Want to See My Rhinoplasty?
posted by Danielle Citron
Doctors are increasingly offering discounts on elective surgeries or free Botox injections in exchange for a patient’s agreement to post videos of the surgery or a before-and-after shot along with an endorsement of the treating physician. You Tube is littered with videos of Lasek surgeries, breast augmentations, and nose jobs. According to The New York Times, patients have taken the discounts on the belief that sharing videos of their transformed eyes or noses tell others nothing about them and thus cannot hurt them. But that assumption is certainly worth rethinking. An employer may be less than thrilled that a Google search of a potential or current employee produces the chronicles of that employee’s plastic surgery. And some suggest that our irises can reveal certain medical conditions, such as hypertension. The grocery store bonus card that tracks the groceries you buy seems quaint by comparison to this trend.
October 14, 2008 at 5:42 pm
Posted in: Privacy (Consumer Privacy)
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Responses (10)
dobe gulia - October 14, 2008 at 7:32 pm
You mean, an employer will hire an expert who would watch a video of a potential employee’s lasik surgery to figure out whether the candidate has hypertension?
Danielle Citron - October 15, 2008 at 12:05 pm
Thanks for prodding me to be more specific. In time, such review might indeed be subject to automation, rather than subject to expensive expert review. And it is worth thinking about whether such information might have an impact in a variety of settings beyond employment such as insurance.
dobe gulia - October 17, 2008 at 10:11 am
Do you have any idea about how insurance companies price their offerings, and how they determine eligibility? Or are you just making up stuff?
Danielle Citron - October 17, 2008 at 12:54 pm
Frank Pasquale has an insightful post on insurance companies’ use of individual’s pharmaceutical records when those individuals seek insurance in a nongroup basis. See http://www.concurringopinions.com/archives/2008/07/one_more_triump.html#comments.
dobe gulia - October 17, 2008 at 10:23 pm
Ahem, first, there wasn’t anything “insightful” in that post of Pasquale’s. All he wrote was that “an untold number of people have been rejected for medical coverage” by an untold number of insurance companies, all entirely speculative, as “researched” by Business Week. Pasquale then proceeded with his usual confused claim that the governmentally-forced subsidization of people who are known as ante as sick by the rest of us qualifies as “insurance”, even though every competent health economist (or insurance economist) will tell you that insurance is the pooling of risk across people whose ex ante chances of disease are similar. “Wealth transfers to the sick” and “insurance” are decidedly not the same thing.
But your post is worse than Pasquale’s: even if it is true that some insurance companies used drug purchase data in their actuarial analysis, that issue is entirely different from the one you are presenting. It’s one thing to buy a database of prescription drug purchases (cost-effective and accurate). It’s completely different to hire an army of internet-surfers to search for videos of cosmetic surgeries performed on people who later apply for insurance, and then hire an army of healthcare experts to evaluate every one of those surgeries for the possible impact on insurance costs.
You won’t find an actuary who wouldn’t laugh you in the face at the latter proposition.
Danielle Citron - October 18, 2008 at 8:45 am
There may be no need for an army of Internet surfers as technology like web scraping is increasingly developed and invoked: http://en.wikipedia.org/wiki/Web_scraping
dobe gulia - October 18, 2008 at 10:27 am
Aha, and how do you suppose an insurance company will “scrape” the web to match videos of “Anna from Los Angeles” and “Lynn, 45 y/o”, to the last names of hundreds of thousands of insurance applicants? Recall that drugstore databases come with full identifying info, addresses, current insurance info, and often include SS#.
Frank - October 18, 2008 at 8:52 pm
Let me see if I get dobe gulia’s reasoning down here. In short: “If it hasn’t been done before, it can’t be done in the future, right? I mean, information used for one purpose is only kept for that purpose, right?”
Sadly, no. Check out this story on insurers prying into pharmaceutical records to figure out whom to deny coverage to:
http://www.businessweek.com/magazine/content/08_31/b4094000643943.htm?campaign_id=rss_daily
Or check out the Viacom vs. Google lawsuit on the disclosure of YouTube user records:
http://icommons.org/articles/youtube-viacom-and-data-concerns
At this rate, you have no idea if, say, telling K&G Menswear you have a 42 inch waist will lead to a data trail that will lead life or health insurers to shun you for being obese and thus a poor risk.
And frankly, dobe gulia, it’s the type of close-minded complacency you display here that undermines lawmaking that would help stop those worrisome possibilities.
The real burden is on you: prove that there’s some law or other preventive mechanism to keep insurers from finding out about these testimonials. Unless you’re some type of forensic genius, your inability to think of how they can do it proves precious little.
dobe gulia - October 20, 2008 at 11:24 am
Pasquale: you’ve got it exactly backwards. The burden is not on me to show why Danielle’s science-fiction-like fantasies about some future march of robots are indeed nothing but science fiction fantasies. The burden is on Danielle to show why her fantasies of how insurance companies will hire experts to watch someone’s cosmetic surgery have any relation to reality. More generally: It’s the proponents of regulation who have a burden of showing that (a) there is a real-world problem that is not being addressed by markets and existing laws; (b) their proposed regulation is likely to lessen the problem; and (c) their proposed regulation will not cause more harm than good. Neither you nor Danielle explained to us (a) why an insurance company would care that someone had a cosmetic nose job (do they care if you had a haircut?); (b) how having a cosmetic nose job would be translated into insurance premia and affect eligibility; (c) how insurance companies would collect that kind of info from the web and attach it to millions of insurance applicants; (d) how insurance companies will process that kind of info, identify specific diseases, risks, etc.
You and Danielle sound as if the main goal of an insurance company is to reduce the number of insureds. If you two really have no idea how the insurance industry works, you should learn something about it before mouthing off.
Frank - October 20, 2008 at 11:39 am
Dobe–I welcome you to attend my health care finance and regulation classes focusing on the insurance market–will that be enough proof that I “know what I’m talking about”?
We’ve given you ample evidence of the myriad re-purposings of information in a variety of contexts. The type of proof you’re demanding is likely protected as trade secrets by insurance companies–so congratulations on formulating an impossible standard of proof. I’m sure there are lots of industry think tanks in DC who’d love to employ your talents:
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=962462
Your comments really are a great example of denialism–”the use of rhetorical techniques and predictable tactics to erect barriers to debate and consideration of any type of reform, regardless of the facts.”
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