why health insurance and big data are a good fit

August 19, 2013

quantified self

With the explosion in fitness trackers and mobile apps that want to help manage everything from weight loss to pregnancy, there’s already a small panic brewing as technology critics worry that insurance companies will require you to wear devices that track your health, playing around with your premiums based on how well or how badly you take care of yourself. As the current leader of the reverse Singularitarians, Evgeny Morozov, argues, the new idea of the quantified self is a minefield being created with little thought about the consequences. Certainly there is a potential for abuse of very personal health metrics and Morozov is at his best when he explains how naive techno-utopians don’t understand how they come off, and how the reality of how their tools have been used in the wild differs drastically from their vision, so his fear is not completely unfounded or downright reflexive, like some of his latest pieces have been. But in the case of the quantified self idea being applied to our healthcare, the benefits are more likely to outweigh the risks.

One of the reasons why healthcare in the United States is so incredibly expensive is the lack of focus on preventitive medicine. Health problems are allowed to fester until they become simply too bothersome to ignore, a battery of expensive tests is ordered, and usually expensive acute treatments are administered. Had they been caught in time, the treatments would not have to be so intensive, and if there was ample, trustworthy biometric information available to the attending doctors, there wouldn’t need to be as much testing to arrive at an accurate diagnosis. As many doctors grumble about oceans of paperwork, logistics of testing, and the inability to really talk to patients in the standard 15 minute visit, why not use devices that would help with the paperwork and do a great deal of preliminary research for them before they ever see the patient? And yes, the devices would have to be able to gather data by themselves because we often tell little white lies about how active we are and how well we eat, even when both we and our doctors know that we’re lying. And this only hurts us in the end by making the doctors’ work more difficult.

That brings us full circle to health insurance premiums and requirements to wear these devices to keep our coverage. Certainly it’s kind of creepy that there would be so much data about us so readily available to insurance companies, but here’s the thing. They already have this data from your doctors and can access it whenever they want in the course of processing your claim. With biometric trackers and loggers, they could do the smart and profitable thing and instead of using a statistical model generated from a hodgepodge of claim notes, take advantage of the real time data coming in to send you to the doctor when a health problem is detected. They pay less for a less acute treatment plan, you feel healthier and have some piece of mind that you’re now less likely to be caught by surprise by some nasty disease or condition, and your premiums won’t be hiked as much since the insurers now have higher margins and stave off rebellions from big and small companies who’ll now have more coverage choices built around smart health data. And all this isn’t even mentioning the bonanza for researchers and policy experts who can now get a big picture view from what would be the most massive health study ever conducted.

How many times have you read a study purporting the health benefits of eating berries and jogs one week only to read another one that promotes eating nuts and saying that jogs are pointless with the different conclusions coming as a result of different sample sizes and subjects involved in the studies? Well, here, scientists could collect tens of millions of anonymized records and do very thorough modeling based on uniform data sets from real people, and find out what actually works and for whom when it comes to achieving their fitness and weight loss goals. Couple more data and more intelligent policy with the potential for economic gain and the gamification offered by fitness trackers, and you end up with saner healthcare costs, a new focus on preventing and maintaining rather than diagnosing and treating, fewer sick days, and longer average lifespans as the side effect of being sick less often and encouraged to stay active and fit, and you have a very compelling argument for letting insurance companies put medical trackers on you and build a new business model around them and the data they collect. It will pay off in the long run.

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  • TheBrett

    Put me in the camp that would go for trackers and health checks to get cheaper health insurance, if I was the one paying for it in the individual market (I have insurance through my company, so I don’t need to worry about that yet). The only real thing that would make me question it would be if they could then use that data to deny me on a pre-conditions basis if I had to switch insurers.

    As for Morozev . .. ugh. I’m sure he’s making a point, but his posts tend to be verbal diarrhea. Reading anything he writes feels like a slog.

  • You have never had to fight with insurance companies that have no desire to part with any money whatsoever, and deny coverage for items they very clearly cover, counting on a certain percentage of people simply giving up the fight and paying it out of their own pocket.

    You have never paid extra for hurricane coverage while living in a high-risk area, then had you coverage dropped when you tried to make a claim after a hurricane actually made landfall.

    And then, of course, there’s the idea of some actuary making medical diagnoses based on statistical sampling, or worse, the general public trusting in the system to do what you propose and being notified when they should be seeking treatment. More likely, any insurance provider seeing a potentially expensive treatment looming would simply hike its premiums. Employers are already being influenced by “risk-rated” insurance providers that charge higher rates for females and older workers, and will now be prejudiced against employees with a family risk of heart disease or hitting above some “ideal biometric” – which has yet to be determined accurately anyway.

    Part of the reason people fail to seek medical attention is because of the expense, which exists as “deductibles” even with good coverage, and can be absolutely ridiculous without. And part of the reason for these costs is insurance companies; another part is privatized, profit-run healthcare. While doctors may gain a wealth of information from fitness trackers, such data has to be within a working infrastructure devoted to health, not profit. It’s not the data that’s the issue.