Thursday, October 18, 2007

HEALTH INSURANCE RATES LIKE CREDIT SCORES



Congratulations to Bill Gates for Health Vault, and his op-ed piece in The Wall Street Journal on October 9, 2007. We all play a role in making this happen. We need a solution for garbage in, garbage out diagnoses, the trial and error, "here, try this drug" treatments that doctors provide based on fragments of information, and that patients endure like guinea pigs. As patients, who feels like filling out all those forms and reciting your health history to a doctor when you are doubled over in pain and not at your best and most reasonable state of mind? My 80 year old Dad bought himself a copy machine, and made 50 copies of a handwritten 8.5" x 11" piece of paper with all the drugs he takes now, his cholesterol and other stats, and the history of treatments and surgery's he has ever had. When any doctor asks him the usual questions he simply pulls the folded paper out of his pocket and hands it over. The look of relief of the doctors' face says it all. Health Vault Beta? 















So what if I handed over a piece of paper like that to my health insurance company? Or gave them access to my Heath Vault account? Since we get interest rates for loans based on credit scores, why not base our health insurance rates on health scores. If preventative, personalized medicine is to be taken seriously, can we be inspired to put our money where our mouths are? Eat well and save money on health insurance! I want to be rewarded for the great care I take care of myself. 

I am a 40 year old type 1 juvenile diabetic, and I recently contacted 10 companies about getting individual health insurance. Eight out of 10 said they won't cover juvenile diabetics. The other two said for any pre-existing condition they can only provide limited insurance (up to $100,000 per occurrence vs. $1,000,000 for a "healthy person"), they didn't have prescription drug coverage for insulin, and they suggested I am better off with a group plan. Why? My HbA1C is 5.9. For diabetics, the HbA1C test is like a baseball player's season batting average. Both A1C and the batting average tell you about a person's overall success. Normal HbAIc values for non-diabetics is approximately 4.0 - 6.2 percent. The American Diabetes Association recommends that it should be below 7 for diabetics to prevent the complications from diabetes. So I want to pay insurance rates based on my performance. Just like getting a speeding ticket or not paying my bills, when my health numbers change out of "normal" range, I agree to pay more. I simply want a fair system.

We need pay for performance guidelines mandated by insurance companies that include provisions for annual diagnostic tests that reward excellence financially with lower rates. Can Bill Gates and Health Vault help with that?