Wednesday, September 16, 2009

Insurance companies vs. general-purpose devices used for health care

The New York Times published today an interesting article about insurance companies opposing the use of general-purpose devices, e.g. mobile phones or mainstream PCs for health care applications. The article also covers some other insurance rules that hinder or prevent using modern technology to lower the cost of health care.

Medicare and private health insurers decline to cover cheap devices like iPhones and netbook PCs that can help the speech-impaired, despite their usefulness and lower cost.

Instead, public and private insurers insist that, if Ms. Lynn and others like her want insurance to pay, they must spend 10 to 20 times as much for dedicated, proprietary devices that can do far less.

The problem is that the insurance rules are made for tailor-made single-purpose devices to help the patients. If an general-purpose device would be used, it would be considerably cheaper, but also more difficult to manage. Not all patients are able, e.g., to install new software or update phone software themselves. There is also the question of liability if software or hardware fails in a critical moment. With single-purpose devices, the prices are, however, ridiculously high, a specially made PC with speech-recognition software and support functions costing 8000 USD.

These kind of policies, however, make it very difficult to create affordable home health care services. Many chronic diseases could be monitored with a simple sensor attached to a standard mobile phone containing just some special software. The software could send monitoring data to health care services, or call help if necessary. Of course this is not 100% safe as the battery can run low in a critical moment, but neither would it be 100% safe to be chronically ill at home with no monitoring except for routine visits at a physician.

Doctors must still bring a patient into their offices instead of, say, inspecting an e-mailed photo of a rash if they want most insurers to pay for the consultation.

This is somewhat understandable, as there is little to prevent insurance fraud in such a case. To modernize the health care system to cut costs, the need of the doctor to physically meet the patient should be cut to the really important cases, not for routine prescription of cortisone salve.