In a world that's edging ever toward dystopian fiction, it's not surprising that information on where you shop, what you eat, and who you vote for could be used by corporations to make decisions about your health.
The Wall Street Journal recently reported that some companies, like the steadily nefarious Walmart, are hiring outside "employee wellness firms" to mine employee data. The information they collect ranges from what employees buy and where to what prescriptions they're getting filled—in theory, in order to identify employees with certain health conditions and make predictive suggestions to help manage their healthcare.
Wellness firms like Castlight, Jiff Inc., and ActiveHealth Management Inc. purport that they can help employers cut-down on health care costs with early intervention. But as the Wall Street Journal points out, the obvious cost of these metrics is employee privacy.
"Typically, when a company hires a firm…it authorizes the firm to collect information from insurers and other health companies that work with the client company. Employees are prompted to grant the firm permission to send them health and wellness information via an app, email or other channels, but can opt out," the Wall Street Journal reports.
Jay Stanley, a senior policy analyst at the ACLU, notes that employee wellness firms can also buy additional information on employees through data mining companies. "Some of these firms buy information from data brokers," he says. "Data mining is a giant, multi-billion dollar industry that a lot of Americans have no idea about. And data brokers are basically in the same business that Soviet secret police were in in East Germany, which is collecting as much information about as many people as they can. They collect giant files on people's preferences, lifestyles, and demographic information. That information can be mined for all kinds of insights."
Supposedly, employers aren't legally able to access this data on individual employees. Employers are, however, able to task a wellness firm with providing aggregate data on the number of employees with a certain condition and initiate targeted interventions. One example that the Wall Street Journal article uses is costly spinal surgery:
After finding that 30% of employees who got second opinions from top-rated medical centers ended up forgoing spinal surgery, Wal-Mart tapped Castlight to identify and communicate with workers suffering from back pain… To find them, Castlight scans insurance claims related to back pain, back imaging or physical therapy, plus pharmaceutical claims for pain medications or spinal injections. Once identified, the workers get information about measures that could delay or head off surgery, such as physical therapy or second-opinion providers.
Troublingly for women, this same method could be used to predict pregnancies. One employee wellness firm, Castlight, has developed software that "scans insurance claims to find women who have stopped filling birth-control prescriptions, as well as women who have made fertility-related searches on Castlight's health app."
Castlight says that information is used to offer "tips for choosing an obstetrician or other prenatal care." But there's a long, storied history of discrimination against pregnant women in the workplace—not least of all at Walmart. The US Equal Employment Opportunity Commission (EEOC) stipulates that employers must treat pregnant employees "in the same way as it treats any other temporarily disabled employees" by providing alternative work. But in many instances, pregnant yet otherwise able workers have still been forced into unpaid leave, or fired. In 2010, 6,119 pregnant women filed discrimination claims to the EEOC, and data suggests that those numbers are only rising.
Read more: Does the Tech Industry Even Deserve Women?
Nevertheless, gender discrimination already happens in the workplace. Should we be worried that an employer could have more tools at their disposal to hire and fire women based on their plans to become pregnant?
"If someone has an incentive to help you avoid health problems, that can be good thing," says Stanley, "but if they're working on the behalf of your employer to fire you rather than pay for expensive medical costs, that can be troublesome. There's real incentive here for privacy invasion. I think, in general, this is an area where a lot more scrutiny of practices, incentives, and rules is needed.
He continues, "There's something a little spooky about an employer trying to dissuade its employees from having an expensive surgery."