Just how much do you trust big companies, including the one you work for, with your health information? That issue may become increasingly important as employers campaign to help themselves and their employees by banding together to curb health care costs. It also may matter more as enterprises quietly and largely out of sight data-mine electronic health records for economic advantage in markets and products.
With 18 percent of the U.S. gross domestic product taken up by health care, there’s no escaping the big money in medicine. I’ve written before that it’s becoming key these days to scan business coverage as much as the news columns, broadcasts, and web sites devoted to health, medicine, or wellness to keep up with matters affecting health care.
So let’s connect some dots in business news about health. Let’s look at an announcement of a new alliance, aimed at improving health care, and representing “20 companies [that] are responsible for health care benefits for four million people and [that] spend more than $14 billion annually on health care for employees, their dependents and retirees.”
The participants include: American Express, American Water, BNSF Railway, Brunswick, Caterpillar, Coca-Cola, E.I. du Pont de Nemours, HCA Inc, Hartford Financial Services, IBM, Ingersoll Rand, International Paper, Lincoln Financial, Macy’s, Marriott International, NextEra Energy, Pitney Bowes, Shell Oil, Verizon Communications, and Weyerhaeuser.
They have pledged to create a nonprofit alliance to improve for their companies and employees what they call an “unsustainable” and too costly health system. They hope to focus on market efficiencies, better learning from data, educating employees, and breaking bad habits in health care consumption.
Admirable goals but …
All this stuff may sound admirable─you’d be crazy not to wish them well. But it’s important to keep our eyes wide open about this alliance, and how its best intentions get carried out. I can’t be the only one who gets nervous when you put together so many corporate titans from so many different kinds of businesses.
As critics already have hastened to note, corporations have a track record of acting in their own best interests, first and foremost. Take for example recent questions arising about a group that purports to be advocates for patients─but, which, turns out to be a public relations effort favoring Big Pharma; the Health News Review holds up Patients Rising and its sister group Patients Rising Now as examples of what it calls “Astroturf” or shill or front organizations that try to gull the uniformed.
As for the business alliance on health care, in its planning, its organizers already have made clear that they plan to take huge amounts of employee data and to share and mine it, among members for now. Will they also protect it─or will they exploit it and sell it?
Americans already have gotten an unpleasant taste of what can happen when employers intrude in their health through workplace wellness programs. As I’ve written before, these initiatives haven’t worked well but they have made workers uncomfortable and shown Big Brother willingness to be invasive.
Do you really want your employer knowing about the meds you take for your mental health or your sexual well-being? Do you want the company you work for to start penalizing you for how much soda you drink or for failing to hit the gym this week? Yes, employee health data will be aggregated and it’s supposed to stay anonymous. But how comfortable are you with profit-seeking shareholders and big investors prodding your corporate chiefs into bundling up all the company might know about you and your family and your health care and selling it into new markets?
Health data mining
Who might the buyers be? As another financial report points out, there are companies like IMS Health scouring for health information. It’s a successful company built on, frankly, a smart idea: It acquires billions of bits of anonymous data from pharmacies, insurers, and others in health care. It mines the material to help Big Pharma and others figure which drugs seem to be working, and more importantly, which are selling well and might be targets for higher prices. Patients and even many physicians, meantime, likely don’t know how health information gets trafficked, exploited, and, we all are left largely in the dark, as to how this critical information gets protected.
I’ve written before about steps consumers can take to protect the privacy of their health records, chiefly from snoops and hackers. As these vital materials go digital─and we benefit from the cost, efficiency, and care improvements that result─we also need to be wary of the unintended consequences of technology’s advance.
The way that the American system evolved, with health insurance provided in the workplace, certainly puts employers and corporations squarely in the midst of any discussions about improving health care. But we also need to be wary of and to remind with great force that Big Business can’t run roughshod over our individual rights to control our own health, including the confidential, private information and data that’s part of our medical records.