is insanely scary. At least with the current system, we have a choice of which third party we use to pay for treatment.

Ideally, I think the only people involved in such decisions should be doctor and patient. In that model, the patient directly pays the doctor.

ok, I was surprised by your comment so glad I misunderstood your intent.

Direct pay would solve some problems but it doesnt solve the need for pooling of risk that insurance provides. Many illnesses would completely wipe out the patient's ability to pay. So then we are back to single payer for the millions of new bankrupts. Not a workable solution imo.

 

[lollipop]

Thanks! Is this only about CPAP machines or any medical data in general? I suspect it is the latter but just curious what you have seen/heard. As I mentioned in other posts, considering LabCorp and Quest have biomarker (and thus DNA) data on majority of US people, often going back decades, I would be surprised if they do not share it with data mining companies like Google and Amazon. Of course, it is "properly" anonymized, so nothing to worry about folks. /s
To me, LabCorp and Quest are a much bigger threat to privacy than any insurance company or even DNA outfits like Ancestry.com

Hi @haidut
The article speaks about CPAP, but as I understand it from another article (forgive me, I can not remember where I read it), any medical visit, the office shares both with insurance AND govt agency. Oh I remember @achillea posted a podcast one time where a MD was advocating for the patient and warned people under some law their information was required to be shared with the US gov, especially if they had insurance. Maybe @achillea can reshape that podcast here.

 

[tankasnowgod]

ok, I was surprised by your comment so glad I misunderstood your intent.

Direct pay would solve some problems but it doesnt solve the need for pooling of risk that insurance provides. Many illnesses would completely wipe out the patient's ability to pay. So then we are back to single payer for the millions of new bankrupts. Not a workable solution imo.

Insurance companies have their own issues. Essentially, they trade in derivatives. And they are not immune from becoming insolvent. Just the opposite. If you remember the economic crash in 2008, it was an insurance company (AIG) that essentially triggered the entire thing.

I agree, some treatments for certain illnesses could bankrupt people. But.... are those treatments even necessary? A series of radiation and chemotherapy could run into the hundreds of thousands, but a years supply of aspirin, niacinamide, IV Vitamin C, and a series of therapeutic phlebotomies would could be done in the hundreds of dollars. Which treatment is safer? Which will enable the patient to feel better? Which will allow the patient to live longer?

And lastly, healthcare existed long before insurance companies and HMOs came around. Charity (from friends, family, co-workers, strangers, doctors, or churches) works a lot better for dealing with huge costs, and there is always the option of bankruptcy. And honestly, I don't know if insurance companies and such in any way lower the number of bankruptcies due to medical costs, anyway. I tend to think they cause the majority of them.

 

[Catcream]

Slightly off topic, but talking to a doctor friend of mine who is studying skin cancer removal, was told she uses her patients as case studies. They pay her . She uses their info for free in her studies to gain more credentials. I doubt they are informed they are being used . She also talks about needing to make more money and needing more patients. It’s all a bit ****88 .

 

[Blossom]

@haidut This is an article about Sleep Apnea, BUT interesting reveals about data. A few paragraphs highlighting the problem:

“In an email, a Blue Cross Blue Shield spokesperson said that it’s standard practice for insurers to monitor sleep apnea patients and deny payment if they aren’t using the machine. And privacy experts said that sharing the data with insurance companies is allowed under federal privacy laws. A ResMed representative said once patients have given consent, it may share the data it gathers, which is encrypted, with the patients’ doctors, insurers, and supply companies.”


“Luke Petty, the operations manager for Medigy, said a lot of CPAP users direct their ire at companies like his. The complaints online number in the thousands. But insurance companies set the prices and make the rules, he said, and suppliers follow them so they can get paid.

“Every year it’s a new hurdle, a new trick, a new game for the patients,” Petty said.”


You snooze, you lose: Insurers make the old adage literally true

This was starting with some truck drivers with sleep apnea between 2004-2007. It could have been earlier and I’m just not aware. The reasoning was that if the patient was non compliant it could potentially put the lives of others at risk if they fell asleep behind the wheel. The problem with that is where does it stop?

 

[lollipop]

This was starting with some truck drivers with sleep apnea between 2004-2007. It could have been earlier and I’m just not aware. The reasoning was that if the patient was non compliant it could potentially put the lives of others at risk if they fell asleep behind the wheel. The problem with that is where does it stop?

Interesting @Blossom - must say a fairly reasonable beginning. The boundary does seem to be the problem. The starting premise makes sense, and perhaps they saw the benefit of such reporting for everyone. What troubles me is the whole medical system has begun dancing on a line I personally find unattractive: not in charge of my information AND/OR not in charge of who reads or receives my information.

I want to emphasize for others reading, I am not goofy, please rush me to the emergency room and save my life if necessary. I just hope you are working in the emergency room that day

That said, I know of one executive that was struggling with emotional issues. His wife refused to let the company know, the company insurance etc, or his career would have been destroyed. Sad. So she discretely found help and paid cash - knowing she had a better chance of it not being reported to Gov by paying with cash. Doctors have to report with insurance involved. Now, this family has resources, most people do not have such privilege. This saddens me. If someone is checked into a mental ward or hospital, seriously, that information follows them for the rest of their lives. What if they were just in a period of extreme stress, get help, and recover? How sad that such a stigma follows them forever - and I bet any children or grandchildren as well...

 

[Blossom]

Interesting @Blossom - must say a fairly reasonable beginning. The boundary does seem to be the problem. The starting premise makes sense, and perhaps they saw the benefit of such reporting for everyone. What troubles me is the whole medical system has begun dancing on a line I personally find unattractive: not in charge of my information AND/OR not in charge of who reads or receives my information.

I want to emphasize for others reading, I am not goofy, please rush me to the emergency room and save my life if necessary. I just hope you are working in the emergency room that day

That said, I know of one executive that was struggling with emotional issues. His wife refused to let the company know, the company insurance etc, or his career would have been destroyed. Sad. So she discretely found help and paid cash - knowing she had a better chance of it not being reported to Gov by paying with cash. Doctors have to report with insurance involved. Now, this family has resources, most people do not have such privilege. This saddens me. If someone is checked into a mental ward or hospital, seriously, that information follows them for the rest of their lives. What if they were just in a period of extreme stress, get help, and recover? How sad that such a stigma follows them forever - and I bet any children or grandchildren as well...

Yes, you are so correct. It's much better to avoid the medical trap all together when possible. I'm sure my data is already out there unfortunately. Sadly I don't think it's possible to keep our data private anymore. The cpap thing may have started off innocently enough but just like everything else it has taken on a life of it's own and morphed into something totally unacceptable. I'm just not sure what can be done except spreading awareness.