Comment by Abishek_Muthian | Hacker News Reader

Comment by Abishek_Muthian | Hacker News Reader

Abishek_Muthian

This will do great harm in markets where there are no protection for health data.

Health insurers in my country(India) are already discriminatory, top health insurers here denied me health insurance because I disclosed my disabilities[1] despite Govt. guidelines against blanket denial of policies for the disabled. This is pretty much the case for anyone who discloses their disability truthfully here[2][3].

This is because they're not keeping in sync with the progress in medical science, why should my orthopedic troubles be a risk factor for providing insurance to cover COVID-19 treatment?

Now with say health data from devices, they'll likely find more statistical data to deny coverage (with some obscure reason) or increase premium to many even if the applicant isn't sick and thereby denying a chance of health insurance coverage if they really get sick. Especially when an unqualified underwriter decides whether I should get a health insurance or not.

[1]https://abishekmuthian.com/insurers-are-putting-the-lives-of...

[2]https://www.indiaspend.com/covid-19-insurers-are-denying-pol...

[3]https://twitter.com/pavinann/status/1339952358235631625

I'm going to write something unpopular, but your data is probably safer from sale to insurers with Google than with a pre-acquisition Fitbit. Google already has a fantastic revenue stream, and only has downsides from doing something "evil" for piddling revenue gain. In an alternate timeline, Fitbit could go out of business next year and then be up for sale.

Also, I think Fitbit already makes money this way

Aren’t Google and Fitbit one in the same now given the acquisition? Or are you implying that Fitbit will function independently and Google will sell it if Fitbit isn’t profitable?

Edited my post. Alternate timeline, counterfactuals, interdimensional cable.

Why would your personal data be safer with an advertising company? Google is amassing personal data so they can charge higher rates for their so-called targeted/personalized ads. With all your personal data residing with a single ad company, it will be far easier to offer discounts to certain people, in-effect introducing tiered insurance pricing. The health insurance companies just want to figure out a way to charge sick people more, and healthy people less so they can maximize their customer base. It won't happen overnight, but then again Google started with the mission of organizing the worlds information. Hah, how often do you hear about that from them? You can barely go past page 10 on search results from the "millions" of supposed results.

Because Google doesn't sell the data, they only make targeting available from data (but not necessarily all data, specifically the health data being talked about here).

If you don't purchase insurance by clicking on ads, then you're fine?

Even if you click the ads, you're probably fine. Google isn't telling the advertiser what data they used to serve the ad.

The advertiser knows the targeting criteria they paid for.

>If you don't purchase insurance by clicking on ads, then you're fine?

not if insurers make the default more expensive, then make advertisments for a "secret" cheaper plan targeted at fit people.

That's literally what insurers are doing with Fitbit + corporate wellness plans right now.

This is more likely and not quite the same.

But I don't know anyone who is going to buy insurance from an ad. Almost everyone is getting insurance from work.

Google doesn't even seem to know why Google is doing the things Google does.

Where your Fitbit data ends up and how it will be used is just as much of a question with Google as with any other random acquirer.

> Google already has a fantastic revenue stream, and only has downsides from doing something "evil" for piddling revenue gain.

How can you have this opinion when they are already being sued by the government for doing this exact thing (in another area of their business)?

There are a few lawsuits going in the USA. To which one are you referring?

Does it matter to my point? My point is that Google has multiple times exceeded their bounds to do something evil to make extra money, so much so that they are being explicitly sued for just some of those now. Your point seemed to be why would they take the risk to do something evil and shady for extra money, when my point was that they already have a history of doing that exact thing.

The lawsuit I had in mind was the one calling out their shady AMP practices.

Sure. The "don't be evil" motto seems like more of a guideline, really. But they're not selling data to 3rd parties here, and especially not something that is obviously personal like health data. Whereas in the AMP case the alleged shenanigans nobody really understands outside of the HN crowd, if even that. They're capable of it, any company is. I think they are much less likely to try and monetize that data source this way.

Fun fact, "Don't be evil" is no longer officially part of Google's mission.

Google also has a long history of successfully monetizing consumer data without just handing it over.

That's not ideal, but it's also far from the worst case scenario.

I'm not telling Google will sell 'X person is/may suffer from Y disease' to the health insurers, they needn't even do that.

The key term to note from my statements are -

> Already discriminatory

•I wouldn't be surprised if the health insurers are already getting email ids of those who land in medical sites by searching for an ailment, Aren't email ids are even visible to the website if they had just implemented 'Sign in' and the user had already signed in the browser?

•I have reasons to believe that they are collecting patient data from the hospitals directly from my lengthy conversations with the people from insurance company. There is no HIPAA here.

Any additional data from health-tech, even if indirectly to just target advertisements could be used as an ammunition for further discrimination by parallel construction bypassing anti-discriminatory guidelines/laws from the Govt.(like they're already doing).

Of course insurers can collect health-tech data without direct access to the device through their own app, Say 'We need permission to access health data from X app for 5% discount in premium' would not invoke resistance from those who don't know that they are falling into a greater pit.

To reassure you on the point #1, no that would not make sense given the huge number of people browsing random ailments either by hypocondria or by mere curiosity.

Honestly at this point I would have no more health cover whatsoever, as I am a big consumer of random bits of medical knowledge.

I'm not sure about that - if only because it gives a "large target" for insurers. Underwriting based on health conditions (something that is currently banned in the US for health insurance, but allowed for life/disability insurance) is all about the cost/benefit of searching for data. If a lot of people have data with Google, it might make sense to pay to look at it.

Under US law at least, your health data isn't inaccessible to companies. It just requires your consent for release. That consent is basically baked into the process under a checkbox for the terms of whatever you're trying to buy.

That said, this kind of data is probably uninteresting. Diagnoses & prescription drug fills are probably more indicative (and folks like https://www.rxhistories.com/ helpfully aggregate and standardize the data).

I begrudgingly have to agree. Google will try to monetize the data somehow but not outright sell it, while Fitbit might have sold it directly if they stayed independent, especially if they struggled financially.

But really, neither Google nor Fitbit are the biggest worry, the mere existence of such health tracking devices already is the problem. Health Insurers and even life Insurers will ask you to submit your data "voluntarily". Right now, there are plenty of insurers already who offer rebates on premiums if you wear a health tracker and submit data showing you meet some goals[1].

My guess is that in the future policies in many jurisdictions will become prohibitively expensive without the "rebate" you get for wearing health tracking devices, if this goes unregulated (or any such regulations are not enforced). Insurers might force you into "voluntarily" sharing your data this way, and may even force you into "voluntarily" sharing historical data when you apply for a policy.

My German insurer offers to pitch in I think 90 EUR to buy a fitness/health tracking device. They cannot ask me or anybody for the data (yet) in return for rebates or amenities, due to regulation, which is good. However, I already dread the day when our politicians decide that to "help people stay fit" and "encourage people to stay healthy" and "help reduce insurance costs for regular(!) people(!)" the regulations need to change to allow such schemes.

[1] e.g. https://www.washingtonpost.com/business/2018/09/25/an-insura...

Heh, it's just a matter of time till this scenario "fully" reaches us here in the EU, and in the US probably, too. E.g. my health insurance company (AOK) here in Germany called me last year, and tried to give me an Apple Watch for free. The main part of the contract was, to submit my movements for "a study". In return they offered me something like "bonus points", and cheaper additional insurance plans. I said no, and they asked if I'm interested to have this for my kids, and that they also have a smart toothbrush "to motivate" kids to brush their teeth 3 times a day, I just WTF'ed, and told them to not call anymore with such offers. https://apps.apple.com/de/app/aok-bonus-app/id1085724967 with this App you submit your activity, this was part of the contract. 100.000+ downloads on Google Play says it all, Apple does not display an App download counter.

Generali has a similar program called Vitality (which apparently is a subsidiary or a distinct entity). You gather points for healthy actions you take, e.g walk/run a certain number of times/distance per month (sync your tracker), you stop smoking (proof of buying nicotine substitutes/doctor’a order), you take a yearly checkup at the doc (doctor’s order/medical results)... and you get coupons at Amazon, sport gear shops, get reimbursed an Apple Watch. The rebate on Garmin devices comes with no strings attached though.

It’s an option to the health insurance contract, so in a way they already have much more data than whatever would be provided (since they process far more sensitive medical data for reimbursement), but as I said it’s also structurally a subsidiary.

But you know that insurers have only benefits to keep you healthy (because then you only pay your monthly fee and they don't need to refund you any medical expense), so there are lots of these health-preserving programs, as there always has been even before the wearables.

Here where I live there is an insurance company offering you points to walk miles and/or go to the gym, and then exchange your points for presents. To keep you healthy and thus profitable to them.

Insurance is a worthless model where enough information is known to differentiate pricing between different classes of buyers. Asking insurers to pretend to be stupid enough to price their products inaccurately even as more and more information becomes available and playing whack a mole with regulations is a losing battle. The only solution is to abandon insurance as a model for paying for health care.

I've honestly never understood why anyone would advocate for anything other than a socialized health system.

Consumers cannot exit the market for health services. So we will never get the benefits of a free-market economy.

A "free" market where consumers cannot exit will always trend towards becoming the most expensive the economy can bear.

I think the main reason this doesn't trend all the way towards this theoretical extreme is that people don't really get into healthcare just to make money.

Oh, if India ab-uses this data for health insurance then how long until somebody games the system.

The prospect of seeing people jogging with a dozen fitbits upon each arm is something I will not be supprised too see now.

After all - people pay other people to walk their dog, not a huge leap to pay other people to take their activity monitor for a jog.

>“Haryana-based gang identified terminal cancer patients from rural, low-income backgrounds, got them to insure themselves with multiple companies by hiding their condition, waited for them to die, and then put their dead bodies through “accidents”

This unbelievable con-trick story came out last year, and seems to have had real life effect that insurers have started denying insurance to the vulnerable.

[1] - https://www.hindustantimes.com/india-news/haryana-scam-cashe...

I think another problem is the accuracy of the info and ability to dispute it. I noticed my FitBit (and I'm told with many other wrist-based heart rate monitors) don't do well with sports like boxing and rowing. My chest strap is more accurate, but doesn't get integrated with FitBit's data. I'm sure there are many other unaccounted for issues and often these kinds of data sets can't be disputed because the process is mostly automated and not transparent.

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