Re: Prescription Data Used To Assess Consumers: Records Aid Insurers but Prompt Privacy Concerns

[Guest guest]

How disgusting! This should be outlawed. I can now see how the powers

to be have designed everything to be able to eliminate the sick, the

elderly, and the poor. How could any God-fearing person work for one

of these corporations?

Barth

www.presenting.net/sbs/sbs.html

SUBMIT YOUR DOCTOR: www.presenting.net/sbs/molddoctors.html

---

L> Has anyone ever had trouble getting insurance or a job because of their

L> health issues?

L> This is an interesting article in today's Washington Post

L>

http://www.washingtonpost.com/wp-dyn/content/article/2008/08/03/AR2008080302077.\

html

L> *Prescription Data Used To Assess Consumers*

L> *Records Aid Insurers but Prompt Privacy Concerns*

L> This data is not covered by any laws, because people sign waivers allowing

L> them to get it, for example, when they apply for a job or try to buy health

L> insurance.

L> Here is an excerpt:

L> * " Health and life insurance companies have access to a powerful new tool for

L> evaluating whether to cover individual consumers: a health " credit report "

L> drawn from databases containing prescription drug records on more than 200

L> million Americans.

L> Collecting and analyzing personal health information in commercial databases

L> is a fledgling industry, but one poised to take off as the nation enters the

L> age of electronic medical records. While lawmakers debate how best to

L> oversee the shift to computerized records, some insurers have already begun

L> testing systems that tap into not only prescription drug information, but

L> also data about patients held by clinical and pathological laboratories.

L> Traditionally, insurance companies have judged an applicant's risk by

L> gathering medical records from physicians' offices. But the new tools offer

L> the advantage of being " electronic, fast and cheap, " said Mark Franzen,

L> managing director of Milliman IntelliScript, which provides consumers'

L> personal drug profiles to insurers.

L> *

L> * The trend holds promise for improved health care and cost savings, but

L> privacy and consumer advocates fear it is taking place largely outside the

L> scrutiny of federal health regulators and lawmakers. *

L> *Ingenix, a Minnesota-based health information services company that had

L> $1.3 billion in sales last year -- and Wisconsin-based rival Milliman -- say

L> the drug profiles are an accurate, less expensive alternative to seeking

L> physician records, which can take months and hundreds of dollars to obtain.

L> They note that consumers authorize the data release and that the services

L> can save insurance companies millions of dollars and benefit consumers

L> anxious for a decision. *

L> * " Some insurers can make a decision in the same day, or right on the spot, "

L> Franzen said. " That's the real 'value-add.' " *

L> *But the practice also illustrates how electronic data gathered for one

L> purpose can be used and marketed for another -- often without consumers'

L> knowledge, privacy advocates say. And they argue that although consumers

L> sign consent forms, they effectively have to authorize the data release if

L> they want insurance. *

L> * " As health care moves into the digital age, there are more and more

L> companies holding vast amounts of patients' health information, " said Joy

L> Pritts, research professor at town University's Health Policy

L> Institute. " Most people don't even know these organizations exist.

L> Unfortunately the federal health privacy rule does not cover many of them. .

L> . . The lack of transparency with how all of this works is disturbing. " *

L> *Ingenix and Milliman create the profiles by plumbing rich databases of

L> prescription drug histories kept by pharmacy benefit managers (PBMs), which

L> help insurers process drug claims. Ingenix, for instance, has servers in the

L> PBM data centers, updating the drug files as frequently as once a day, said

L> Stenson, senior vice president of consulting for Ingenix, which is a

L> division of UnitedHealth Group. The corporation also owns UnitedHealthcare,

L> the nation's second-largest insurer. *

L> *When an insurer makes an online query about an applicant, Ingenix or

L> Milliman's servers scour the data and within minutes or less return reports

L> to a central server at the company. The server aggregates the information

L> going back as far as five years, including the drugs and dosages prescribed,

L> dates filled and refilled, the therapeutic class and the name and address of

L> the prescribing doctor. *

L> * Then comes the analysis. *

L> *Ingenix's MedPoint tool provides insurers a " pharmacy risk score, " or a

L> number that represents an " expected risk " for a group of people, such as 30-

L> to 35-year-old women who have taken prescription drugs, Stenson said. Higher

L> scores imply higher medical costs. *

L> *

L> CONTINUED 1

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L> * * " *

L>

[Guest guest]

I, too, find this very " chilling " - and something to challenge. It

completely erodes any 'confidentiality' they claim for patient care.

--- In , Patilla DaHun <glypella@...>

wrote:

>

> How disgusting! This should be outlawed. I can now see how the

powers

> to be have designed everything to be able to eliminate the sick, the

> elderly, and the poor. How could any God-fearing person work for one

> of these corporations?

>

> Barth

>

> www.presenting.net/sbs/sbs.html

>

> SUBMIT YOUR DOCTOR: www.presenting.net/sbs/molddoctors.html

>

> ---

>

> L> Has anyone ever had trouble getting insurance or a job because

of their

> L> health issues?

>

> L> This is an interesting article in today's Washington Post

>

>

> L> http://www.washingtonpost.com/wp-

dyn/content/article/2008/08/03/AR2008080302077.html

>

> L> *Prescription Data Used To Assess Consumers*

> L> *Records Aid Insurers but Prompt Privacy Concerns*

>

> L> This data is not covered by any laws, because people sign

waivers allowing

> L> them to get it, for example, when they apply for a job or try to

buy health

> L> insurance.

> L> Here is an excerpt:

>

> L> * " Health and life insurance companies have access to a powerful

new tool for

> L> evaluating whether to cover individual consumers: a

health " credit report "

> L> drawn from databases containing prescription drug records on

more than 200

> L> million Americans.

>

> L> Collecting and analyzing personal health information in

commercial databases

> L> is a fledgling industry, but one poised to take off as the

nation enters the

> L> age of electronic medical records. While lawmakers debate how

best to

> L> oversee the shift to computerized records, some insurers have

already begun

> L> testing systems that tap into not only prescription drug

information, but

> L> also data about patients held by clinical and pathological

laboratories.

>

> L> Traditionally, insurance companies have judged an applicant's

risk by

> L> gathering medical records from physicians' offices. But the new

tools offer

> L> the advantage of being " electronic, fast and cheap, " said Mark

Franzen,

> L> managing director of Milliman IntelliScript, which provides

consumers'

> L> personal drug profiles to insurers.

>

> L> *

>

> L> * The trend holds promise for improved health care and cost

savings, but

> L> privacy and consumer advocates fear it is taking place largely

outside the

> L> scrutiny of federal health regulators and lawmakers. *

>

> L> *Ingenix, a Minnesota-based health information services company

that had

> L> $1.3 billion in sales last year -- and Wisconsin-based rival

Milliman -- say

> L> the drug profiles are an accurate, less expensive alternative to

seeking

> L> physician records, which can take months and hundreds of dollars

to obtain.

> L> They note that consumers authorize the data release and that the

services

> L> can save insurance companies millions of dollars and benefit

consumers

> L> anxious for a decision. *

>

> L> * " Some insurers can make a decision in the same day, or right

on the spot, "

> L> Franzen said. " That's the real 'value-add.' " *

>

> L> *But the practice also illustrates how electronic data gathered

for one

> L> purpose can be used and marketed for another -- often without

consumers'

> L> knowledge, privacy advocates say. And they argue that although

consumers

> L> sign consent forms, they effectively have to authorize the data

release if

> L> they want insurance. *

>

> L> * " As health care moves into the digital age, there are more and

more

> L> companies holding vast amounts of patients' health information, "

said Joy

> L> Pritts, research professor at town University's Health

Policy

> L> Institute. " Most people don't even know these organizations

exist.

> L> Unfortunately the federal health privacy rule does not cover

many of them. .

> L> . . The lack of transparency with how all of this works is

disturbing. " *

>

> L> *Ingenix and Milliman create the profiles by plumbing rich

databases of

> L> prescription drug histories kept by pharmacy benefit managers

(PBMs), which

> L> help insurers process drug claims. Ingenix, for instance, has

servers in the

> L> PBM data centers, updating the drug files as frequently as once

a day, said

> L> Stenson, senior vice president of consulting for Ingenix,

which is a

> L> division of UnitedHealth Group. The corporation also owns

UnitedHealthcare,

> L> the nation's second-largest insurer. *

>

> L> *When an insurer makes an online query about an applicant,

Ingenix or

> L> Milliman's servers scour the data and within minutes or less

return reports

> L> to a central server at the company. The server aggregates the

information

> L> going back as far as five years, including the drugs and dosages

prescribed,

> L> dates filled and refilled, the therapeutic class and the name

and address of

> L> the prescribing doctor. *

>

> L> * Then comes the analysis. *

>

> L> *Ingenix's MedPoint tool provides insurers a " pharmacy risk

score, " or a

> L> number that represents an " expected risk " for a group of people,

such as 30-

> L> to 35-year-old women who have taken prescription drugs, Stenson

said. Higher

> L> scores imply higher medical costs. *

> L> *

> L> CONTINUED 1

> L> 2<http://www.washingtonpost.com/wp-

dyn/content/article/2008/08/03/AR2008080302077_2.html>

> L> 2<http://www.washingtonpost.com/wp-

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> L> 3<http://www.washingtonpost.com/wp-

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> L> 3<http://www.washingtonpost.com/wp-

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> L> Next<http://www.washingtonpost.com/wp-

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> L> Next<http://www.washingtonpost.com/wp-

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> L> * * " *

>

>

> L>

[Guest guest]

There are two sides to this issue.

Basically, I feel that its part of the cost that needs to be addressed

when they are doing these cost-benefit caculations.

Figure if 25% of us have the genetcs to become sick from mold, they

can't just write us off. If we do get sick from it, it costs us

hundreds of thousands of dollars over a lifetime. Everything from the

$250 monthly cost of cholestyramine, to the cost to one's career of

being forced out of the workplace during your prime earning years by

illness for years.. perhaps never to return.

You should also be reimbursed for money you and your spouse have spent

preparing for a career.

These issues are inherent to privatized health insurance. Insurance

is a gamble for insurance companies. When they insure you, they are

bettng that you will remain well. If information exists that implies

that you may have claims, insurance companies feel as if they have a

right to ask you for that information and deny you coverage if you are

sick or might get sick.

They feel they are at a disadvantage because you, the purchaser, might

know things about your health that they don't know about your health.

They are trying to level the playing field. The same thing with an

employer. Employers hire people to *work*. They spend money training

people to *work*. If they can't work, that is money they have wasted,

in their eyes.

Employers are not welfare agencies, and neither are insurers. These

health and welfare and employment issues are the government's domain,

not theirs, they feel.

They are in the business to make a profit.

Thats why a fair price to the insurance industry always includes a

profit margin that is calculated based on the risk that the purchaser

exposes them to. Sometimes its a huge one, as with someone who knows

that they are at risk for cancer or some other serious, life

threatening illness. Even chronic illnesses can cost hundreds of

thousands of dollars over someone's lifetime in drug costs. For

example, mold illness probably costs a lot because of all the health

problems people with it have, ESPECIALLY as they are often - almost

always, actually, misdiagnosed as other things.

But as long as we stick with for-profit insurance, we will have to put

up with them pricing insurance so that they can make a profit.

There may be some changes in 2012-2013 or more likely, 2016.

Cross your fingers.

Pray.

[Guest guest]

If you get sick, they want to eliminate you. The industry should not

be a for-profit industry.

>

> I, too, find this very " chilling " - and something to challenge. It

> completely erodes any 'confidentiality' they claim for patient care.

>

[Guest guest]

We definitelt don't need to aid insurers. Aren't they part of the

problem? This will be bad for patients.