Abstract
Can data-driven innovations, working across an internet of connected things, personalize health insurance prices? The emergence of self-tracking technologies and their adoption and promotion in health insurance products has been characterized as a threat to solidaristic models of healthcare provision. If individual behaviour rather than group membership were to become the basis of risk assessment, the social, economic and political consequences would be far-reaching. It would disrupt the distributive, solidaristic character that is expressed within all health insurance schemes, even in those nominally designated as private or commercial. Personalized risk pricing is at odds with the infrastructures that presently define, regulate and deliver health insurance. Self-tracking can be readily imagined as an element in an ongoing bio-political redistribution of the burden of responsibility from the state to citizens but it is not clear that such a scenario could be delivered within existing individual private health insurance operational and regulatory infrastructures. In what can be gleaned from publicly available sources discussing pricing experience in the individual markets established by the Patient Protection and Affordable Care Act 2010 (ACA), widely known as ‘Obamacare’, it appears unlikely that it can provide the means to personalize price. Using the case of Oscar Health, a technology driven start-up trading in the ACA marketplaces, I explore the concepts, politics and infrastructures at work in health insurance markets.
Highlights
How attentive to the personal should price be? Personalized products and services, the bespoke, tailored, monogrammed and unique are usually prized but prices are different
In what can be gleaned from publicly available sources discussing pricing experience in the individual markets established by the Patient Protection and Affordable Care Act 2010 (ACA), widely known as ‘Obamacare’, it appears unlikely that it can provide the means to personalize price
‘What if’, Steven Bertoni (2014) asked, ‘thanks to wearables, health insurance began to work like car insurance where every health infraction hurt your health score and rocketed your health premiums?’ Schlosser countered that discriminatory pricing is illegal under the ACA and Oscar’s investment was calculated for risk reduction, not assessment: ‘if we can really get people to walk more, it will almost for sure have a huge impact on population health, and eventually health care costs, and that’s certainly worth investing in’ (Fischer, 2014), see Figure 2
Summary
How attentive to the personal should price be? Personalized products and services, the bespoke, tailored, monogrammed and unique are usually prized but prices are different. This initiative drove much of the firm’s initial press coverage which drew parallels with in-car telematics devices to frame questions about the future prospects of price personalization.17 ‘What if’, Steven Bertoni (2014) asked, ‘thanks to wearables, health insurance began to work like car insurance where every health infraction (say a bar bender, Thanksgiving feast or sedentary Sunday of Netflix binge) hurt your health score and rocketed your health premiums?’ Schlosser countered that discriminatory pricing is illegal under the ACA and Oscar’s investment was calculated for risk reduction, not assessment: ‘if we can really get people to walk more, it will almost for sure have a huge impact on population health, and eventually health care costs, and that’s certainly worth investing in’ (Fischer, 2014), see Figure 2.
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