In 2016, Americans paid $352.5 billion out of pocket to go to the doctor

Philothée Gaymard source : Usbek et Rica, 08/10/2018 15:01

As health insurance prices go up and health coverage becomes increasingly decorrelated from work, more and more people turn to preventive medicine -- with the help of data-powered startups.

“You shouldn’t have to be wealthy to be healthy.” The baseline for CoverUs, an app that will launch in 2019 to allow patients to get paid for their health data, may sound strange to European ears. But in the United States, where there is no universal health coverage and the cost of health insurance keeps rising, CoverUs could be one of the solutions to help keep people healthy -- even when they are not wealthy.

A fourth of American workers are “underinsured”

According to the Centers for Medicaid and Medicare Services, in 2016, Americans paid $352.5 billion out of pocket to go to the doctor. This means that U.S. households represented 28.1% of national health spending that year, while the government was at 28.3% and businesses at 19.9%.

People now increasingly rely on the kindness of strangers to pay their medical bills.

In the summer of 2018, crowdfunding platform Gofundme revealed that a third of their campaigns are healthcare related: people now increasingly rely on the kindness of strangers to pay their medical bills. Even more worrying is the fact that the cost of insurance keeps getting higher. “For the last five years, insurance has gone up in price between 5% and 7% annually,” writes Fast Company in an article aptly titled “Why work has failed us: Because you can have a job and still not afford the doctor.”

(CC Mark Warner - Flikr)

Being able to afford medical services is a pressing issue for millions of Americans, even when they have a job and the insurance that should come with it. This is partly because the development of the gig economy means that many workers are considered independent contractors who do not benefit from the social benefits that employees have; it is also because “the Trump administration offers businesses even more opportunities to buy (...) cheaper and less comprehensive coverage than is typically required by the Affordable Care Act.” In 2016, nearly a fourth of workers were deemed “underinsured,” as per a report from the Commonwealth Fund. Their number has grown more than two-fold since 2003.

Selling medical data to pay the bills

Of course, the bulk of the solution should be political, but it is not likely to happen under the current administration. So start-ups and patients are coming up with solutions that, sure, borderline on dystopian when you are lucky enough to be born in a country with subsidized healthcare, but may be a lot of people’s best bet right now. 

Maybe a future in which selling your medical data allows you to pay the hospital bills is not a worst-case scenario

Some of them rely on data to shift the focus away from care and towards prevention. Parsley Health, a company founded by a medical intern called Robin Berzin, offers healthcare subscriptions: “for a flat monthly fee–$150-$250–the company will review a patient’s eating and exercise habits, their vitals, their weight, their mental health, their sleep, and other data to help them be their healthiest,” explains Fast Company. Via its company Verily, Google is also investing massively in data-powered preventive healthcare.
Others use data as well, but in a way that makes patients earn money. It is the whole premise of CoverUs, who wants to make it so that people finally own their healthcare data. “Private companies are making tens of billions of dollars by collecting and selling medical data (...). This happens without permission, and puts individual privacy at risk,” writes the company. Their solution? Connecting their members to the medical industry and financially compensating them in exchange for the data that helps “power the life-saving healthcare innovations of tomorrow.”

Focus groups, a new way to pay for health care ?

Less enthusiastic but also eager to promote the interest of patients is Savvy, a patient-owned co-op that rewards patients for sharing their health experiences with medical companies -- though not through data: they answer interviews or surveys or participate in focus groups.
We would put our money on the solutions, like CoverUs, that rely on blockchain to make this data sharing business safe. In any case, and in the absence of political decisions that make healthcare accessible to all, maybe a future in which selling your medical data allows you to pay the hospital bills is not a worst-case scenario after all.