It's official. After 3 months of back and forth, a major medical provider has elected to drop me as a patient for not having a Google or Apple device.
It is unclear if this is legal, but it is very clearly discriminatory and unethical.
Any tech journalists or lawyers interested in this?
I would like to do anything I can to ensure this never happens to anyone else.
@lrvick what?? Why on earth would you need an Apple or Google device?
@BenAveling @Jennifer There are no medical devices involved.
They said they only willing to communicate, schedule, and exchange medical information with patients with their apple/google mobile app moving forward, even if it means terminating relationships with existing patients.
I even offered to show up in person for every communication, and they refused.
@lrvick This is infuriating! I'm so sorry you are dealing with this shit.
@lrvick @BenAveling @Jennifer 1 in 3 seniors does not even own a smartphone.
I don't understand how this could be even economically feasible, let alone legal.
What's the company?
@neilk @lrvick @BenAveling @Jennifer I’m old but was a software engineer for Apple products so live on my iPhone. But parents & in-laws could never use any mobile phone, either to keep it charged or dial with the tiny keypad, much less use a smartphone. Medical providers have to accommodate such people, or tell the world they’re not going to care for elderly people
@PenguinToot @neilk @lrvick @BenAveling @Jennifer
wondering if that's part of the point.
I'm assuming elderly people are more expensive customers, as a health provider. From a stricly financial point of view, a measure that allows you to discriminate them while calling it a technical limitation sounds quite tempting.
(no idea whether it's legal or not anywhere, tho, but it's certainly very questionable ethically)
@PenguinToot @neilk @lrvick @BenAveling @Jennifer
And so you've accidentally stumbled upon the actual reason.
No medicine-for-profit company wants old people with their measly Medicare reimbursements and lots of chronic illnesses. Better to get the cases of tennis elbow paid for by employer plans.
If they can be made to exit the rolls simply by requiring use of a mobile phone, that's cost savings that goes right to the CEO's Ivory Backscratcher fund.
@RealGene
I really had the feeling this was a result of the medical company just wanting to be able to make advertising money off of their patients in addition to their fees and insurance billing but this actually seems very plausible. Perhaps it's both.
Both probably are factors in this move. The only thing for certain is that medical care is not at all about care anymore.
@PenguinToot @neilk @lrvick @BenAveling @Jennifer
@RealGene @neilk @lrvick @BenAveling @Jennifer Daughter works for her state health insurers, visits lonely elderly to be sure they’re getting medical care, phones physicians as necessary to arrange visits, etc. But she’s one of few people who do this, clearly more will be needed as the population ages. At least Medicare is functioning for her clients.
@PenguinToot @neilk @lrvick @BenAveling @Jennifer The thing is.. your medical insurers are in it for the profit and nothing else. Over here there is a legal requirement to provide insurance to everybody, and thus to accomodate people who can't or won't use smart phones. They cannot refuse people or pre-existing conditions or for (for instance) a condition that makes using a smartphone impossible, like old age or beginning dementia.
@neilk @lrvick @BenAveling @Jennifer older people are less healthy = more costly for healthcare providers, if this "excuse" goes through they'll start doing it on purpose.
@neilk Hmmm, not possible those 1 in 3 seniors without smartphones are people they'd be happy to get rid of, then?
@neilk @lrvick @BenAveling @Jennifer It might be intentional, to whittle down their patient base to people who are younger and less likely to be on medicare/medicaid.
@lrvick @BenAveling @Jennifer There isn’t even a suitable web experience? (Putting aside that even that isn’t good enough of course), it’s installed app or bust? That’s crazy.
@philip @BenAveling @Jennifer We asked this, and they said webapp was not an option. Android/Apple device/app or GTFO.
@lrvick @philip @BenAveling @Jennifer That's disgusting. I'm so sorry. My providers have web portals but don't require you to use any of it. They're trying to root out the patients they won't get as much from. This sucks, because others will start if they see it working.
@lrvick @BenAveling that is so unethical! Might be a long shot, but send an email to the Verge and Ars Technica. They cover all kinds of tech news and have big audiences. @nilay_patel is on here but don't know how active he is.
@lrvick sorry you’re dealing w this. if this is in the US - providers can not discriminate based on sex, race, and ethnicity. Beyond that they can pick and choose patients at their discretion. Your local newspaper and news station might be interested to hear. I wonder if this could be argued that it creates a monopoly. Orgs/companies like AARP, Jitterbug, your email provider would/could help fight.
@jodmentum
I think you’re right w.r.t. national and local law, but what about international law?
The Universal Declaration of Human Rights (#UDHR) ensures that your property cannot be a factor in discrimination:
art.2:
Everyone is entitled to all the rights and freedoms set forth in this Declaration,
without distinction of any kind, such as race, colour, sex, language, religion,
political or other opinion, national or social origin, **property**, birth or other status.
art.3:
Everyone has the right to life, liberty and the security of person.
art.25:
Everyone has the right to a standard of living adequate for the health and
well-being of himself and of his family, including food, clothing, housing
and medical care…
art.21¶2 Everyone has the right of equal access to public service in his country.
It’s difficult to enforce the UDHR but in recent years the UDHR is gaining ground in terms of enforcement. It’s worth it to point it out in any case.
You haven't said which country you are based in, but under USA law, UK law, and EU law, it's called "tying" and is illegal under the anti-monopoly legislation.
This is one of the things that the #FAANG 's are being sued over right now. :D
Matt Stoller would be able to point you to someone who could help.
@BillySmith
I’m skeptical that this would be regarded as tying considering:
* the clinic gives a choice between Apple & Google
* the clinic is probably not a shareholder of Apple or Google and gains no market share by the bundling
I’m not a lawyer but that’s what I would expect the clinic to argue. Your link goes to a page with many articles. I could not find an article that covers this. If this is in fact tying, then I have some banks to sue.
(edit) Just realized you were giving a reference to a person not a particular article. In any case, I would like to find an article that covers tying in the forced-app store scenario.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
Yes, i was talking about the person. There's a number of articles that have the tying behaviour as one strand.
eg. The articles about the vertical monopoly in Professional Cheerleading.
Tying is only one of the methods used in the monopolistic approach.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
Looking at the medical devices, and the tying is done on a number of levels.
There's the tying of the phone hardware to the phone OS.
There's the tying of the phone app to the medical devices.
There's the limiting of the acceptable comm's systems between the app and the user,
ie. if you don't have a email address that comes from one of the major providers then Google will start treating all of your replies as spam.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
That last one is why all of the major tech companies are being sued, as within specific industry sectors and market niches, they've been trying to set up cartels to block out new competition.
The #RightToRepair campaigns against the John Deere company's enshittification of their tractors that penalises the tractor's owners, is another example within a different industry sector.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
The Private Equity funds that are creating regional Vertical Monopolies in the Healthcare system in the USA are also responsible for this behaviour.
As is discussed in another strand of these toots, when a healthcare system is run as a for-profit system, with a "maximising profit above all else" basis, then unprofitable patients will be dumped.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
Forcing patients to give up their rights via the use of Software Licences that are attached to mandated software, gives the healthcare companies another work-around, to denying their patient's legal rights, by reducing their access to the public courts through the use of "Forced Arbitration" agreements hidden in the software licenses.
Like i said, cartel behaviour.
@bojkotiMalbona @lrvick @BenAveling @Jennifer
And the Justice Department agrees... :D
@BillySmith
That article is strictly Apple. If @lrvick ’s healthcare provider were to force Apple only, then I think it would be a more viable case of tying although still there would be the hurdle that the healthcare provider likely has different ownership than Apple.
I would love to find a tying case made in a situation where a supplier forces a choice of Google or Apple because the world is littered with that scenario right now.
That article is about Apple, but Google are still in court. :D
There's one set of investigations running through the USA Congress, as well as the EU monitoring ofGoogle's behaviour and compliance with the updated GDPR requirements.
Same for FB. :D
Also, under UK law, there's disability accessibility requirements, hence the req's for a web interface for the NHS systems.
Cory Doctorow is another person who would be able to point you to someone who could help.
@aral might be able to point you to EU-based help.
@lrvick Terrible. I'm seeing more and more health providers and other businesses trying really hard to get people to install & use apps and I just won't do it. @BenAveling @Jennifer
@Nonya_Bidniss @lrvick @BenAveling @Jennifer
It's also worth remembering that most of the mobile apps are just a html/web interface which uses a click-agreement wrap-around, so they can't be legally reverse-engineered, so security through obscurity.
The bonus for the service providers is that they can require the mandated use of arbitration rather than the courts through any changes in the ToS agreements.
Don't agree, and you don't get to use the service.
@BillySmith @Nonya_Bidniss @lrvick @BenAveling @Jennifer
This is a big point that @pluralistic is often on about, that these “apps” are merely HTML wrappers that allow them to evade standard security, ToS, etc. I am glad you called Bs on this!
@cyberlyra @Nonya_Bidniss @lrvick @BenAveling @Jennifer @pluralistic
They're using the DMCA legislation in exactly the way that was warned about when the DMCA laws were being written.
So... they're using a third party app to keep customer data safe? Or is this an in house app by the medical provider... Either way I'm sure that app provider has nothing but the most top notch security in place, and this totally wont end up biting them in the ass.
@lrvick y i k e s D:
@BenAveling @lrvick @Jennifer that’s appalling and has to be illegal!