How Do Insurance Companies Know My Health History? (2017)
houseoflawandorder.com
houseoflawandorder.com
No! Mathematically the insurance business works the same as long as the average premiums cover the average costs for the pool. Identifying higher risk individuals and charging them more does nothing to lower the average cost as long as they continue to buy insurance. It only spreads the costs around differently.
That is, unless the idea is to make the cost so high for risky patients as to force them not to participate in the pool.
Which is I guess what they are saying. It does lower average premiums in the pool the only way mathematically possible, by forcing at-risk or sick patients out of coverage.
This raises average costs for the original pool (from before some patients were priced out) because those patients forced out will show up later at emergency rooms with expensive problems and no coverage. But that is no longer the insurance company's problem, so who cares.
Well at a society level there is no forcing people out other than death. So unless we can get enough sick people to die quickly and cheaply this system just forces higher costs on everyone.
Or maybe we could just cover everyone in one national pool without keeping a secret database of everyone's health history to use against them and gouge them more?
Say insurers know nothing about customers, just an anonymous number. In this world they would have to charge everyone the same, the average cost of insuring a person. Everyone pays the same premium, and has all their medical bills paid.
In a parallel world, insurers have perfect information. They know your medical future, not just the history. In this world, insurers will price your premium at exactly the cost of paying your medical costs. If you won't have to go to the doctor this year (this is a world where insurers know the future), you won't be charged anything. If you're going to be in a car accident, you will be charged for surgery and rehab.
In world no. 2 where insurers have maximum knowledge, insurance basically doesn't exist. Insurance is exactly the same as just paying your bills directly. In world 1, insurance works fine, but a 19 y/o pays a little more than they do today and sick or elderly people pay less than in the real world.
As data/information becomes more ubiquitous, we travel down this continuum.
Call me cynical but in practice I think that kind of asymmetric information is only going to serve the insurer to rake in bigger benefits.
The real world scenario is that a combination of better startistics/ML, and access to a lot more data moves us increasingly closer to that world where medical insurance doesn't make any sense. Insurance works for unknown/unknowable situations.
Spontaneous combustion insurance is cheap because it could happen to anyone.
I disagree. The “the lucky should share in the costs of the unlucky” aspect of insurance still is there; the difference is that, in a perfect information world with self-serving individuals, the need still is there for the unlucky, but the lucky won’t be willing to take part.
In that system everyone who pays the insurance would be better off putting the money aside as they wouldn't have to pay for the admin overhead.
Even if the catastrophic event happens early in the timeline it would probably be better to take out a loan than to pay the insurance.
The pricing game is between the insurance companies and the providers; the end recipients of services have no involvement in the decision making process.
Its kind of like cattle, veterinarians, and ranchers. The cattle don't have much of a say in the finances or what treatments they get. The ranchers want them to feel good to make them easier to control, but ...
Virtually all health care is local and monopoly and time sensitive, just like policing or kindergarten.
I live six blocks from supposedly the best neonatal intensive care unit in the region; Only people who live nearby can benefit and I should pay more for it. Much like I pay a lot of prop tax for the local police to keep crime rates to low range of the suburban experience. Much like education I'm sure the feds and state will kick in some bucks but most of the money will come from property tax (much as most of the benefits to me come from living nearby)
In other countries, it is considered distasteful that people in poor neighborhoods get less funding for their schools and police force. And especially for schools, the country at large reaps the benefit from people going to a good school, much moreso than it is a benefit to parents that their children go to a good school.
With the rise of identity politics in the USA, there's little motivation to help the kids of people who hate you and your kids, its a natural outcome of a multicultural nation.
Poor communities of all races have been underserved since long before whenever you imagine "identity politics" started to "rise" in the USA. Was "identity politics" not enshrined in the US Constitution, which protected racial slavery while giving more-slaveowning states extra voting power over less-slaveowning states
https://blackpast.org/aah/three-fifths-clause-united-states-...
Not even. In P&C insurance at least, the premiums are invested. Even if you operate at an actuarial loss (i.e. you pay out more than you receive in revenue), you can still make a profit on the investment income.
I remember when Alphago was beating the go master, we couldn't really tell why it made certain moves.
But it certain makes sense to require an explanation for things that affect us in our lives.
If you're making algos for that directly affect another human's basic needs, I think it's really important to be able to back up why the algo did what it did. I feel like you're probably opening yourself up to massive liability (regardless of region your operating in) if you can't explain to a court why your system did X to a person that resulted in them suing your company.
Which is the exact result people want. We want explanations that are valid and understandable in relatively plain language, using postulate logic.
Let's take simplified case, to make visualization easier. Suppose the black box is deciding whether to approve mortgages, and it only has three inputs: income, credit score, and mortgage amount.
You can visualize the inputs as points in a 3-dimensional space, each point representing a unique combination of income, credit score, and mortgage amount.
Now imagine in that space we place green dots at all the points that represent inputs that result in approval of the mortgage application. Do nothing at the points for inputs that represent rejected inputs.
Need to give someone an explanation of their rejection? Find their point in that space, and then find points on the green region that are nearest their point, and tell them what would need to change to move their point to those green points.
I'd suggest, in this 3-dimensional space, to look at four green region points. (1) the nearest green point reached moving from their point parallel to the income axis, (2) same but using credit score axis, (3) same but using mortgage amount axis, and (4) the nearest green point.
In case your answer is yes, would it be acceptable to use the track record of a particular network and similarly trained networks, and why or why not?
That's not just health insurance. All insurance wants to take your money and then avoid paying in any way possible.
https://quoteinvestigator.com/2011/04/07/banker-umbrella/
I personally like the 1949 version:
>Definition of a banker: A man who loans you an umbrella when the sun is shining, asks for it back at the first sprinkle of rain, and doesn’t own the umbrella in the first place.
The article in this post, however, is lacking an explanation of how MIB gathers the medical records. It is therefore unclear if the users gave their consent to share the information even if it was through vague fine print. On the other hand the story would be very different if the data was gathered and shared without consent and I might wonder if a legal case can be made here.
Various third parties have real-time access to your hospital admissions and prescriptions, in some cases before your insurer.
As an example, when my wife was admitted to the hospital at 8 weeks for a miscarriage that almost killed her, the level of detail provided to data brokers allowed Enfamil to Fedex a big sample box of formula to us on what would have been the due date of the baby.
No consent was given or needed.
So basically, if you don’t want your information in MIB don’t apply for insurance that requires a medical history.
Hmmm ... might be able to get a copy here: https://www.mib.com/request_your_record.html
"Pack year" is often used as a risk assessment: https://en.wikipedia.org/wiki/Pack-year 1 pack year in a lifetime is not safe, but it is a vastly lower risk profile than a pack+ per day smoker.