> This is really clever from Apple. The journalist use case is just the PR story. This will be really useful for identity verification and insurance apps
This is definitely not an Apple thing, though the use profile is more ubiquitous. Canon had, more than twenty years ago, when they first started making DSLRs, the question of "If we want law enforcement to use these, how do we handle the inevitable questions?" and as a result built out the option to digitally sign the raw sensor data in-camera so the raw file could be pointed to in court with an attestation of image integrity.
The first part of this one is more hilarious when you ask "Find me the nearest Starbucks" while CarPlay is actively providing you navigation: "I'm sorry, I don't know your location".
I feel like imaging and physicians really amped up on pushing this over the last decade or two. Most of the big DI companies (GE, Philips, Siemens) had very friendly financing targeted heavily at physicians. They had "matching" services ("Find other providers in your area who'd also like to own a DI facility"). They'd help with consultants to facilitate getting your Certificate of Need (i.e. how not to piss off the other facilities in your area who get to say whether or not they'd reduce their investment in serving the area if you open up).
And the not unsurprising conclusion of all this? Physicians who own a DI facility or stake in one (and realize this doesn't have to be just radiologists, but any physician) refer their patients to imaging at rates far above expectations.
But now, line must go up, so we're doing this "scan your whole body and let's see what we can do to give you a touch-up", and ever-so-helpfully we have a whole network of providers lined up for referrals (that's if we don't just handle things in-house). I will be similarly unsurprised if many of the outcomes from this raft of scanning are procedures that are medically unnecessary.
> I will be similarly unsurprised if many of the outcomes from this raft of scanning are procedures that are medically unnecessary.
I have trouble comprehending this perspective. The point of defect detection is detecting defects. The IDEAL outcome is that nothing shows up. That's not a failure of the test! in this case, the next desired outcome is that something caught can be addressed, so your life isn't terminated early.
Is it worth doing? That depends on the circumstances, of course. If you have high risk genetics or exposure, and you have some strange symptoms, many people would gladly fork over money for something that effects the remainder of their lives. If you're just doing it because you're paranoid, maybe once every 10 years is reasonable, especially in upper ages, if you can afford it.
My thoughts there are that there are a couple of factors at play - false positives, which might lead to interventions, even exploratory, that are not zero-risk. Even without risk, not zero-cost. And as such you end up with "you had no symptoms or concerns about condition X until you had this not-recommended MRI, and then treatment was ordered about condition X that was actually a false positive". Insurance doesn't view full body MRIs as medically necessary preventative screenings and this is generally accurate (though I'm also not naive enough to believe that a non-insignificant part of their objection might be cost).
> false positives, which might lead to interventions, even exploratory, that are not zero-risk
Do you have an example in mind for this? Non-zero risk interventions are pretty rare if only one signal is present. If that signal was deemed worthy to result in a non-zero risk intervention, then you're completely ignoring the risk associated with ignoring that signal, which is what justified that non-zero intervention!
> Insurance doesn't view
This suggests a very fundamental misunderstanding of healthcare, treatments, and what insurance companies exist for. They are not about health policy or well being. They are about derisking profit loss. Their recommendations are to reduce cost, and nothing more. Doctors understand this, and will tell you this very plainly, as you fight to get required treatments covered.
> This suggests a very fundamental misunderstanding of healthcare, treatments, and what insurance companies exist for. They are not about health policy or well being. They are about derisking profit loss. Their recommendations are to reduce cost, and nothing more. Doctors understand this, and will tell you this very plainly, as you fight to get required treatments covered.
I am someone who has worked for providers, worked as a paramedic, and worked for a company whose customers were health insurers, as we built claim benefits management systems for them, so literally the logic to calculate deductibles, handle accumulators, provider negotiated rates.
The issue is not my misunderstanding, it is that "health insurance" in the US is the worst of all worlds - health insurance when convenient (to the insurer), amortized healthcare when convenient. It used to be that about the biggest offering that health insurers could give you was better provider-negotiated rates, but that era is largely behind us with the vertical integration of supply chains, and a health insurance industry that can only make more money when prices go up (if your profits for premium administration are capped at 15%, the only way that number goes up is if premiums go up, because healthcare costs more - this is compounded by the fact that it's in everyone in the system's interests for it to cost more except the actual consumer).
Everything has had to be fought for - otherwise, to your point, why are actual clinical "annual exams"/"wellness" visits covered at zero cost, but incentives for weight loss (as in obesity reduction, even pre GLP-1s) or cardiac health are near zero while a gastric bypass is covered in toto.
Liver lesions, often benign cysts. Other cysts too (kidney, ovarian). Will often require targeted contrast MRI, and needle biopsy - which has notable risks for bleeding, often minor, but 3-4% can require surgery or even transfusion.
Bile leakage or infection can also result, or injuries to the gallbladder, bowel, bile ducts.
The CRAs compete for breach business, because it's absolutely a profitable enterprise for them:
How many people actually sign up for your "free credit monitoring for a year" following a breach?
When you do, you typically do so by signing up for the highest tier (sometimes $30 or even $50 a month) product with a redemption code for one year free. You have to enter a credit card to do so, and to no-one's surprise, if you don't cancel in time, it automatically converts to a paid subscription "for your convenience".
There are many consumer protection farces in the US, but right up there has to be the notion that "identity theft" is the consumer's responsibility/obligation to prevent or resolve, not the entity that actually had the data stolen. You're considered liable until you prove innocence, even though you did nothing wrong.
This very nearly burned me when buying my home - having been an AT&T customer in the PNW for nearly two decades, "I" apparently decided to hit up a Walmart on the outskirts of El Paso, sign up for a Verizon service, run up two months of international calls and bail out.
Despite a police report, my utility statements, AT&T bills, etc. (all of which were, to be blunt, none of VZWs business), VZW stood by it initially, "On review of your documentation, we remain satisfied that this debt belongs to you based on the documents used to open your account".
I asked to see them, since they were, in VZW's own words, "mine". "We can't, for customer privacy reasons." Oh, so "mine when the bill needs paid, may not be mine for privacy purposes".
Was ran through the same gauntlet by a medical provider billing me for services. Insurance wouldn't pay them due to "insufficient documentation". Wouldn't disclose what documentation they had received or what documentation they needed. Just that is was inadequate. Service provider wouldn't tell me what they had sent.
Somehow a few hours before our court hearing they by some miracle decided to settle the debt with no fee to me.
> the notion that "identity theft" is the consumer's responsibility/obligation to prevent or resolve, not the entity that actually had the data stolen.
You may enjoy/find-useful this Mitchell & Webb radio-skit [0] of a conversation between a banker and a visiting customer.
It's definitely not 10%, more like 3%. His net worth is currently listed as $248B. If he has to pay out the penalty on both acquisitions, his net worth will still be about $240B. There's nothing articulable about the difference in his life as a result.
I will give you the time though, or the motivations (however appalling they are) for his exertion of energy on these.
> There should be a national registry of officers fired for misconduct that makes them ineligible for rehire in all jurisdictions
There is/was (though Trump has largely de-fanged it) - tracks officers fired or who resigned in lieu of termination.
> but police unions and the politicians they back would never let it happen.
Correct again. The Unions that represent ~70% of police across the country have managed to get into their CBAs that the database is not to be used for hiring or promotion decisions (i.e. not to be used).
The problem is that when such things happens, insurers have said - and won - in Court with:
"We are not denying or delaying care for our customer. We are, instead, only noting that we are not going to be the Responsible Party for paying for it. They are, as they have been all along, free to get the care they believe they need and pay for it themselves."
This brought to you by the same legal scholars that brought you theories such as "Everyone knows 'own' doesn't mean 'own'" and "It's okay to give the judge hearing your case tons of money because that's just gifts between friends as long as you don't explicitly say it's a bribe". Our legal system seems to be based around deciding on the outcome you want regardless of rationality or the law, talking nonsense long enough that it seems like there's intractable disagreement and then declaring your solution to be the common-sense middle ground.
The difference here is that oftentimes your situation can markedly deteriorate, sometimes irreversibly, as a result of that denial. And the "make a stink" can come at a time you're least equipped to deal with it.
> It's all negotiation. They put forth an initial low-ball offer because most people accept it.
And that's the problem. People having to make a stink because insurers are doing things that are in contradiction to the policy they wrote, if not the law, because private enterprise wants more money.
Private enterprise that has simultaneously almost singlehandedly caused the skyrocketing of medical costs, because the only way to make more money when your profits are regulated is to increase costs, and nobody except the consumer/patient is incentivized to do anything about it, quite the opposite - they're entirely happy to go along with it. And then insurers will stand up in Court and say "Oh, we're not denying care to our customer, we're just saying we won't pay for it. They're free to pay for it out of pocket." My old boss would have received a $1.8M bill for his daughter's care, born at 33 weeks. A coworker of mine had to raise a substantial portion of an expected $1.25M bill for a lung transplant for her son. My kidney stone would have cost $70,000 to have not been resolved (they went in, found infection, retreated and gave me IV antibiotics instead, and revisited the issue two weeks later, which had its own separate bill). My ENT had to put me on two expensive and useless nasal sprays for months so that when he recommended deviated septum surgery for an effectively blocked nostril (90%+ deviation) that insurance wouldn't deny it because (gasp, shock, horror) nasal sprays don't realign or open up cartilage.
Exactly. You shouldn't have to lift a finger to negotiate with a company where there is a written agreement that they owe you money or that you are entitled to a claim or similar.
This whole "you have to haggle for everything" culture we're putting together stinks.
That's not how it works, and I have firsthand experience, and hasn't been for at least three decades. The very first thing that happens when you show up in Fontenay-sous-bois is that they run Interpol checks and other checks in your country of residence or anything notable in your passport.
Gone are the days of accepting any criminal openly.
They do however, if you either complete your contract, or are injured, deem you eligible for French citizenship "by spilled blood".
This is definitely not an Apple thing, though the use profile is more ubiquitous. Canon had, more than twenty years ago, when they first started making DSLRs, the question of "If we want law enforcement to use these, how do we handle the inevitable questions?" and as a result built out the option to digitally sign the raw sensor data in-camera so the raw file could be pointed to in court with an attestation of image integrity.
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