According to a CNBC report, Apple is currently in talks with private Medicare plan providers to come up with ways to subsidize their watches and get them onto the wrists of senior citizens. Apple already has partnerships with Aetna and United Healthcare to provide such subsidies.
The Apple Watch Series 4, the newest version, is the watch that insurance plans want their seniors to have since it includes an electrocardiogram feature to measure the heart’s rhythm, but prices for the device start at $399. (Older versions of the watch without the ECG feature start at $279.)
A source close to the talks told the news outlet that no deals have been made yet, but that Apple representatives have visited many insurers, both large and small, to set up deals that would allow the watches to become readily available to the elderly.
Seniors are a particularly good market for the new Apple Watch since it measures activity and heart rate and also includes fall detection sensors, all in addition to the new heart arrhythmia monitoring. The hope is that the watch will act as preventative care, allowing doctors to catch abnormalities before they turn life-threatening, and even reduce doctor visits by monitoring wearers’ vital signs.
It sounds like a win for everyone – insurers save money, patients get more personalized healthcare, and Apple sees its device proliferate all over the world and become a standard healthcare device.
Apple CEO Tim Cook has even claimed that Apple is setting itself up to let users proactively manage their health, and this will all help change the future of healthcare:
We are taking what has been with the institution and empowering the individual to manage their health. And we’re just at the front end of this. But I do think, looking back, in the future, you will answer that question: Apple’s most important contribution to mankind has been in health.
Personally, I’m pretty skeptical of someone who tells me I’m being empowered by a $400 product they’re selling and seeking to have subsidized by a health insurance company that needs my data.
But it’s clear that Apple is going to continue to invest in this area.
Many tech writers, researchers, and ethicists, myself included, have written about the dangers of constant medical monitoring and the potential for hacking and other privacy violations that come with new wearable devices. That doesn’t mean people should toss them aside, but that we need to get much more clear on how this data will be stored, who can access it, and what an insurance company can do with your data if it’s going to give you a discount on an expensive gadget like an Apple Series 4.
If you have a watch now, do you know how your data is stored and whether it’s secure? Do you simply believe that it is secure because Apple tells you it’s protected in the Cloud? Do you know what your data is worth to hackers? ($1000 on the dark web, by some accounts.) Did you know that access to your wearable device could give people insight into your activity levels, your stress levels, health and pill reminders you've set, and even your location?
Maybe you don’t care if someone knows you didn’t get your 10,000 steps in. But what about an employer who provides you with the health insurance that gets you the Apple watch – do you want them to know you took 10,000 steps during the workday when you were supposed to be in your cubicle? What if you’re a highway engineer or in the service industry – do you want your employer to see how active you were every day during work hours and make judgments about your productivity based on that?
In 2017, Springbuk released the Employer Guide to Wearables 2.0 which reviewed features and implementations of corporate wellness programs. They found that out of the 8,000 employers they surveyed, 35% of companies use wearables in their workplace wellness program, and more are looking into it. Is friendly inter-office competition worth it? Maybe you’ve thought long and hard about it and decided it is worth it to you. But it might not be to everyone. Should you be rewarded for sharing private data with discounts?
How about your doctors and insurance companies (whose job it is to keep you healthy) – have you always been completely honest with them? What do you think of being forced to give them your health data? Do they get to ask about your lack of heart rate spikes and deem your sex life less than adequate? Could your insurance premiums go up if you don’t get enough exercise? Have you read enough of the fine print in any of your insurance documentation to make sure that can’t happen?
And if you think hospitals and doctors are capable of protecting this precious data, it might help to take a look at how many time health care companies have been hacked or have accidentally exposed private information. Some of it has even been held for ransom and hospitals have had to pay handsomely to get it back – but that doesn’t mean it’s not still out there in some form.
Regardless of whether or not data sharing becomes mandatory, plenty of people will simply be careless about privacy or agree outright to share it with companies. Should this concern the rest of us? Hell yes.
Amassing a large data set of height, weight, age, sex, location, job, activity, and biometric data is going to do one thing – give companies and researchers the opportunity to crunch those numbers and come up with algorithms they can use to gauge your health and life expectancy.
The algorithms probably won’t be all that accurate at first either. As we know, the way both people and machines crunch numbers can be biased. But big data will get its chance to weasel its way into your health care based on these new data sets regardless. Plenty of researchers will get a paper out of comparing daily steps taken and different kinds of diseases. If they only look at two factors, it’ll be easy to draw simplistic correlations and give people inaccurate advice. Do you really have the time (and access) to read through the methodology section of every scientific paper that comes out in a journal or do you rely on the headlines that come later? You are what you click.
It’s not always wise for individuals to base their everyday life choices on a dataset involving hundreds of thousands of people who may or may not be sharing all the relevant information. Sure, a certain heart rate range might be fairly accurate in predicting whether people are about to visit a doctor, but does that mean that every reading in that range warrants a call from a doctor or a warning from your watch? What about an alert to a loved one or caretaker?
Once this data is amassed and insurers are convinced that it’s useful, of course they will ask you about it on your healthcare forms. Will we always have the protections provided by the Affordable Care Act that bars them from denying us coverage based on our answers? Are you content to commit insurance fraud if you don’t get 30 minutes of exercise a day and they decide to deem that mandatory for cardiovascular coverage in the future? It’s may be hypothetical, but it’s all good business for the companies.
Don’t get me wrong, I’m happy for the lives technology has saved. I have an Apple Watch. I’m lucky enough to have insurance as well. I think technology can improve our lives in ways we can’t even think of yet. But I also know that we’re getting some pretty vague assurances that all will be well in the privacy department, and the number of hacks we’ve seen so far does not give me hope that it’s going to get better, especially as our data becomes richer and more valuable. And I also know that many of us are at a disadvantage in this data collection game because of things like disabilities or other pre-existing conditions. Likewise, some of us can live long and healthy lives without hitting a generic fitness goal every day. We are not our data. Our so-called “quantified selves” are just a machine reading, even if they do improve some of our behavior.
So be careful when you accept that shiny new watch from your insurer. Read the fine print. Ask a lot of questions. Find out how to use your privacy settings. Find out how your data will be used. Ask for guarantees in writing – you won’t get them, but more people asking for more protection is one way to pressure companies into providing more thorough information (and maybe even scaring them out of going against their word later).
And remember, your insurance company wants you healthy and alive, but at the end of the day, you as an individual are less important than their bottom line.
