RX data used as health “credit report”

An article in the August 4th, 2008 Washington Post describes how health and life insurance companies are now accessing databases of individuals’ personal prescription records to rate their relative risk.

They note that consumers authorize the data release and that the services can save insurance companies millions of dollars and benefit consumers anxious for a decision. 

Why are we so focused on saving the insurance companies millions of dollars?  I frequently encounter requests from certain pharmaceutical benefit plans requesting that I change a patient from a medication, that they are usually doing well on, to one that is truly not a generic equivalent, for the sole purpose of saving money.  However, when examined more closely, it only serves to save the insurance plan money.  


More and more, I find myself concerned about the future of for-profit, insurance-driven medicine.  It seems too problematic to have such divergent interests working together:  serving the health care needs of the individual (providing quality care) and the business goals of the insurance company (minimizing costs).  We have already experienced the deterioration of the doctor-patient relationship due to time constraints that exist (de-facto) due to the insurance paradigm.  Now we are seemingly at the edge of a more efficient means of maximizing profits for the insurers by mitigating risk:  unfortunately, the risk that is avoided is providing healthcare to those who might actually need it.  What types of conditions will be considered too high a risk: diabetes, depression?  What happens to those individuals when they are excluded or have to pay rates that are cost prohibitive?  It is an unfortunate, and perhaps unforeseen by-product of the move to computerize our health records.  I am entirely in favor of information, but not at the expense of privacy violations or corporate profiteering.

~ by drdymphna on August 4, 2008.

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