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Database Nation by Simson Garfinkel

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Forcing Physicians To Lie

Indeed, insurance companies obtain information from a variety of sources, including the Disability Insurance Record System (DIRS) and the Health Claims Index . And the fact that insurance companies are lawfully allowed to deny consumers health or life insurance because of preexisting conditions has put doctors under a tremendous amount of pressure. On the one hand, doctors clearly have a professional and legal requirement to keep accurate records on their patients and submit truthful billing statements. On the other hand, doctors know that if they are truthful in their diagnoses, they might be creating notations in their patients' healthcare records that will prevent the patient from getting insurance in the future. Even without a written diagnosis, much of what insurance companies want to learn can be gleaned automatically from billing codes.

"Insurance companies collect tremendous amounts of information," says Dr. Peter Tarczy-Hornoch, who directs numerous telemedicine projects at the University of Washington Medical Center. The information is "not the really cool sexy information." Instead, it's things like "What medical diseases did your grandmother have? Have you ever been hospitalized with a drug or alcohol problem? Do you have a problem that is expensive to take care of that you have previously taken care of? They are not particularly concerned with accuracy. It's a screening process. Ninety percent is good enough for a lot of this stuff."[22]

Ninety ...

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