Woman Moves 10 Miles in California, Blue Cross Raises Premiums From $418 a Month to $524–Quantified “Crap Algorithm&
Posted Dec 19 2012 9:39pm
Yes we are having issues with algorithms all over the place today and here’s another example. The woman moves 10 miles and her premiums increase over $100 a month. These are some very complicated formulas used by insurers today. As a matter of fact some of the calculations today just might be a little “too” complex. She’s seeing the same doctors and getting the same care, just living in a new place 10 miles down the road. Consumers are getting the brunt of all of the analytics used today and of course doctors get this type of evaluation too. Here’s something to look at from United for a comparison and all of them are using complex formulas to evaluate doctors and patients and this means there’s a ton of room for errors with one small parameter being incomplete or if it falls into a another category. Take a look at this link and see if you can figure out if a doctor meets what United wants them to meet in credentialed areas. It’s a mess. Doctors get something along this line from all the insurers they work with. It’s now just moving into the consumer area with analytics on steroids. If that doesn’t get you we have the auto refill pharmacy Algorithm which gives consumers headaches.
Over in the car insurance world I had my own rogue algorithm attack with data mining and the new owners of my house, six months after the sale, get added to my car insurance policy. Obviously is was data mining looking for information they thought I had omitted? My local office had everything correct and said it was that “other division” that was having problems getting some of their data corrected. The other division, guess that was the data miner group running queries through public records and anywhere else they can go.
One think I can say for sure for insurance analytics, they are going into the crapper when it comes to accuracy. It has to do with this addition with selling data and the automated algorithms that run the processes and it’s getting worse. I’m guessing that this woman in her appeal to Blue Cross is waiting for someone to modify the parameters of this algorithm that caused her monthly premiums to raise. One other area the insurers use today and that is MIB and fat chance of getting things fixed there is they have errors. It can take years as their focus right now is making money selling data. Their operation of being just a holding place for consumer data has changed and they have become pretty aggressive in marketing.
In addition to an individual’s credit history, data collected by the Medical Information Bureau (MIB) may include medical conditions, driving records, criminal activity, drug use, participation in hazardous sports, and personal or family genetic history, among other facts. Here’s more on that topic as they also sit around and calculate how long you may or may not live. Who knows when insurance carriers pull some of these analytics to add to your risk assessment? It’s out there. It’s all about data for sale and the heck with the consumer. Everything is not transparent and we have no clue what data they used to evaluate risk. So perhaps they added some of this information as well to her file when she moved?
We need to license and tax the data sellers and have a federal page of disclosures from all who sell data and with violations then law enforcement has a leg to stand on to fine or retract licensees to sell data.
Watch this video from Christopher Steiner who wrote the book “Automate This” and get in touch with what is really being done with math and algorithms…who gets to be the kingpin of the algorithms that move the money he asks. The Blue Cross Algorithm took over and made this decision with the consumer with no other recourse than to appeal and see if Blue Cross will adjust any parameter that made this change take place. If you need more, watch the videos on the left had side of this blog and you will get educated very quickly. When are these processes with algorithms a utility and when do they become a menace he says. The woman’s husband is on Medicare and says he’s glad he no problems like this! She also had pre-existing conditions to she’s stuck with not being able to change either. BD
This kind of arbitrary rate increase is legal, according to the Times, because insurance companies have divided the state into rate zones based on the average cost of local doctors and hospitals. Move into another rate zone, and your premiums can go up. This just looks like another way to gouge citizens in their time of need, and stuff corporate pockets with more of people’s hard-earned money. It has absolutely nothing to do with providing good health care. If California could implement a universal, publicly-financed health system, you would never have to worry about how your premiums will be affected if you relocated. Because your premiums would be $0.