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Health data in the future. The end of solidarity? Even years after the big hype, big data remains an exciting and groundbreaking development. This makes it all the more important to have the latest industry-specific insights and assess the potential impact on society.
Sunjoy Mathieu
There are many unanswered questions regarding data in healthcare. For example, how does the increasing collection of health data affect the solidarity principle of health care? What does it mean for the behavior of an individual and society if artificial intelligence can predict a probable serious illness? Does the use of health data serve to control and monitor or can it help people achieve their health goals? The Sanitas Health Insurance Foundation and The Gottlieb Duttweiler Institute (GDI) recently hosted the “Future Medicine” conference in Rüschlikon, Switzerland. The event’s focus was the study “Does the smart desolidarize? Scenarios for a datafied healthcare system”.
The right balance of prediction and control: 4 scenarios The so-called “data processing” and digitalization of health employing the many tools, gadgets and analyses can lead on the one hand to increasingly precise predictions, but also to more and more behavioral controls. Ex-
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amples are the pedometers of health insurance companies, through which one can achieve discounts in supplementary insurance, or the checking of a person after he has received the prediction that he will become seriously ill without a behavior change. In the tension between these two poles, both of which have the potential to undermine social solidarity, the GDI study developed four different scenarios for the future handling of health data. Importantly, each of the scenarios represents a self-contained extreme. More likely is a combination of several manifestations.
1. BIG GOVERNMENT In this scenario, a strong state is responsible for the population’s health and collects health data centrally. In this way, prevention is very targeted (“prevention on steroids”), as many different aspects are included—for example, the influence of working hours or environmental pollution on health behavior. While this means extremely personalized, well-fitting and effective prevention, it also means prescribing behavior. So what does the state do if someone does not meet these criteria and behaves in an unsound manner? Here, sanctions and incentives must be used. Or, as Jakub Samochowiec – Senior Researcher at the GDI Gottlieb Duttweiler Institute – put it, “If you don’t fit, you’ll be made to fit.” One also thinks here of the Social Credit Score, introduced in China, which rewards “acceptable” behavior and punishes others. Not to be forgotten: in this scenario, the state must provide the skills for healthy living. This includes a functioning and high-quality health care system and opportunities to do sports and eat healthily.
