Dystopia Now: Insurance Company Secretly Spying On Sleep Apnea Patients

Privacy

from the tomorrow's-dystopia,-today dept

Mon, Nov 26th 2018 6:40am — Karl Bode

So for years digital rights activists have worried about insurance companies getting their hands on everything from your smart car data to your pacemaker information and using that to deny you coverage, charge you more money, or make an extra buck selling said data to the highest bidder. That's especially a problem in an era where consumer privacy rights are under constant siege, alongside the right to repair and open access these devices (and any data they might store about you).

If you thought this rather dystopian future was activist hyperbole or still a decade or so out, you may be disappointed.

Propublica recently released a rather interesting story about a CPAP (continuous positive airway pressure, used to treat sleep apnea) user who found that their insurance company had been accessing sleep data generated by the device, and using it to deny coverage:

"Last March, Tony Schmidt discovered something unsettling about the machine that helps him breathe at night. Without his knowledge, it was spying on him. From his bedside, the device was tracking when he was using it and sending the information not just to his doctor, but to the maker of the machine, to the medical supply company that provided it and to his health insurer."

CPAP machines are essential to sleep apnea patients, whose health and quality of life is dramatically and negatively impacted by the fits and starts of interrupted sleep. But like so many health care sectors, these users already face all manner of hostile restrictions from their insurance companies, who often won't cover the machines if users don't rent them from specific companies at a steep premium. The insurance companies simply say they're trying to ensure that consumers actively use the machines as intended; critics say say insurance industry is simply trying to shift the cost of such services to unsuspecting patients.

"But the companies’ practices have spawned lawsuits and concerns by some doctors who say that policies that restrict access to the machines could have serious, or even deadly, consequences for patients with severe conditions. And privacy experts worry that data collected by insurers could be used to discriminate against patients or raise their costs."

“The doctors and providers are not in control of medicine anymore,” said Harry Lawrence, owner of Advanced Oxy-Med Services, a New York company that provides CPAP supplies. “It’s strictly the insurance companies. They call the shots."

In Schmidt's case, he quickly found that the device's manufacturer, ResMed, had access to his usage data. As did his supply company, Medigy. As did his health insurer, Blue Cross Blue Shield. Of course because US privacy laws remain stuck in the era of the wild west this is all perfectly legal, resulting in Schmidt running into a brick wall when he began to complain about the privacy implications of being monitored and having his medical information shared with a bevy of companies. The Better Business Bureau wouldn't help. Neither would the federal government.

Again, insurance companies say they're simply monitoring usage and denying coverage to avoid paying for CPAP machines that aren't being used (which does happen, since adjusting to sleeping with a mask and tubes is often a challenge). But as the story makes clear, a lot of the system is structured (surely entirely coincidentally!) to ensure that health care patients are paying out far, far more money than the $500 hardware actually costs. Usually courtesy of deductible structures and mandated rental requirements that can making actually having insurance more expensive than going without:

"The rental fees can surpass the retail cost of the machine, patients and doctors say. Alan Levy, an attorney who lives in Rahway, New Jersey, bought an individual insurance plan through the now-defunct Health Republic Insurance of New Jersey in 2015. When his doctor prescribed a CPAP, the company that supplied his device, At Home Medical, told him he needed to rent the device for $104 a month for 15 months. The company told him the cost of the CPAP was $2,400.

Levy said he wouldn’t have worried about the cost if his insurance had paid it. But Levy’s plan required him to reach a $5,000 deductible before his insurance plan paid a dime. So Levy looked online and discovered the machine actually cost about $500."

Levy said he called At Home Medical to ask if he could avoid the rental fee and pay $500 up front for the machine, and a company representative said no. “I’m being overcharged simply because I have insurance,” Levy recalled protesting.

Of course as the internet of broken things, wireless, and other sectors make clear, once your data is collected and sold, you're part of a system where you have little control, since using this data to make an extra buck takes absolute priority over security, privacy, or consumer welfare. And as more and more sectors begin to gobble up your daily data (from driving habits to how many times you opened your smart refrigerator), there's an ocean of problems just over the horizon that current privacy laws and regulatory agencies are utterly ill-equipped (and usually unwilling) to address.

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Filed Under: insurance, privacy, sleep apnea, surveillance
Companies: blue cross blue shield, health republic, home medical, medigy, resmed

111 Comments

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Reader Comments

The First Word

“

“The doctors and providers are not in control of medicine anymore,” said Harry Lawrence, owner of Advanced Oxy-Med Services, a New York company that provides CPAP supplies. “It’s strictly the insurance companies. They call the shots."

This is what I've been saying for years. You know what you call the guy who pays all the bills? "Boss."

Insurance companies have been running a very dangerous scam for decades now, since the Nixon administration, to get into the position they're in today.

Create the perception that health care is too expensive.
Make it very easy to get people on health insurance by offering it, not to them, but to their employer as a benefit for employees.
Once you reach a critical percentage of coverage, to the point that you're the major payer, use this leverage to make health care providers offer terms that are hostile to people not using your insurance. Higher prices, network restrictions, etc.
Cry crocodile tears when a law is passed giving you a government-enforced monopoly by requiring all citizens to purchase health insurance, while secretly laughing all the way to the bank.
Now that the competition (which is not other health insurance; it's people paying for healthcare without any insurance) is gone, you have essentially unlimited power. You get to play god, deciding who lives and who dies by denying treatments at a whim.

It's important to remember, health insurance is not a healthcare product; it's a financial product, produced and sold to us by Wall Street, and step 5 is where we are today. Their control over the details of our health is more scary than any of the other abuses they've perpetrated.

When campaigning for the ACA, President Obama talked about how we would end up with something like 30 million less uninsured people. Like so many things, he had this exactly backwards; what we need is not 30 million less uninsured people, but 300 million more. We need a health care system where people can afford their own health out-of-pocket, which is largely what we would have if it were not for Wall Street monopolists actively driving prices up.

—Mason Wheeler

”

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Anonymous Coward, 26 Nov 2018 @ 6:54am

Levy said he called At Home Medical to ask if he could avoid the rental fee and pay $500 up front for the machine, and a company representative said no. “I’m being overcharged simply because I have insurance,” Levy recalled protesting.

Well, this is just CRAP.
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I.T. Guy, 26 Nov 2018 @ 6:56am

Tony claims to be in IT. Now, as an IT Professional for 20 years if you had told me that my CPAP machine needed to be connected to the internet, first thing I would ask is why. Second thing I would do after not believing what I was told is disconnect it from the internet.

"Schmidt, an information technology specialist from Carrollton, Texas, was shocked. “I had no idea they were sending my information across the wire.”"

The other article didn't mention but does the machine have wireless or cellular?

Also:
"A ResMed representative said once patients have given consent, it may share the data it gathers, which is encrypted, with the patients’ doctors, insurers and supply companies."

Was this consent buried in legal mumbo jumbo? I have to sign all kinds of papers to let my doctors give info to my wife with all kinds of bold headers telling you what the document is. I cannot see how this does not violate HIPAA.
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I.T. Guy, 26 Nov 2018 @ 6:56am

Re:
-10 points.
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Anonymous Coward, 26 Nov 2018 @ 7:06am

Don't sign the paperwork if you aren't going to read it. He agreed to that data sharing when he signed up for the device. Don't let your insurance company give you the run around. You can shop around to different suppliers if you aren't happy with the supplier you have. I went through a few and settled on American Home Patient. Never had a problem with them. And I love that I don't have to deal with taking the machine in or swapping out an SD card just for them to see if I need any adjustments in my pressure. The doctor gets regular updates on my sleep patterns and can adjust the settings without me even needing to make an appointment.
Also, fight your insurance company if they insist that you rent. I bought my last machine outright and worked it out with insurance to reimburse me over 12 months. They want you to rent so they don't have the large outlay all at once. Especially if you aren't going to use it.
As for getting used to a CPAP, everyone I've ever talked to that has had one had no issues adjusting. Sure it's a bit different the first few nights, but after that you can't sleep without it. Hell, I can be wide awake and I put that mask on and I'm out. Your brain just learns that the mask means sleep.
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Anonymous Coward, 26 Nov 2018 @ 7:23am

Re:
> Well, this is just CRAP.

At Home Medical is a New Jersey company, and therefore not Scottish. So yeah.
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Anonymous Coward, 26 Nov 2018 @ 7:24am

Why is it connected to the internet?
There is no reason for this other than greed.
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Anonymous Coward, 26 Nov 2018 @ 7:25am

Re:

Also, fight your insurance company

Good luck with that. Works well with any wild bears you may encounter also.

Not.
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John Peacock (profile), 26 Nov 2018 @ 7:27am

Re:
Yes, modern CPAP machines have always-on cellular access. Slightly older models had a SD card that had to be hand carried to the doctor for analysis. Even older models had nothing other than a counter for hours used (and the entire unit had to be brought in).

I doubt that the type of summary data provided to the insurance company or suppliers (e.g. number of hours used per night), falls under HIPAA regulations. Those are strictly concerned with protecting the details of your medical information. Your doctor can't talk about those without explicit permission, hence the scary forms you have to fill out to let your wife know.
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Sam O All-Ways, 26 Nov 2018 @ 7:40am

Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
It's the formula here, never mention of the vast corporations, especially GOOGLE, that are doing a THOUSAND times more every day.
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Stephen T. Stone (profile), 26 Nov 2018 @ 7:42am

Start a blog and write your own articles or quit complaining. You have no editorial control here.
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Michael, 26 Nov 2018 @ 7:42am

Re:
It MUST be connected to the internet. For safety.

Disconnecting it from the internet voids your insurance, kills a rainforest, and is harmful to honey bees.
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David, 26 Nov 2018 @ 7:43am

Re:
Uh, what do you think an insurance company is based on? The whole point of its operation is netting more than it spends. It's not a charity. So greed is certainly good enough of a reason, like for most businesses. The question only is whether or not it crosses the border to obscenity.
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Mason Wheeler (profile), 26 Nov 2018 @ 7:47am
“The doctors and providers are not in control of medicine anymore,” said Harry Lawrence, owner of Advanced Oxy-Med Services, a New York company that provides CPAP supplies. “It’s strictly the insurance companies. They call the shots."

This is what I've been saying for years. You know what you call the guy who pays all the bills? "Boss."

Insurance companies have been running a very dangerous scam for decades now, since the Nixon administration, to get into the position they're in today.
1. Create the perception that health care is too expensive.
2. Make it very easy to get people on health insurance by offering it, not to them, but to their employer as a benefit for employees.
3. Once you reach a critical percentage of coverage, to the point that you're the major payer, use this leverage to make health care providers offer terms that are hostile to people not using your insurance. Higher prices, network restrictions, etc.
4. Cry crocodile tears when a law is passed giving you a government-enforced monopoly by requiring all citizens to purchase health insurance, while secretly laughing all the way to the bank.
5. Now that the competition (which is not other health insurance; it's people paying for healthcare without any insurance) is gone, you have essentially unlimited power. You get to play god, deciding who lives and who dies by denying treatments at a whim.
It's important to remember, health insurance is not a healthcare product; it's a financial product, produced and sold to us by Wall Street, and step 5 is where we are today. Their control over the details of our health is more scary than any of the other abuses they've perpetrated.

When campaigning for the ACA, President Obama talked about how we would end up with something like 30 million less uninsured people. Like so many things, he had this exactly backwards; what we need is not 30 million less uninsured people, but 300 million more. We need a health care system where people can afford their own health out-of-pocket, which is largely what we would have if it were not for Wall Street monopolists actively driving prices up.
[ link to this | view in thread ]
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Anonymous Coward, 26 Nov 2018 @ 7:58am

Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
LOL. The little authoritarians are out trying to stop free speech.
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Anonymous Coward, 26 Nov 2018 @ 8:03am

Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
You and blue boy seriously need to get a room.
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Nom-de-ecran, 26 Nov 2018 @ 8:04am

Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

Start a blog and write your own articles or quit complaining. You have no editorial control here.

??? What are you talking about? Do you expect to be obeyed? -- And oh yes, I do: COMPLETE editorial control over what I PUBLISH here on this site that invites it. -- Though Techdirt then violates the forms contract by exerting editorial control, actually making itself responsible for ALL that's published for here.

And in sum: GET STRAIGHT, kid. (Reverse of bent, which you apparently already are!)
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Anonymous Coward, 26 Nov 2018 @ 8:06am

Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
> You and blue boy seriously need to get a room.

Please don't gendershame even whoever.
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Anonymous Coward, 26 Nov 2018 @ 8:08am

Re: Re:
Uhhhh - I see your point and raise the fact that health insurance is simply a wealth extraction mechanism for the rich.

People do not need health insurance, they need health coverage.

Middle men extracting a toll, that is it.
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Anonymous Coward, 26 Nov 2018 @ 8:19am

Nothing you've said is worth reading. What's your address, I need to bill you for the time I've wasted doing so.
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Anonymous Coward, 26 Nov 2018 @ 8:20am

Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
Go fuck yourself.

Or is that "gendershaming", too?
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James Burkhardt (profile), 26 Nov 2018 @ 8:21am

Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
Strawman! Stephen was responding to your calls for Techdirt to make different editorial decisions for blog topics. Not the non-editorial content in the comment section.

Also, please point to the "forms contract" violated by Techdirt, explain how it is violated, and how that makes them responsible for user comments.
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I.T. Guy, 26 Nov 2018 @ 8:25am

Re:
1. Create the perception that health care is too expensive.

Perception? It is. Why does it cost $13,000 US for am MRI and 4 hours in the hospital? Under pre-Obama"care" I paid $100 out of pocket. Yes, I had very good insurance coverage. Now? Instant $5000 dollar debt.

2. 10 years ago my daughter was born. I got a $16,000 bill and almost fell over. Until I saw the 0 balance. My wife's insurance covered 100% of the bill.

"We need a health care system where people can afford their own health out-of-pocket, which is largely what we would have if it were not for Wall Street monopolists actively driving prices up."

This is what unraveled ACA for me. Well, one of many. Nowhere was the cost of heath care(not insurance) addressed. Nowhere was the cost of liability insurance addressed. Limits of liability, etc. None of it. It was, and still is a complete sham.
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Anonymous Coward, 26 Nov 2018 @ 8:27am

This is really why we can't have nice things...
Specifically I am talking about the opportunities we would have if not for this kind of privacy fuckery they insist on doing.
You know, I would love to have my health data being sent to a doctor or service that could monitor for inconsistencies if I could trust they would treat that data as sacred.
I would love a service that could proactively tell me if there was something I should be aware of with my car.
I would love a service that could tell and show me everything in and about my home.
I would love a fingerprint or DNA register to make it easier to catch criminals (combined with other evidence of course).

There are so many options for great things we could do even with the internet we have today, but the constant misuse and sharing/selling of our data is destroying any possibility of this happening.
Our health data is being sold to advertisers or insurance.
Our vehicle data is being used with GPS to monitor movement and also insurance companies use it to deny paying.
Our home data is laughably insecure on current devices.
A DNA register would be misused by insurance to deny anyone who have the wrong genes (and who knows what else in the future) and I suspect our legal system would start to rely on in as a sure thing and the only evidence needed combined with that it would become smaller and smaller issues it would be used for.

I wonder, is there any of these things that won't be corrupted? I love technology and have for many years, but these perversions of progress is not the result I ever foresaw or wanted.
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I.T. Guy, 26 Nov 2018 @ 8:29am

Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
"And in sum: GET STRAIGHT, kid. (Reverse of bent, which you apparently already are!)"

ROFL. You're such a putz.
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Anonymous Coward, 26 Nov 2018 @ 8:31am

Re:
It's a bit strange, when I got my ResMed CPAP they told me it would send the data to my doctor (they didn't say anything about my insurance... I'll have to make a call about that) and I asked them if I needed to set up on Wi-Fi. They told me no, so I assume it has some other connection like cellular. Since I have severe apnea I kinda like the idea that my doctor can alert me if something is amiss.

Of course my situation is slightly different from the article as I was able to buy my CPAP outright and don't remember having to sign any legal docs for it. And I wonder how does sending my info to my insurance not violate HIPAA?
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Anonymous Coward, 26 Nov 2018 @ 8:32am

Re:
So because you haven't had a problem means no one has any problems?
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Richard M (profile), 26 Nov 2018 @ 8:34am

There are options
You can buy them online fairly easily if you want to pay out of pocket. I just replaced one that burnt up with the rest of my house. Fire insurance covered it so I just went online and purchased one. I paid for the first one in cash as well but it was a few years ago and if I remember correctly it was not quite as easy to just buy one back then.

If you want to be able to track your stats online (which is actually fairly handy) but without everyone and their brother having the info you can just create an account with a false name which is what I did.

It does take more time and money if you want to keep your private info private. If you do not think about what you are doing, are signing things without reading them then, and not putting forth any effort you really should not be bitching when your privacy is lost.
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Anonymous Coward, 26 Nov 2018 @ 8:34am

Oh great, another thing to keep me up at night.
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David, 26 Nov 2018 @ 8:35am

Re: Re: Re:
Sure, that's the point of every insurance company. They are based on collecting from many and giving to fewer people, like a lottery. The difference is that the lottery gives to the lucky, and the insurance company gives to the unlucky.

They mitigate the risk of health coverage by distributing it over all clients, not by taking it on themselves. On average, you pay more than you get out. But if the non-average case would cause disproportional damage to you (bankruptcy, death), it may still be worth the cost of insuring against it.
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Anonymous Coward, 26 Nov 2018 @ 8:42am

If only you had GDPR and a NHS...
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Anonymous Coward, 26 Nov 2018 @ 8:44am

Of course because US privacy laws remain stuck in the era of the wild west this is all perfectly legal

Hmm. What was that TD article from last week?

constant regulatory attacks by EU policymakers on the key elements of innovation in the digital age

The European approach, consistently, appears to favor slowing (or stopping) innovation unless all possible "harms" are minimized, even if this comes at the expense of the benefits.

Oh, right.
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Ninja (profile), 26 Nov 2018 @ 8:48am

Re: Re:
The players involved are artificially inflating the prices. I mean, you get charged $10 for a goddamn dipyrone dose when it costs less than 5% of it in a regular drugstore because they'll enter an arm wrestling with the insurance company and drive this way down (but still overpriced). When you reach such levels of insanity people go after insurance to protect themselves even if the scenario is entirely artificial. This is modern cronyism at its finest.

Add public healthcare and you'll see this shit go down very quickly and provide dignity to the people. But this is too Communist, we'd rather spend stupid amounts of money playing war because cronyism as well.
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NeghVar (profile), 26 Nov 2018 @ 8:56am

These ones that use an internet connection and/or cellular. What would happen if a firewall policy was made or the CPAP machine was in a faraday bag? Would it still function or not? What if you use in an area outside cell range or with no internet?
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Hyman Rosen (profile), 26 Nov 2018 @ 8:57am

CPAP "spying"
It's not secret. I've known about this since I got my machine. Maybe it's just people who don't use CPAP who are surprised?

I assume the point is to make sure that no one is signing up fake users in order to bill insurance companies for supplies that are never used.

I find moral panics over privacy to be baffling, so the fact that my CPAP machine reports my sleep habits doesn't bother me at all. I have some vague hope that there is someone looking at the data who would notice a problem and notify me about it, and otherwise I don't care.
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Ninja (profile), 26 Nov 2018 @ 8:58am

Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
You keep yelling how TD doesn't call Google for its bad behavior while ignoring the many, many articles where this was exactly what TD did.

You keep comparing apples to oranges because in this case the consumer is locked with a determined company while you can perfectly keep google out of your browsing habits if you really want to by blocking their domains from loading stuff and they can't do a thing to stop you (ie: Google is completely blocked from loading anything here in TD on my browsers).

And last but not least, you keep bringing stuff that have nothing to do with the article being discussed in one of the mos persistent cases of whataboutism I've seen ever. I mean, it seems it's your life purpose to stalk TD articles and be a general asshole. It's nice because it reminds us that there are dumbasses that swallow the bullshit whole and provides the chance to reiterate how much of bullshit it is but in all seriousness you should go look for psychological care. It isn't healthy.

I'm just reminding people of your idiocy, not that I believe you will change your ways.
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Anonymous Coward, 26 Nov 2018 @ 9:03am

this article settles any question i might have about seeking this kind of treatment.
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(same screen name), 26 Nov 2018 @ 9:11am

Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

You keep yelling how TD doesn't call Google for its bad behavior while ignoring the many, many articles where this was exactly what TD did.

Yeah, I've missed those! -- Got a link to ANY where Techdirt even mildly berates GOOGLE for its MAIN income stream of full-time SPYING? No. Only a little carping re-writing a piece after run in New York Times to show it's okay. NEVER any substance on GOOGLE.

You spent a lot of time sheerly divert the charge, claiming it's answered, and you are LYING.
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(same screen name), 26 Nov 2018 @ 9:15am

Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

Also, please point to the "forms contract" violated by Techdirt

Since you put that in quotes as if don't understand that's LAW (CRFA: not very effective, but overwhelmingly supported by US Congress), you must first state the definition of a forms contract before I find you worth arguing with.
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(same screen name), 26 Nov 2018 @ 9:21am

Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

Nothing you've said is worth reading. What's your address, I need to bill you for the time I've wasted doing so.

I'm sure that I could afford your minimum wage worth at my reading rate (that'd be under a cent!), except that probably took you an hour, and you're just not worth it, kid.

Now, I'm even better at ad hom than you kids, and I note that my first comment was actually topic, even if you disagree with my notions, and I'm upset to see you kids trash the comments (so you'll surely continue). But YOU are the ones who are not interesting. A bot or a monkey can do the ad hominem here. Sheesh.
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Anonymous Coward, 26 Nov 2018 @ 9:23am

I have heard commercials about these machines where they state that 50% of the people who have them don't actually use them.

So yeah, I think the insurance company has a right to know which people are not using it.
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Mason Wheeler (profile), 26 Nov 2018 @ 9:27am

Re:

Perception? It is.

It is now. Step 1 was decades ago.
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The Wanderer (profile), 26 Nov 2018 @ 9:28am

Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
I couldn't find a definition of that term at all, just offhand.

I did manage to find the Wikipedia entry for a "standard form contract", which defines that as "a contract between two parties, where the terms and conditions of the contract are set by one of the parties, and the other party has little or no ability to negotiate more favorable terms and is thus placed in a "take it or leave it" position". That isn't the same term as "forms contract", however, and that definition wouldn't seem to fit with the way you've used the term.

From the way you use it (and from a vague sort-of impression I've gotten from somewhere), I have the idea that it might mean something like "an implied, automatic contract, with certain terms, which exists and is enforceable under certain circumstances even if one of the participants in those circumstances did not intend to enter into any contract", but I have no idea what if any the basis for that would be.

So, if you have a definition for "forms contract" which you want the rest of us to use for purposes of discussions with you, please either provide or point to it.
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Mason Wheeler (profile), 26 Nov 2018 @ 9:29am

Re:
This is all well and good for people tech-savvy enough to know about such things and how to implement them, but what about the other 98% of the populace?
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Mason Wheeler (profile), 26 Nov 2018 @ 9:31am

Re:
Why? Do they have the right to know whether or not you're taking medication that was prescribed to you? And how is this any different?

Their job is to pay for the treatments that you need. Whether or not you take proper advantage of them is irrelevant.
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bob, 26 Nov 2018 @ 9:35am

Re: Re:
If you go into the settings menu y9u can disable transmitting of data. Instead it will only be saved on an SD card.

I haven't verified if disabling the cellular connection really disables it but when you do it data doesn't show up on the tracking website available to users.
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Anonymous Coward, 26 Nov 2018 @ 9:36am

Re:
It is worth noting that the article you linked is written by Mike Masnick, while this article is written by Karl Bode. Different writers may have differing opinions on certain key things.

It's also worth noting that part of the issue with the GDPR in particular is how it's written and the problematic, wide-ranging effects of the regulation. While it's ultimately for Karl and Mike to clarify the specifics of their positions (probably already fairly clear if you read the full articles) it's also entirely possible, and logical, to be critical of specific regulation while also critical of a lack of regulation, in different legal regimes, on the same sort of topic.

For my own part, GDPR has some major issues that need redress. By the same token, I would support well-crafted privacy laws that bring the hammer down hard on abuse of the nature delineated in this article.
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Anonymous Coward, 26 Nov 2018 @ 9:38am

Re: Re:
I find the fact that an Insurance Company is allowed to deny a claim for any reason other than actual fraud to be unconscionable.
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Anonymous Coward, 26 Nov 2018 @ 9:40am

Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
I bill at $550 per piece. Invoice is now at $1850, due immediately.
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bob, 26 Nov 2018 @ 9:42am

Re: Re:
Its a simple on off setting in the device menu. No training needed other than 5 seconds when you get the device to know how to get to it.
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James Burkhardt (profile), 26 Nov 2018 @ 9:42am

Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
CRFA: California Family Rights Act? Certified Retirement Financial Advisor? Common Risk Factor Approach? Canadian Restaurant and Foodservices Association? Cancer Research Foundation of America? Not sure how any of these apply to 'the forms contract'. I had assumed you meant the 'form's contract', as in the the contract we agreed to to use the comment submission form, but apparently you are referring to a law whose acronym is unclear. Then again you refer to congressional support as if it matters, so it might be a bill, not a law.

I can't state the definition of a legal term that doesn't appear in the oxford law dictionary. Perhaps that is a shorthand or non-standard use for a term that I can look up? Direct me to a source on its meaning? Hiding the meaning of the terms you use and putting the burden on me to prove your claims is not a valid topic of discussion.
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DB (profile), 26 Nov 2018 @ 9:49am

Re:
"Don't sign the paperwork if you aren't going to read it."

That's nearly worthless advice.

Reading the paperwork won't inform you about the implications of the terms. Permission to share information "with your doctor, healthcare providers, hospital and other parties" covers... everyone.
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David, 26 Nov 2018 @ 9:56am

Re: Re: Re:
Fraud would be fewer people using the machine than insured, or more people using the machine than insured, or different people using the machine than insured.

For example, get such a machine prescribed and then rent it out, or take shifts. If the machine is used more than 20 hours a day while a different medical machine is used for similar amounts of time on something incompatible, there may be insurance fraud at play.

So there are fraud scenarios. Whether the prospective damage to the insurance company (consisting on increased machine wear and on one paying "person" needing disproportionate amounts of treatments) justifies that kind of surveillance is an entirely different question.
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Anonymous Coward, 26 Nov 2018 @ 9:57am

Re: Re: Re: Re:
Yes, that is the concept of insurance everyone is supposed to believe. However - when you think about it, health happens every second of every day in every year doesn't it? It is not a one in a million occurrence which can be paid for via small fees levied upon everyone, it is something that will absolutely happen to everyone, every day of every year. The term "health insurance" is really stupid way in which to reference the horrible system in place today. It is a disgrace.
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This comment has been flagged by the community. Click here to show it

(same screen name), 26 Nov 2018 @ 9:59am

Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

The Consumer Review Fairness Act Is an Win for Free Speech Online, Despite Possible Flaw

President Obama recently signed the Consumer Review Fairness Act of 2016 (H.R. 5111), which passed both houses of Congress unanimously. The bill addresses a dangerous trend: businesses inserting clauses into their form contracts that attempt to limit their customers' ability to criticize products and services online. We're pleased to see Congress taking a big step to protect free speech online and rein in abusive form contracts. The CRFA tackles two different ways that businesses attempt to squash their customers' reviews. The first is rather straightforward: simply inserting clauses into their form contracts saying that customers can't post negative reviews online, or imposing a fine for them. For instance, the Union Street Guest House used such a contract and attempted to fine guests over their bad reviews. The second tactic is a bit more roundabout: businesses put a clause in their contracts saying that they own the copyright to customers' reviews. Then, when they see a review that they don't like, they file a takedown notice under the Digital Millennium Copyright Act (DMCA). One notorious example of that trick is a form contract for doctors offered by a company called Medical Justice. The U.S. Department of Health and Human Services ordered doctors to quit using such contracts in 2013, but similar practices live on across different industries. The CRFA voids both types of contract clauses and makes it illegal for businesses to offer them.

https://www.eff.org/deeplinks/2016/12/president-signs-law-protecting-right-review

YES, not exactly apposite, but there's the term, and the principle of a right to critical review (on equal basis with others, no editorial warning inserted by the site) applies even here at mighty Techdirt. You're probably a foreigner, though, with no real knowledge of US rights except that want to make us miserable as you.

So I've proved you're not actually familiar with free speech law, except as believe empowers you / Techdirt to stifle dissent.
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Anonymous Coward, 26 Nov 2018 @ 10:01am

Re: Re:
Your anecdotal story proves the point, health insurance is a scam.
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(same screen name), 26 Nov 2018 @ 10:02am

Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

I'm just reminding people of your idiocy, not that I believe you will change your ways.

And I sincerely thank you! Lest I fall prey to hubris.

Also thanks for stating that you know is futile. Sheesh. How about just you clowns QUIT futile acts that ONLY ruin the site for everyone?
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This comment has been flagged by the community. Click here to show it

(same screen name), 26 Nov 2018 @ 10:03am

Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
https://www.eff.org/deeplinks/2016/12/president-signs-law-protecting-right-review
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This comment has been flagged by the community. Click here to show it

(same screen name), 26 Nov 2018 @ 10:06am

Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]

I bill at $550 per piece. Invoice is now at $1850, due immediately.

Oh, now you're poorshaming everyone, eh?

What are you doing here on this TINY little site if your time is so valuable? HMM? -- Or is astro-turfing / hidden manipulation what you bill suckers for? -- Doubt you're that good a "piece", too.
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bob, 26 Nov 2018 @ 10:08am

the real dangers of CPAP connectivity.
I'm surprised no one has brought up the issue that these devices are normally connected to a cellular network and that doctors can adjust the pressure generated by the machine remotely.

If the pressure is too high you can cause lung damage. What a nice potential vulnerability you could use to hurt or kill someone. But as we all know, the cellular network is safe and secure so this situation ccould never happen.
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Anonymous Coward, 26 Nov 2018 @ 10:11am

Re: Re:
Because thinking like this drives up the cost of healthcare, it isn't irrelevant.

If you don't take medicines prescribed to you, and you have those prescriptions filled, you not only waste money but you put your health at risk. Is that irrelevant as well?
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Anonymous Coward, 26 Nov 2018 @ 10:12am

Re: Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
I've never seen a form contract from TD. Can you point to one? Can you point to the clause that violates the CRFA? Can you point to how the ability for Techdirt's community to flag posts and make them show up with a warning that the post was flagged that needs to be clicked through in order to see it violates this act?

(Bill's rising to $2400 or $2950 depending on response, still due immediately. I'll probably just send the invoice to your ISP, I'm sure they've got the funds.)
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Anonymous Coward, 26 Nov 2018 @ 10:14am

Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
Ah, I'll have to adjust the amounts elsewhere. This definitely put it to $2400. Maybe not your ISP. Insurance company. They're sure to cave.
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Anonymous Coward, 26 Nov 2018 @ 10:20am

Re:

We need a health care system where people can afford their own health out-of-pocket

Or an insurance system where there's no dealing between the insurers and providers/industry. People pay for their care and send in the bill for reimbursement. Car and home insurance doesn't seem to be inflating prices there.

Or a non-insurance system where people don't have to pay for certain health services. Canada's system is sometimes called "insurance", but it's mostly not. Actually, the US system has a lot of non-insurance too. Insurance covers rare, unpredictable, costly events; if your employer is covering annual checkups, that's a middleman-administered benefit, not insurance.
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Anonymous Coward, 26 Nov 2018 @ 10:25am

Re: CPAP "spying"

I assume the point is to make sure that no one is signing up fake users in order to bill insurance companies for supplies that are never used.

Were that happening, wouldn't Levy have been able to easily find a cheap CPAP machine? A suspiciously cheap one, even.
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That One Guy (profile), 26 Nov 2018 @ 10:48am

Well at least it's a new form of wrong...
Are they trying out a new 'TD isn't allowed to give other commenters a way to flag my posts' delusion then? Nice of them to give people something new to laugh at.
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Gwiz (profile), 26 Nov 2018 @ 10:51am

Re: Re: Re: Re: Re: Re: Re:
Lol, Blue is being his usual brand of obtuse here.

He saw the words "form contract" in the wording of Consumer Review Protection law (link) and thinks that because Techdirt has a webpage form for submitting comments it is somehow a legally binding contract.

If he would have read a little bit further he would have seen that the term "form contract" is defined as "a contract with standardized terms".

Techdirt does not require any sort of agreement (actual, implied, click-through or otherwise) to comment on their pages, therefore no legally binding contract has been entered into by either party.

Blue, I still invite you to take your wacky, quasi-legal theory to any respectable lawyer to see how far it will get you in the real world.
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That One Guy (profile), 26 Nov 2018 @ 10:59am

Why must the lawyers suffer so...
Blue, I still invite you to take your wacky, quasi-legal theory to any respectable lawyer to see how far it will get you in the real world.

Are you trying to drive some poor lawyer to start drinking heavily? Because that would be a surefire way to get that result.
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Gwiz (profile), 26 Nov 2018 @ 11:23am

Re: Re: Re: Re: Re: Re: Re:
Lol, Blue thinks that the CRFA forces privately owned websites to keep negative reviews up. It doesn't.

The CRFA only protects the consumer from being forced to remove reviews from other THIRD PARTY review sites, like Yelp or Angie's List, by using specific wording in the sales contract or click-through contract. Nothing in the CRFA prohibits a privately owned website from removing any reviews that it wants to, for any reason. Also a civil suit concerning a 15 U.S. Code § 45b violation can only be brought to the courts by either the Federal Trade Commission or a state attorney general.
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Michael Long (profile), 26 Nov 2018 @ 11:35am

Re: Re: Re: Re:
They mitigate the risk of health coverage by distributing it over all clients... and all too often they maximize the profits by refusing said health coverage to as many of those clients in as many cases as possible.

In an "ideal" world, they'd collect premiums and pay... nothing.
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Gwiz (profile), 26 Nov 2018 @ 11:43am

Re: Re: Re: Re: Re: Re: Re:

...the principle of a right to critical review (on equal basis with others, no editorial warning inserted by the site)

Now you are making shit up.

There is no such thing as a "principle of a right to critical review". Sure you have Free Speech rights and certainly have the right to post negative reviews wherever you wish to, but the website of the product you are reviewing has no obligation whatsoever to host your review if they choose not to.

If you disagree, show me the actual law that says a privately owned website HAS to host your comments or reviews.
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Richard M (profile), 26 Nov 2018 @ 12:13pm

Re:
They use a cellular connection or at least mine does not connect to my network as I have it locked down pretty hard.

You can buy ones that do not phone home but keep track of your usage on an SD card. Then when you go back to the doctor you give them the card so they can check and see if any adjustments are needed.

The thing is your insurance company probably gets the info anyway even if your machine does not phone home as they have access to your medical records.
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Anonymous Coward, 26 Nov 2018 @ 12:18pm

Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
Normally I wouldn't bother, but just in case other people are reading and find you at all persuasive:

https://www.techdirt.com/articles/20180419/16184539674/bad-decisions-google-screws-over-t ools-evading-internet-censorship-regimes.shtml

https://www.techdirt.com/articles/20180816/16544540446 /googles-location-info-failure-might-interest-ftc.shtml

For more, use the search bar.
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James Burkhardt (profile), 26 Nov 2018 @ 12:42pm

Re: Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
So, Forms contract does not exist in your quote. Given that you said i needed to state the definition of 'forms contract', I am not sure how this helps you.

Also, I'm not sure what "YES, not exactly apposite", was in reference to.

I am also not sure what terms of what form contract you think are being violated that brings up the CRFA. This law relates to contracts prohibiting the posting of reviews on 3rd party websites. None of these things apply.
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bobob, 26 Nov 2018 @ 12:44pm

Wrap it in aluminum foil and ground the foil to the ground pin on the wall plug
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hegemon13, 26 Nov 2018 @ 12:56pm

Re: Re:
Wait, what? Our opinions and beliefs can have nuance and carefully applied thought? It doesn't have to be all or nothing? What kind of pre-Internet-commenting world did you come from? /s
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Anonymous Coward, 26 Nov 2018 @ 1:34pm

Re: Re:
Plus, what are you supposed to do if you read the terms and disagree with them? Die in your sleep?
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Anonymous Coward, 26 Nov 2018 @ 1:40pm

Re:
Conveniently, you can just connect it to the foil on your head.
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Anonymous Coward, 26 Nov 2018 @ 1:45pm

Re: Re: Re: Re: Re:
You're conflating two things. Something that pays for occasional dental cleanings or an annual physical exam isn't "insurance", because it deals with a mundane predictable event. That would be like paying a home insurance company to pay your mortgage—nothing but pointless inefficiency, unless someone else (maybe your employer) handled the bill.

Something like having a heart attack is very much like having your house washed away by a flood. It will happen to a relatively low number of people, with devastating financial consequences. Technically, insurance does make financial sense there, regardless of whether it's the best public policy.
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ShadowNinja (profile), 26 Nov 2018 @ 1:45pm

Re:
Some medical technology is connected to the Internet so your doctor can monitor it in real time, and at times make necessary adjustments (such as people with a Pacemaker).

There's actually a fear that such technology could/has already been used to murder people. When Vice President Dick Cheney got a pacemaker from his heart conditions the Secret Service wouldn't allow it to be connected to the Internet because of the threat of someone assassinating him by hacking into it.

That said, while I'm not a medical professional, I'm skeptical that there's any need for any real time data or adjustments in sleep apnea. I may be wrong, but I'm still deeply skeptical.
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ShadowNinja (profile), 26 Nov 2018 @ 1:52pm

Re: Re:
Those stuff were a problem before then. The cause of the problem came during WW2, not Obama or Nixon. WW2 is what brought us the horrible employer based healthcare system, which locked us into a horribly inefficient system.

The truth is insurance companies can't really get you a discount, the cost for the doctors or hospitals is the same regardless of if you have insurance or not. But insurance companies need to encourage people to get insurance by driving up the price, hence they force doctors and hospitals to raise the price on others without insurance, and then charge insurance their 'actual' price in effect. Then the average person needs insurance to avoid being raped by the artificial prices for those with no insurance.

I find it most ironic how so many Americans demonize Canada's healthcare system (where the government is everyone's insurance provider), all while loving those Canadian cheap drug prices and thinking we should re-import those US made drugs we shipped to them.
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Anonymous Coward, 26 Nov 2018 @ 2:14pm

Re:
Depends on what it's needed for. Some Class A drivers need to actively use them and have it be confirmed use in order to renew their medical certification. I imagine it's also used to provide coverage in a way that would have in the past required a more involved sleep study.

Then...you also get the crap that happens in the above article. This is why we can't have anything nice.
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Zugmeister, 26 Nov 2018 @ 2:18pm

Re: Tony claims to be in IT
From my brief personal experience with a ResMed machine, it skips the wireless interface entirely but has a cellular connection turned on by default. Using this connection you can monitor your sleep time / quality and such through a phone app or their web site. If you get into the "administrative" settings of the CPAP (Google is your friend) you can turn that all off. About a week after I did that on mine I started getting prompts on my phone asking why I wasn't using my hardware.
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zugmeister (profile), 26 Nov 2018 @ 2:22pm

Re: Re: Re:
About a week after I disabled mine the app (and email I think) started bugging me to know why I was no longer using my CPAP. So yeah, it probably does disable the data. If you were to be properly foil-hatted about it I seem to remember it had a removable SIM chip. YMMV.
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Anonymous Coward, 26 Nov 2018 @ 2:34pm

Re: Re: Re: Re: Re: Re: Re: Company X spying BAD! [Tacitly: GOOGLE spying GOOD.]
So, it seems by this logic, we can't block incoming calls on our phones, or perhaps just label those numbers as spammers/scammers, and even more importantly, we definitely can't be allowed to mute the TV when the commercials are on, or put our fingers in our ears to try and ignore gibberish on the street.

There is NOTHING about the Techdirt flagging of your comments such as to hide them from instant view that prevents them from being visible to people who CHOOSE to see them. Your comments (inane/humourous/out-of-context/possibly misunderstood) haven't resulted in you being blocked or being sent a bogus bill for negative comments.

Occasionally the subject gets off-topic here (sometimes on really strange tangents) because some commenters have misinterpreted what a comment is ACTUALLY about, because they are SO easily triggered about US politics they will flag a humourous comment because they perceived it to be about something other than its actual content/target.
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Anonymous Coward, 26 Nov 2018 @ 2:37pm

Re: Re: Re: Re: Re: Re:
Yes, so why do we pay an insurance co in order to visit a doctor for routine maintenance?
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Stephen T. Stone (profile), 26 Nov 2018 @ 2:45pm

I am trying to encourage free speech—by encouraging you to get your own blog, preferably one where you own all your content, and use that to speak out against Google, Techdirt, and all the other perceived enemies you think you have in your “I’m virtuous, it’s everyone else who is evil” worldview. If you want to see more articles about how evil Google is, either submit them to Techdirt or publish them yourself.

You can rant and rave and talk about your perpetual virtue in re: Google all you want. What I am telling you, you sweet summer child, is that Techdirt has no obligation whatsoever to publish, display, or store your rants in a way that makes you orgasmically ecstatic. You only have full control over your speech if you own the platform on which you publish it. You do not own Techdirt; you have no editorial control here, and you never will. Build your own blog or prepare for the perpetual disappointment of having your comments hidden—make your choice.
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Stephen T. Stone (profile), 26 Nov 2018 @ 2:47pm

Send him to a copyright lawyer, then.
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Anonymous Coward, 26 Nov 2018 @ 2:50pm

Re: Re: Re: Re: Re: Re: Re:
So there's at least some skin in the game so you don't take up doctor time because you totally had the sniffles for a few minutes after drinking a hot coffee.
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Toom1275 (profile), 26 Nov 2018 @ 3:00pm

Re:
If it doesn't refuse to start without a working connection, expect that "feature" to pop up soon.
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Bloke, 26 Nov 2018 @ 3:46pm

Useless Story
So where's the privacy concern, what have the companies done with that information that is bad?
And this dude needs a better job and insurance. I have one, paid exactly ZERO for the machine and the supplies. Sounds like he picked the wrong plan (and the wrong company to work for)
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Bloke, 26 Nov 2018 @ 3:49pm

Re: CPAP "spying"
exactly, CPAP machines are spying, but that new smartwatch everyone is raving about, which you got a great cyber monday deal on isn't?
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Anonymous Coward, 26 Nov 2018 @ 4:48pm

Re: Re: Re:
My experience completely disagrees with your assertions.

Doctors regularly bill the insurance company for $X. The insurance company pays $X - $Y. But if I go in without insurance I pay significantly less than $X.

What this tells me is that the providers will charge the insurance companies as much as they can get away with but they'll charge cash payers the more reasonable rate. The insurance companies aren't encouraging higher prices directly, only indirectly insofar as they will pay up to the maximum specified in their contracts with the providers; Naturally the providers push for those maximums every time.

Of course all of this pushes the patients to their yearly out-of-pocket maximums pretty quickly but hey, you were gonna hit that before the end of the year anyway, right? Right??
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Anonymous Coward, 26 Nov 2018 @ 4:52pm

Re: Useless Story
> Sounds like he picked the wrong plan (and the wrong company to work for)

Yeah, because we all have a full menu to choose from and refuse to work for companies that don't provide better coverage. /s

My coverage is expensive ($600/mo for family) but I pay a maximum of $10 for *anything*, even surgery. However, this is rare. Most people get crappy plans (because that's all that is available) that still cost a lot monthly and then charge huge deductibles and percentages of medical care cost. That's the norm. Not good, just typical. Try to look beyond your personal situation because not everyone has the same choices available to them.
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Anonymous Coward, 26 Nov 2018 @ 5:01pm

You gonna cry again?
Why do you hate paying artists for their work?
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Anonymous Coward, 26 Nov 2018 @ 5:17pm

Re: Re: Re: Re: Re: Re: Re: Re:
If the question was about why insurers don't cover the whole amount, that's correct. Though workplace policies that require proof of illness are the usual reason people go to doctors for minor illnesses (or come to the office while sick, thus spreading their illnesses).

If it was about how insurance companies got involved in such silliness, see Mason's comment for a start. People expect employers to offer health coverage now, and they expect it to cover routine expenses because that's what they're used to. Or often because they're bad with money, or if they're smart, because they've calculated that they'll get a net subsidy from the other employees (due to large family size or bad health). Employers make everyone sign up for the plans, because otherwise the healthy people would opt out and it would become unsustainably expensive.

But in theory, in a non-distorted market with people who are good at saving money, the most efficient way to pay would be to put money in a Health Savings Account (thus avoiding income tax on that amount), use that to get reimbursed after paying directly for medical expenses, then use high-deductible insurance for the extraordinary stuff. For example, you pay the first $5000/year from the HSA, then insurance covers 90% of the rest.
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Anonymous Coward, 26 Nov 2018 @ 5:20pm

Re: Re: CPAP "spying"
Smartphones would be a better example, or fitness trackers perhaps. Smartwatches aren't all that popular yet, despite the manufacturers acting like they totally should be.
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R.H. (profile), 26 Nov 2018 @ 6:12pm

Re: Re: Re: Re: Re: Re: Re:
You don't have to. You can choose to pay for that ~$100 visit out-of-pocket if you so choose. There's nothing stopping you. For example, the primary argument in favor of single-payer insurance isn't catastrophic insurance, since most people won't need that over the course of their lives, but rather that everyone benefits if all people actually see the doctor for regular well-person visits for things like vaccinations and other health maintenance since a healthy population is generally more productive.
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carlb, 26 Nov 2018 @ 7:57pm

a big sack of coal with that?
It knows when you are sleeping
It knows when you're awake
It knows if you've been bad or good
So be good for goodness sake!
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cornflahkes (profile), 26 Nov 2018 @ 10:09pm

Re:
No. This Is CPAP!
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Bergman (profile), 26 Nov 2018 @ 10:12pm

Re:
It's a little expensive, but if it will work to stop people from remote-wiping devices in law enforcement custody, it will keep a CPAP machine from phoning home wirelessly too.

https://www.amazon.com/Mission-Darkness-Enforcement-Military-Protection/dp/B077NS2MMJ
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Anonymous Coward, 27 Nov 2018 @ 6:41am

Re: Re: Re: Re: Re:
"They mitigate the risk of health coverage by distributing it over all clients"

What is the "risk" of me needing a physical at age 50 and why should everyone else be forced into helping me pay for it, in addition to paying the toll keepers at the insurance companies?
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Anonymous Coward, 27 Nov 2018 @ 6:46am

Re: Re: Re:
As if the prescribed medication is needed by the patient rather than the profit needed by the doctor/pharma grifters.
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Anonymous Coward, 27 Nov 2018 @ 6:47am

Re: the real dangers of CPAP connectivity.
... and that function can only be performed in real time by a "doctor" over the internet.
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Anonymous Coward, 27 Nov 2018 @ 6:48am

Re: Useless Story
"this dude needs a better job and insurance."

LOL - yeah, it's their own fault isn't it?
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nasch (profile), 29 Nov 2018 @ 7:45am

Re: Re:
Well it's a tangent, but Cheney's implant is a pump, not a pacemaker. Because of it, he literally no longer has a pulse.

https://blogs.scientificamerican.com/observations/former-vice-president-dick-cheney-receives-a rtificial-heart-part/
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nasch (profile), 29 Nov 2018 @ 7:53am

Re: Re: Re: Re: Re: Re:
Assume that if everyone gets that physical, then overall health care costs go down. Furthermore, assume that the health insurance market is competitive. That may not be quite true but it simplifies the picture. When everyone gets the physical, the insurance companies have to pay out less in claims. To stay competitive, they'll need to then reduce their premiums, or increase benefits, or some equivalent. So everyone benefits.

To the extent that one or both of the assumptions is not correct, the benefits to society will decrease.
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nasch (profile), 29 Nov 2018 @ 8:05am

Re:

We need a health care system where people can afford their own health out-of-pocket, which is largely what we would have if it were not for Wall Street monopolists actively driving prices up.

Even if hospital care cost a tenth of what it does now, a single medical catastrophe would bankrupt a significant percentage of people. There's a lot wrong with the health insurance system we have, but making everyone pay for all care out of pocket isn't the right answer either. That would even further exacerbate inequality since the quality and quantity of health care you get would depend on how much money you have.
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Mason Wheeler (profile), 29 Nov 2018 @ 3:24pm

Re: Re:
And that's where we would have a place for a legitimate medical insurance system. That's what insurance is for: covering unforeseeable catastrophes.

Medical "insurance" as we know it in the USA bears no resemblance to real insurance, though. They cover routine healthcare and do everything possible--often going to truly disgusting extremes--to avoid having to pay for actual catastrophes. Elizabeth Warren was quite right to compare the system to an umbrella that melts in the rain.

No matter which angle you look at it from, it's a thoroughly corrupt system that needs to be done away with.
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nasch (profile), 29 Nov 2018 @ 3:35pm

Re: Re: Re:

They cover routine healthcare

That's actually good. If insurance only covers catastrophes, people (especially poor people who can't easily afford routine medical care) have an incentive to wait until their condition is catastrophic before getting care. Which then makes insurance incredibly expensive.

do everything possible--often going to truly disgusting extremes--to avoid having to pay for actual catastrophes.

Obviously that's extremely bad.

No matter which angle you look at it from, it's a thoroughly corrupt system that needs to be done away with.

I would say thoroughly reformed.
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Mason Wheeler (profile), 30 Nov 2018 @ 8:12am

Re: Re: Re: Re:

That's actually good. If insurance only covers catastrophes, people (especially poor people who can't easily afford routine medical care) have an incentive to wait until their condition is catastrophic before getting care.

Yes, but now we're back to my original point: if it were not for Wall Street insurance companies driving the prices of health care up in order to price out of the market anyone who doesn't buy their financial products, routine care would not be unaffordable to John Q. Citizen.
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nasch (profile), 30 Nov 2018 @ 6:24pm

Re: Re: Re: Re: Re:

if it were not for Wall Street insurance companies driving the prices of health care up in order to price out of the market anyone who doesn't buy their financial products, routine care would not be unaffordable to John Q. Citizen.

For certain definitions of John Q. Citizen. Even if you could reduce costs by 90%, there are still people who couldn't afford as much routine medical care as would be optimal. Ideally (and I know we're far from that) those people would have a system that pays for their health care - routine and catastrophic - out of tax funds. Unless you first completely eradicate poverty, you just can't get health care costs low enough for everyone to be able to pay out of pocket.
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