Why does Aetna need racial and ethnic data?
The Washington Post
March 5, 2003
The Associated Press
Report: Aetna Collecting Minority Data
Aetna Inc. has begun collecting data on the racial and ethnic backgrounds of some of its 14 million health plan members in what the insurer calls an effort to narrow the gaps in treatment between whites and minority patients, The Wall Street Journal reported.
Aetna said it is trying to understand differences in how white and minority patients get medical care, and to develop prevention, education and treatment programs to narrow the gap. But critics say collecting the data raises questions about patient privacy and racial profiling.
One concern is that insurance companies could use such information for underwriting decisions and "make it difficult for the people who need coverage to get coverage," said Clyde Yancy, a cardiologist at the University of Texas Southwestern Medical Center in Dallas, who has studied racial disparities.
The Hartford, Conn.-based company rolled out the initiative in 13 states and the District of Columbia in September, asking new members or those changing health plans or beneficiaries to voluntarily list their race or ethnic status on the application.
"There is a disparity under every rock and a disparity behind every tree," Aetna chairman and chief executive John W. Rowe told the paper in a story on its Web site. "We need to do something about it."
http://www.washingtonpost.com/wp-dyn/articles/A43387-2003Mar5.html
Comment: It is very difficult to see what clinical use Aetna would make with racial and ethnic data collected during the enrollment or underwriting process. Clinical interventions, such as disease management programs usually are initiated by identifying clinical problems through the claims process instead. Since responses are voluntary, this is a population sampling process and not a process designed for individual intervention.
It is unlikely that this information would be used for underwriting in the individual market. Although risk does vary with ethnicity and race, could you imagine Aetna sending a notice of higher premiums or even rejection because you're black? Although Aetna's business practices have often been insensitive to needs of patients, they're not dumb enough to institute a program that could provoke a boycott.
But this information could have important business value for Aetna in their group health plan markets. A significant sampling of race and ethnicity could indicate to them that there is risk of greater medical losses. Thus they could tailor the premiums, benefits and cost sharing to assure profitability in these "unfavorable" markets. This is a policy that assures that those with the greatest health care needs will also have the greatest financial exposure.
Although the insurance industry consumes an outrageous amount of our health care dollars, they are not providing a service but rather a disservice by compounding the inequities and injustices of our system. Why do we continue with policies that reward this amoral and even immoral industry? If we had our own single, universal, public program, we could assure that the appropriate extra resources required by groups that suffer from disparities would be directed to their needs.
But, instead, it looks like we'll continue to build on our current system that assures that John Rowe will continue to build his mega-wealth.
Sick! Sick!