Big Brother is Coming to Healthcare – How Hospitals are Entering Your Credit Card Info Into Algorithms

Screen Shot 2014-06-28 at 11.23.58 AMThe article below is a great example of the unforeseen dangers of creating gigantic bureaucratic systems into which potentially hundreds of millions of people are forced into involuntarily, i.e., Obamacare.

The moment you create a national system of healthcare is the moment everybody suddenly has this so-called “health responsibility” to everyone else. Which is fascistic and the opposite of freedom. Again, I don’t have an issue with human beings voluntarily organizing into whatever kind of systems they want. This brings me back to this idea that we need to move more toward city-states and decentralization as a means of human organization. If the people of Boulder for example want to have a city-wide healthcare system they devise, great. Let the people decide. If you don’t want to live under that, you can easily move to another city that does it differently. This idea that one healthcare system should be in place for a gigantic, culturally diverse land of 315 million people is childish, inefficient and, for lack of a better word, stupid.

Naturally, now that we have Obamacare all sorts of invasive things are going to be justified for the “greater good.” As Bloomberg notes in the important article below, you may soon be getting calls from your doctor about your personal habits thanks to credit card data mining. If people want to opt-in to such a system fine, but if this is imposed upon the population involuntarily, there is only one word to describe it: Tyranny.

Here are some excerpt from the extremely creepy Bloomberg article:

You may soon get a call from your doctor if you’ve let your gym membership lapse, made a habit of picking up candy bars at the check-out counter or begin shopping at plus-sized stores.

That’s because some hospitals are starting to use detailed consumer data to create profiles on current and potential patients to identify those most likely to get sick, so the hospitals can intervene before they do.

Information compiled by data brokers from public records and credit card transactions can reveal where a person shops, the food they buy, and whether they smoke. The largest hospital chain in the Carolinas is plugging data for 2 million people into algorithms designed to identify high-risk patients, while Pennsylvania’s biggest system uses household and demographic data. Patients and their advocates, meanwhile, say they’re concerned that big data’s expansion into medical care will hurt the doctor-patient relationship and threaten privacy.

Well of course it will hurt the doctor-patient relationship. No one is going to trust anything or anybody anymore.

Carolinas HealthCare System operates the largest group of medical centers in North Carolina and South Carolina, with more than 900 care centers, including hospitals, nursing homes, doctors’ offices and surgical centers. The health system is placing its data, which include purchases a patient has made using a credit card or store loyalty card, into predictive models that give a risk score to patients.

This doesn’t seem voluntary from what I can tell, which is insanely inappropriate.

Within the next two years, Dulin plans for that score to be regularly passed to doctors and nurses who can reach out to high-risk patients to suggest interventions before patients fall ill.

For a patient with asthma, the hospital would be able to score how likely they are to arrive at the emergency room by looking at whether they’ve refilled their asthma medication at the pharmacy, been buying cigarettes at the grocery store and live in an area with a high pollen count, Dulin said.

“What we are looking to find are people before they end up in trouble,” said Dulin, who is also a practicing physician. “The idea is to use big data and predictive models to think about population health and drill down to the individual levels to find someone running into trouble that we can reach out to and try to help out.”

If the early steps are successful, though, Dulin said he would like to renegotiate to get the data provider to share more specific details on patient spending with doctors.

While all information would be bound by doctor-patient confidentiality, he said he’s aware some people may be uncomfortable with data going to doctors and hospitals. For these people, the system is considering an opt-out mechanism that will keep their data private, Dulin said.

Personally, I think “opt-out” should be the default, and you should have to opt-in instead.

While the patients may gain from the strategy, hospitals also have a growing financial stake in knowing more about the people they care for.

Under the Patient Protection and Affordable Care Act, known as Obamacare, hospital pay is becoming increasingly linked to quality metrics rather than the traditional fee-for-service model where hospitals were paid based on their numbers of tests or procedures.

Just another nightmare brought to you by the centralized, federal shit-show known as Obamacare.

As a result, the U.S. has begun levying fines against hospitals that have too many patients readmitted within a month, and rewarding hospitals that do well on a benchmark of clinical outcomes and patient surveys.

The strategy “is very paternalistic toward individuals, inclined to see human beings as simply the sum of data points about them,” Irina Raicu, director of the Internet ethics program at the Markkula Center for Applied Ethics at Santa Clara University, said in a telephone interview.

Brave New World.

Full article here.

In Liberty,
Michael Krieger

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4 Comments

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  1. Mike, I noticed the same thing seven years ago when my health insurer sent around their annual privacy notice. Now, almost nobody bothers to read these things, but I was curious and noticed where they reserve the right to collect data about “your health, finances, character, habits, hobbies, reputation, career, and credit.” Two paragraphs later, they say “We may share private information with persons or entities outside of our company without your OK in some cases.”

    Well, this motivated me to call them and ask (always in a calm voice) exactly what information they were collecting. After a 30 minute runaround, they said that clause referred to my name, address and payment information. That sounded like a giant lie, especially since the phone rep came back to the phone extremely nervous and evasive.

    Make of that story what you will. Bear in mind those clauses were effective July 1, 2007.

  2. “we need to move more toward city-states and decentralization as a means of human organization” this is always desirable. Every organization (system) unfortunately picks up also stability when growing in size. This sounds good but it is not. With stability come a big inertia to changes. Due to the fact that we live in a constantly evolving environment, even the best conceived system will be obsolete in no time… :-) just a small remark…

  3. I wonder if the data collection will help compensate patients that are victims of negligence and the pharmaceutical industry.

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