- A bold data-mining trick is being used by health insurance
companies. You'll receive a phone call from someone who will claim to
be working with (or for) your health insurance company. A recent case
of phone interrogation involves a company known as "Lifemasters."
The caller was charming, cordial and well trained.
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- There are two indicators of who these people really are:
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- 1. Your caller ID will show a company name that isn't
your health insurance company, or perhaps nothing.
- 2. They will begin asking questions about your that your
health insurance company should already know the answers to.
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- They will start with some lie like "we need about
20 minutes of your time to answer some questions." In listening to
such an interview take place, it encompasses EVERYTHING about you, your
life and your family. The interviewer will intersperse health questions
with other incredibly unrelated health related questions such as "How
many grandchildren do you have? What are their ages?" How much does
your husband earn? If you refuse to answer personal questions or say this
isn't a good time, they immediately ask you what your height and weight
is. Using actuarial tables that life insurance companies use, the answers
to those two questions alone speak volumes of information about your condition
and possible health issues.
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- These phone interviews are nothing more than interrogation
without the bright lights and torture.
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- Other invasive questions include what diseases you have,
what medications you are taking, when you take them and what the doses
are. One health insurance company that appears to have employed LifeMasters
is Aetna. Although Aetna is known as an auto and life insurance company,
it is also used by universities and other companies who are self-insured
to manage their plans and make payments to doctors, hospitals etc...
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- The following statement is from the LifeMasters website:
- "At LifeMasters, we believe people working together
can work wonders. That is why we unite individuals, physicians, and payors
[1] toward the achievement of a common purpose: healthier lives and improved
clinical and financial outcomes for those with chronic conditions."
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- Their website also claims an 11.2% net savings in health
care costs.
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- Now consider a patient with MS. How could "Lifemasters"
help them? They can't reverse the condition, nor can they stop or reverse
the disease OR the increase in costs for specialized medicines like Copaxone
- which is only made by ONE company and has increased in cost. Today that
drug alone is almost $2,000.00 a month. Next year it will probably hit
that mark. And the patient must take it for the remainder of their life.
For MS, it's only one of about 5 medicines used to manage the disease.
Other medicines are used to stop serious pain that accompanies almost
half of MS patients, drugs to stop seizures and other drugs to deal with
the unbelievable mental stress that accompanies the disease.
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- There is nothing whatsoever that anyone, including LifeMasters
can do to stop and reverse these symptoms.
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- An arrogant name like "LifeMasters" should
set alarm bells off in one's mind and their company's statement supports
this fact. Note the carefully worded term "payors" used above,
probably referring to health insurance companies. Apparently they believe
there is a magic wand which makes suffering and financial pain decrease.
There is no such thing as an "improved financial outcome" for
someone with a serious illness.
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- WHAT ANYONE CAN DO
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- Changing health care plans with an employer can actually
result in both considerably lower monthly premiums and reduce out-of-pocket
drug copays, as this author has successfully done. But that doesn't require
someone like "HealthMasters" to do. In fact, it's just old- fashioned
homework you have to do - study the available health care plans and compare
their details which any policyholder can do themselves.
- IMPLICATIONS FOR PATIENTS
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- So, what are the hidden hazards of helping someone to
write a dossier on you? They can, and almost certainly will SELL your
highly personal information. It's despicable to think that someone's
health problems could be profitable, but it makes no difference to these
people. I intervened in the phone interview as soon as I heard where it
was going and stopped it cold. This is nothing more than a technique known
as "profiling," and in the coming years it could be used against
you. How? By determining if you are someone worth keeping alive, by seeing
if you are taking your medication properly and regularly and just how
sick you may be. Ultimately, it could be used to deny you lifesaving medicines.
Or as Alex Jones has pointed out, there are plans in the works to tie
in everything you purchase at the grocery store with providing you health
care. One day, they might deny you health care saying "you have been
eating too much red meat" or "too much junk food."
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- Whenever profits are involved, corporations will stop
at NOTHING to improve their bottom line. Imagine going into a hospital
someday, and after giving them your health insurance card they coldly
tell you, "We can't treat you because your health insurance company
has refused to pay. You haven't been eating properly, and you'll have
to leave." Don't think this can happen? Think again. Try going into
any hospital today without health insurance and see what happens.
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- Phone interviews are a very clever way to get around
HIPPA (Health Insurance Privacy Act.) Most people who haven't been to
a doctor in years or at all, know little or nothing about HIPPA. But these
regulations are squarely aimed at protecting a patient's privacy, by
declaring who will see your personal information. A doctor's office MUST
have you sign a form to release your treatment information to your health
insurance company, and any government agency that wants it. The permission
must be given in a SIGNED form - verbal permission is not acceptable.
If there is a specialist you are referred to go see you'll be signing
yet another form at their office, too. Once signed, disclosure permission
is valid just one time, or for an indefinite period until YOU personally
revoke them. However, revoking the permission later is tantamount to trying
stuff a genie back in a bottle.
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- Companies like LifeMasters are clearly trying to bypass
HIPPA regulations, and do not disclose to patients that they will use
this highly personal information to make a profit, and possibly sell
it to others.
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- Ted Twietmeyer
- tedtw@frontiernet.net
- www.data4science.net
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- [1] The term "payors" doesn't come up in a
spell checker. Perhaps this is a British word, and hence it may actually
be a British- owned company.
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