Artificial Intelligence in Health Insurance is here to stay. It is behind every action we are performing each day. It is being used when we are googling anything on the web. It is in use while we book a cab using an app. It helps us to find our way when we are lost or when we are using voice assistant on a smartphone. As in any other area of our life, AI has also started influencing in a big way on the health care as well as health insurance structure of a country.
At present only a handful of private health insurance holder could afford to be covered under the expensive cancer care treatment in most countries. On the other hand, socialized medicine or new innovative treatment is difficult to implement nationally as that is costly. Although huge data is being generated every day, these are doing little to minimize the risk associated with the business of health insurance nor it could do anything to improve the health condition of the people in general.
How Artificial Intelligence can help in reducing the risk of health insurance:
The system today is unfortunately focused on treatment rather than educating people about taking care of themselves. The people are not motivated to stay healthy and when the obvious negative consequences of unhealthy lifestyle choices affect their health then the treatment of the diseases could become unaffordable. This is also putting tremendous pressure on the business of health insurance. The insurance company cannot get enough information about a person's health based on which they could make a fully informed investment on his or her future health. New technologies could offer a chance to change this situation.
Insurance companies in near future will certainly try to make use of the new technologies such as wearable, implanted sensors, and algorithms using artificial intelligence. A prediction about the sale of wearable units to measure health parameters says, that in 2015 a hundred million units like this were sold and in 2019 the number could go up to 245 million. When AI-based algorithms will monitor patient's health data, new correlations and long-term consequences will be discovered. Insurance companies would definitely want to use these data to fixed premium rates based on the health risk pattern of patients. They may also alert patients to their bad lifestyle choices.
Could this mean a new era of health insurance or the rise of a nosy big brother?
It may happen that, companies will only provide insurance if they are allowed to access all the health data of a patient, including data during sleep. Insurance system might discriminate against patients if they find that their medical condition is predominantly genetic and not related to lifestyle. Whatever be the scenario, AI is going to play a major influencing role in determining the shape of the future health insurance business.
What would be best for us – Total privacy or equal healthcare?
There is no doubt that, today's health care is financially not sustainable. Most patients do not have access to the latest innovations and most doctors are struggling to provide decent care with the equipment they have – this is especially true for the underdeveloped or developing economy. Health insurance system must be upgraded to meet up this gap and if with the help of AI it can encourage more people to live healthier lives then that will surely take some burden off from the care providing structure.
However, we certainly need to avoid the emergence of big brother watching over our every move. This means that government and insurance companies need to come up with an acceptable framework which is balanced. Rewarding healthy decisions is very different from punishing the wrong choices. Whether or not Artificial intelligence would directly create an impact on the way health insurance business runs in the future, one thing is sure, Artificial intelligence will play an important role in the health care system itself. It has the potential to impact billions of lives around the world and hopefully in a beneficial way.
Below are the 5 major area of impact –
- Clinical Decision Support
- Medical Imaging
- Pharmaceuticals
- Medical Insurance
- Robotics and Physical Assistance
