Monday, February 09, 2015

Selling your right of privacy at $5 a pop

CommonHealth's Martha Bebinger has an interesting story about insurance products that reward and punish subscribers for their relative compliance with "healthy living" activities.  It's an excellent depiction of the choices consumers will make to garner insurance premium credits . . . or face the penalties.

Smith earned $10 this month just for using the program. She’ll get another $10 every month that her average score is 60 or higher. 

“That’s $20 essentially free money just by making modestly healthy decisions and going to the store, which are things I’m going to do anyway,” Smith says.

Who pays? Her health insurance plan, Harvard Pilgrim Health Care.

The goal is “to get people to understand the value of what they’re putting in their mouths,” says Sue Amsel, a senior product portfolio manager at Harvard Pilgrim.

But on the downside:

And he takes $5 off his health insurance deductible for every 30-minute workout. Rubin has to be at a GPS-confirmed gym or connect through a device like Fitbit. If he does not exercise three times each week, Rubin will lose $5 for every workout he misses. That’s the pact Rubin signed, and offers his employees, through a company called Pact Health

I'm struck by three things:

One, that people are willing to give up details of their private lives to a company for as little as $5 in reward or penalty;

Two, that there’s "very little research that proves health incentives actually improve health."

“We’re not quite there yet,” says Gary Bennett, a professor of psychology, global health and medicine at Duke University. “While the early research in using incentives to promote more healthful behaviors is extremely encouraging, we haven’t seen the kind of larger durable changes that we really need to see to believe that incentives can promote longer term improvements in chronic disease rates.” 

Three, that what appears to be healthy in this program was noted in another CommonHealth story as being problematic.  A commenter notes:

How does this jibe with "The dark side of kale?


Anonymous said...

many third world countries, like Brazil, have used financial incentives for things like ensuring children attend school with great success.

not sure why it wouldn't work for health related issues....(and again, maybe it has been used in those same third world countries successfully....I don't remember from the articles I read...)

nonlocal MD said...

I think it is way too early to turn thumbs down (or up) on health incentives as you and Al Lewis do, and this trial period where a lot of different things are being explored is very useful. It will elucidate what incentives work, and what categories they work on (food vs. exercise, for instance.) The research doesn't show benefit yet but that does not mean it never will, does it. It is very early in this cycle.
As for the privacy issues, it seems to me that our privacy is already invaded in so many myriad ways that this is a drop in the bucket.

Since our medical 'system' fails to show any interest in preventive measures, it is left to employers and consumers to give it a try.

However, I did have to laugh about two things: 1) what brand of pasta sauce to buy. I have never bought pasta sauce in my life - so easy to make at home........
2) Massachusetts small business high insurance premiums. Maybe that's more due to Partners Health Care driving up the state's cost of care than anything else.