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Aetna accidentally exposed customer HIV statuses in clear envelope windows

washingtonpost.com

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Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#81

Post by maxerickson »

chimeracoder wrote: post #38
maxerickson wrote: post #26

Earlier quoted context omitted.

Competing across state lines means all insurance will be regulated by the state with rules that most favor the insurer, it isn't all that likely to be good for consumers. The banking renaissance in South Dakota is a result of a similar situation. https://www.theatlantic.com/business/archive/2013/07/how-cit...

> Competing across state lines means all insurance will be regulated by the state with rules that most favor the insurer Not really; states are still free to set additional requirements for insurance plans that cover members of that state. To be honest, competing across state lines would not actually do much in the long run. It'd provide an extra degree of competition in the short-term, but ultimately then insurers w…

Is that a fundamental aspect of state power or is it an aspect of the particular proposals that have been made?

Cruz's proposed legislation from a couple years ago appears to restrict what "secondary" states can regulate quite a lot:

https://www.congress.gov/bill/114th-congress/senate-bill/647...

(b) Exemptions From Covered Laws in a .—Except as provided in this section, a health insurance issuer with respect to its offer, sale, rating (including medical underwriting), renewal, and issuance of individual health insurance coverage in any secondary State is exempt from any covered laws of the secondary State (and any rules, regulations, agreements, or orders sought or issued by such State under or related to such covered laws) to the extent that such laws would—

Of course it spells out a bunch of situations where the secondary state would still have authority, but reducing the ability of states to regulate sure seems to be one of the goals there.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#82

Post by checker »

jubabuba wrote: post #42
chimeracoder wrote: post #21

Note that the USPS also scans and stores images of the front and back of all mail it delivers, even if you don't opt in for their digital delivery service[0]. So this means that the USPS - and anybody else with access to their images, which includes law enforcement - now knows the HIV status of these people. [0] http://www.nytimes.com/2013/08/03/us/postal-service-confirms...

In practice USPS/law enforcement will have this image data but they will not parse it for some time (if ever).

AFAIK in this case law enforcement is the Inspection Service which is part of USPS; if images are divulged to any other agency, it's through USPSIS.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#83

Post by vidarh »

chimeracoder wrote: post #41
slantedview wrote: post #13

Earlier quoted context omitted.

> Aetna is terrible This is true, but I'd like to qualify this by saying that all of the for-profit insurers (and most of the non-profit ones) are terrible. Generating revenue is in direct conflict with providing patient care which is a fundamental flaw in the setup. It's a uniquely American problem.

> Generating revenue is in direct conflict with providing patient care Without revenue, there's no money to use to actually provide care. > It's a uniquely American problem. It's not at all. Aside from the fact that most of the world uses at least some degree of privatization in providing or paying for healthcare, even the few that don't do so at the metaphorical "last mile" (such as England) still suffer from the un…

The difference is that those systems goes to great lengths to ensure that the decision is done based on clinical needs and objective measures of what achieves the most patient benefit for the available money.

As a result it is very transparent what is sacrificed - e.g. you can find NICE [1] documentation on evaluations of individual drugs and treatments and their benefits, and documentation of the decision making processes of the NHS trusts, so they can be debated and used as a basis for deciding funding, or you're free to sign on to additional private cover if the exemptions worry you.

What we don't get is debates like this where people need to exchange information about whether or not an insurer is likely to try do be excessively strict in denying claims etc., because those kinds of things are extremely marginal here, not something most people ever need to deal with.

[1] https://www.nice.org.uk/

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#84

Post by X86BSD »

yebyen wrote: post #12
mabbo wrote: post #2

Oh neat, I just signed up for Aetna (first time working in America since ACA). Is this normal for them? Am I an idiot?

If you know how to "don't take no for an answer" I'll say optimistically, you'll be alright. My experience with my wife's health care (Aetna) has been that she will call, try to get an issue resolved, be told "there is no resolution possible" enough times by enough different people that she is ready to give up. Then we call together, and suddenly the story changes. The particular issue we were dealing with, is not re…

What floors me is how no one has disrupted this field yet. I have seen a few ground zero startups trying to disrupt healthcare. Make it more effecient, cut out fraud, etc but so far no one is making a dent.

Why is it so hard for some smart young folks to come along and hammer out solutions to accomplish less fraud, easier, and faster to use systems etc?

It seems like it's really REALLY hard to bust up this abortion we call healthcare in the US.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#85

Post by vidarh »

rdiddly wrote: post #54
pluma wrote: post #51

Does the US not have standardized letter and envelope sizes? In Germany we have standards for paper sizes, window placement and the layout of business letters. Considering this type of letter is probably not typed out by hand, it's trivial to use a template with the correct layout. At that point the choice of letter becomes irrelevant. I'd expect the US to have something similar but maybe they don't? If there are sta…

There is no standard that I'm aware of. On a related note, if I had a dollar (or a Euro) for every US problem that the Germans solved long ago through straight thinking, I'd have enough money to move to Germany.

The standards for paper and envelope sizes [1] are so ingrained in me that it's almost like metric vs. imperial. They're ISO standards, though based on German standards, and being able to instantly know roughly how big a paper size is, is very convenient.

E.g. A4 almost the size of US Letter, but from there we know if you take an A4 sheet, turn it 90 degrees and puts another one above it in the same orientation, you have A3. Repeat for A2 and so on. Or fold an A4 in half and you have A6. Meanwhile an A4 sheet will fit in a B4 or C4 envelope without being folded, or in a B5 or C5 envelope folded in half...

[1] https://en.wikipedia.org/wiki/Paper_size#International_paper...

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#86

Post by subway »

emodendroket wrote: post #79
pinneycolton wrote: post #68

Earlier quoted context omitted.

I wonder if they meant that you shouldn't pay providers until things are sorted out. I agree that you need to pay your premiums, but doctors and hospitals will just send you to collections. Still not a great option, but it does keep the money in your pocket until things are sorted out. (Of course, I wouldn't do this unless I was very sure I was right, also, so that any collections issues would be an insurer/provider…

As far as your provider is concerned, whether your insurance should pay or not isn't really their problem. I have never been somewhere that did not make me sign a form saying that I agreed to be responsible for whatever my insurance did not pay.

Most providers understand the shit-show that is insurance, and will drastically adjust their behavior and prices based on who is paying.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#87

Post by noonespecial »

blackguardx wrote: post #62
noonespecial wrote: post #48

Earlier quoted context omitted.

>(don't beat up on their phone agents though, they are just trying to make ends meets). I've gotten very tired of this. Every time I'm on calls like this now I gently suggest to the phone agent that they know that what they are doing contributes to a system that hurts people and that they should try to do something more with their lives. Don't scream or bluster. Do it with gentleness and respect and get ready to be o…

I worked in a call center during high school. Everyone is there just for the paycheck. These call centers are usually in places with terrible economies and these centers are the only job option for many people. I worked alongside many people in their 60s. Imagine doing that as a retirement plan.

I accept that it sounds intensely condescending and harsh. I present it as an alternative to either screaming profanity (which they hear non-stop, all day), or meekly accepting the "there's nothing that can be done" lie they are instructed to feed you to get you off the phone in minimum time.

Nine times out of ten, you'll get a dismissive hangup but every once in a while it shatters the script and you'll get a quick story of someone trapped in a bad situation and then a quick word of advice on how to proceed in a a way that will get results.

Its a rhetorical phone nuke. Use it carefully. I started using it about 5 years ago when I noticed that the "heartfelt plea" had utterly stopped working.

I also use it often when "Microsoft tech support" calls me to tell me that they have detected that my computer has a virus. Its a touch more appropriate in that situation.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#88

Post by chimeracoder »

vidarh wrote: post #83
chimeracoder wrote: post #41

Earlier quoted context omitted.

> Generating revenue is in direct conflict with providing patient care Without revenue, there's no money to use to actually provide care. > It's a uniquely American problem. It's not at all. Aside from the fact that most of the world uses at least some degree of privatization in providing or paying for healthcare, even the few that don't do so at the metaphorical "last mile" (such as England) still suffer from the un…

The difference is that those systems goes to great lengths to ensure that the decision is done based on clinical needs and objective measures of what achieves the most patient benefit for the available money. As a result it is very transparent what is sacrificed - e.g. you can find NICE [1] documentation on evaluations of individual drugs and treatments and their benefits, and documentation of the decision making pro…

> As a result it is very transparent what is sacrificed - e.g. you can find NICE [1] documentation on evaluations of individual drugs and treatments and their benefits, and documentation of the decision making processes of the NHS trusts, so they can be debated and used as a basis for deciding funding, or you're free to sign on to additional private cover if the exemptions worry you.

The decisions that NICE makes are not fundamentally different from the decisions that insurers make when deciding which medications and treatments are covered for various conditions, and in fact, you can find analogous documentation of these decisions from every major insurer.

> The difference is that those systems goes to great lengths to ensure that the decision is done based on clinical needs and objective measures of what achieves the most patient benefit for the available money.

Emphasis mine.

NICE is not operating in some magical world where "revenue" and "costs" are somehow not intrinsically linked with clinical decisions. They're doing the same thing that insurers do - make decisions about treatments based on objective measures of clinical outcomes, subject to a finite budget.

Ironically, this entire thread is about HIV, and HIV treatment and prevention are one area in which the NHS falls drastically short of what's available in the US both to people on private insurance and to people without insurance coverage whatsoever.

Re: Aetna accidentally exposed customer HIV statuses in clear envelope windows

#89

Post by dsfyu404ed »

Since most of this thread has turned into comparing the terribleness of insurance companies I'll say it again:

A good said of less than legitimate identification documents are probably far more useful to someone needing urgent medical care than insurance coverage is.

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