Now that will be profitable!

Now, I understand why they need profits, but tell me again why we need them? WaPo:

Health and life insurance companies have access to a powerful new tool for evaluating whether to cover individual consumers: a health "credit report" drawn from databases containing prescription drug records on more than 200 million Americans.

Then comes the analysis.

Ingenix's MedPoint tool provides insurers a "pharmacy risk score," or a number that represents an "expected risk" for a group of people, such as 30- to 35-year-old women who have taken prescription drugs, Stenson said. Higher scores imply higher medical costs.

Milliman's IntelliScript codes drugs red, yellow or green, according to the insurer's instructions, with red signaling the greatest risk, Franzen said. Red codes could include the so-called AIDS cocktail drugs and cancer medications, he said.

The companies receive data only on individuals who are in clients in PBMs' databases, generally excluding, say, people who pay for drugs in cash. The profiles cost insurers about $15 a search. IntelliScript gets about 1 million queries from insurers a year, largely individual health insurers.

The system can save money for insurers, said Richard Dick, an entrepreneur who built the database system that Ingenix acquired in 2002.

For instance, if MedPoint produces a report that an individual has been on the highest dose of the cholesterol-reducing drug Zocor for 18 monts, the insurer "would be able to know that you have a very high, near-intractable cholesterol problem," Dick said, and could avoid a costly blood test.

From a business standpoint, it makes no sense for an insurer to sell a plan with a $200 monthly premium if the company knows that the consumer is taking medications that cost $400 every six months, industry experts said. That is why having access to an "objective" source of third-party information is valuable, said Tia Goss Sawhney, a Chicago area health insurance actuary who has used both companies' tools.

In February, the Federal Trade Commission issued an order saying that MedPoint and IntelliScript are consumer reports under the Fair Credit Reporting Act, so the companies must notify insurers that consumers denied insurance on the basis of these reports have the right to request a copy of the report and that errors be corrected. The FTC's order followed a settlement of allegations that the companies violated the credit-reporting law by failing to provide such notice to insurers.

Bob Gellman, an independent privacy consultant in Washington, said the FTC's decision not to fine the companies sends "the message that it is okay to ignore the law." That, he said, "is absolutely outrageous."

But the law is for little people!

And that's why I'm so very, very encouraged by the FKD plank on health care:

In a draft of the platform, the party described health care as "a shared responsibility between employers, workers, insurers, providers and government. All Americans should have coverage they can afford."

Michael Yaki, an Obama aide who directed the platform meetings, said the new language was a recognition there may be more than one way to achieve the shared goal of universal coverage. [Via TalkLeft]

Of course, of course.

Now I understand it completely! It's shared!

The insurance companies have the responsibility of denying care so they can profit!

You, on the other hand, have the responsibility of getting care so you can live!

It's shared!

It's all so clear! Thank you, FKD!

NOTE Ah yes, Michael Yaki. He looks like one of Pelosi's creatures, so I guess now I know what Leader Nance thinks of HR 676. Here's a nice little essay on jingoism Yaki wrote. Sigh.