There's money in snooping, we know it from the tabloids, we know it from exposes about every aspect of life and we know it about the health insurance industry. This industry has made its life work saying "gotcha" to millions of consumers trying to have health insurance companies live up to their contractual agreements to help pay for needed medical services.
So why be surprised that Express Scripts, a prescription plan administrator, received an extortion threat from someone who obtained personal information from members? We like the drama of using the word extortion for one. Plan administrators, the ones working with insurance companies like being the only ones able to deny your claim, use your health to extract higher costs EVEN IF your actual medical expenses don't warrant such jacking up of prices for two. And the election of Obama and his big plans for technology in health services is three.
So where are we, really. In my opinion, it's time to reconsider Dr. Samuel Mudd, the country doctor who was sentenced to life in prison for his assistance of Booth after Lincoln's assassination. Though later pardoned, the doctor gives us some insight into where our medical services industry might be going...secret treatment by physicians of people able to pay bypassing the current and ever-expanding "reporting" requirements necessary to get little or any reimbursement from insurance companies.
The report about Express Scripts was in the business reports this week. Their stock price is up, even after the extortion threat. Why? Probably because of the technology requirements that will continue to be pushed as a means of streamlining the administration of medical services at a savings to companies that will then pass those savings onto us (yeah right).
But of course, these "savings" are largely mythical as we listen to how many years out it will take to get everyone on board and online, and as we consider how much a single breach can cost a company, an individual. Be that as it may, the technological push is what we're in for. So what about patient privacy? Will Express Scripts be liable? You can guess probably not and the poor chumps whose privacy is gone? You can bet that's not going to be a big issue either because privacy at this point is largely myth.
The story gives good information for health services consumers: Should really care if the information is "out there?"
Consumers know something that we're not expressing well enough...there is little to no privacy regarding our health anymore. The best we can hope for is to manage "how" the information is used.
Health insurance companies have seen to it that every medical piece of information we have is voluntarily open to scrutiny in order to obtain our "coverage". Every time you submit a health insurance claim you open your file to some clerk and any clerk who is going to try to deny your claim and will do everything possible to justify such denial. In the case of mental health, this includes doctor interpretation of psychological testing.
So how will you keep your own health private? I believe that there are already a new generation of Dr. Samuel Mudds, who will treat people in cash transactions to minimize or negate any paper trail of health status. And while everyone can be outraged of such an assertion, think about every other highly regulated field...businesses avoid corporate taxes by getting off shore accounts, accounts OUTSIDE our system; individuals who want to get their medication cheaper go to Canada, OUTSIDE of our system; people who need or desire expensive surgeries go to other countries, OUTSIDE of our medical services industry. But how about privacy? Privacy is also about money and invasions of privacy are about others making money off your information. Insurance companies have invaded our privacy and entered our doctor's offices with us because they have a financial interest in being there. The only way to take away their right to know is to take away our expectation that they help pay for our medical services. Like that assassin Booth who wanted anonymous medical care, I think we will all need access to our own Dr. Mudd.
Like Dr. Samuel Mudd, physicians who participate in these transactions may or may not be guilty of some sort of malpractice if caught, and I'm sure that the physician malpractice insurance providers would balk at the practice, but in truth, in my opinion, we are paving a way to some sort of black market practice of medicine. Look at what happens to stock when CEO health seems to be failing (for instance Apple when rumors about Steve Jobs spread)...might have been better for him to use a physician who would treat him anonymously. Look at employers who won't hire people if they smoke (even if they don't smoke on the job) yet the obese, the alcoholic and even people with other health risks cannot be denied employment...seems like an opportunity for an employee to see a Dr. Mudd for care.
Is there an alternative to the Dr. Mudd scenario? Of course. For companies that lose information or have it stolen or misplace it, stiffen penalties and create strict liability for every breach. In the event of breach, immediate sums of money are delivered to every consumer as damages. If criminal activity is present in the misuse of such information, those damages are tripled upon the proving of criminal intent especially if the person who stole the information was an employee and as such an agent of the company. Since plan administrators are also agents of health insurance companies, the immediate refund of all premiums for a plan year in which such event occurs should be given to insureds. And legalize the option for patients to keep certain things private with their physicians without requiring physicians to report to insurance companies about patient health without patient consent.
Start there or prepare for the new black market for health services and the return of Dr. Mudd.
