Science

John Hancock Insurance Nudges Customers to Wear FitBits

BIG BROTHER

Starting in January 2019, John Hancock Insurance will incentivize FitBit users to share their health data with the company—but at what cost?

photo of hand with fitbit fit bit showing heart over tablets and pills john hancock insurance company west virginia life health fitness tracker
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John Hancock, one of America’s largest life insurance companies, announced Wednesday that it is encouraging customers to wear fitness trackers like FitBit. Customers who share their fitness data can qualify for benefits like cheaper premiums, Amazon Prime memberships, or more fitness trackers.

It’s the latest in a series of insurance programs offering discounts and incentives to customers who wear tracking devices. Beginning in 2019, the company’s two plans will include one with a free FitBit and lower premiums, and another plan with a recommended fitness tracker and higher premiums.

Earlier this year, another controversial fitness tracker-based insurance program found its way to public schools.

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When West Virginia school teachers went on strike in February and March 2018, their demands included higher wages, improved health insurance costs, and scrapping a plan that would have required all teachers to wear fitness trackers like FitBit or Garmin watches. The program, called Go365, would have set fitness goals for teachers. Those who met goals could win rewards like gift cards or workout gear (which counted as taxable income).

Teachers had good reason to want out of the program. Long hours in the classroom could make exercise difficult to schedule. Some educators called the plan an invasion of privacy and said they felt constantly watched.

Tracking devices are on the rise, often handed out by employers and insurers, the Christian Science Monitor previously reported. In 2017, eight percent of employers handed out fitness trackers as part of their employee health insurance, and recent years have seen a rise in companies equipping their employees with tracking devices, including one company that ran an optional microchipping program for employees.

But the teachers seemingly had no choice. West Virginia teachers who fell short of their exercise goals or opted out faced a $25 increase in monthly premiums and an annual $500 penalty, more than many cash-strapped teachers could handle.

Representatives for West Virginia’s Public Employees Insurance Agency defended the plan by accusing teachers of leading unhealthy lifestyles.

“There’s a lot of people out there who are not healthy people, and they aren’t going to the doctor,” the PEIA’s director said in January, when confronted over fears that the policy was invasive.

The implication: that West Virginia’s often-poor public employees were lazy and did not deserve their insurance plans unless they worked harder for them.

There’s a lot of people out there who are not healthy people, and they aren’t going to the doctor.
West Virginia's PEIA director, when confronted with privacy concerns

The punitive policy is part of a broader digital barrier descending to separate the poor from public benefits. In her 2017 book Automating Inequality, associate professor Virginia Eubanks describes what she calls the “digital poorhouse,” a policy of maligning poor people as lazy, then using technology to monitor them and find reasons to keep them off benefit rolls.

“Conservative critics of the welfare state continue to run a very effective propaganda campaign to convince Americans that the working class and the poor must battle each other in a zero-sum game over limited resources,” Eubanks writes in Automating Inequality.

“More quietly, program administrators and data scientists push high-tech tools that promise to help more people, more humanely, while promoting efficiency, identifying fraud, and containing costs. The digital poorhouse is framed as a way to rationalize and streamline benefits, but the real goal is what it has always been: to profile, police, and punish the poor.”

West Virginia eventually pulled the plug on its tech-dependent health insurance.

West Virginia’s failure hasn’t stopped others from trying to use fitness trackers to quantify health.

John Hancock’s case is slightly different from PEIA. The company is private, not a publicly run program like West Virginia’s.

But the promotional material for John Hancock’s new FitBit-friendly plan reads like a better-worded version of the West Virginia official’s complaint that teachers were “not healthy people, and they aren’t going to the doctor.”

In a press release, John Hancock said it launched the new plan “in response to a troubling shift in Americans' health”:

<p>[L]ifestyle diseases are the leading cause of death. According to the Oxford Health Alliance, just four choices—physical inactivity, an unhealthy diet, excessive alcohol and smoking—now cause more than 60 percent of deaths and 80 percent of the disease burden globally.</p>

Sociologists might tell John Hancock that reduced physical activity and unhealthy diets are often less deliberate “choices” than they are products of poverty, and that low-income Americans are more likely to smoke.

Unlike the West Virginia plan, John Hancock won’t explicitly penalize customers who don’t enter their FitBit or Apple Watch data. But customers who opt for a free FitBit save 15 percent on their annual premiums. The other option only encourages FitBit use and offers a discount on fitness trackers.

John Hancock boasted that participants in an early version of the program 'live 13-21 years longer than the rest of the insured population,' and 'generate 30 percent lower hospitalization costs than the rest of the insured population.'

Customers who log their fitness and food purchase data can cash in for rewards, like discounts on “healthy” foods at Walmart, discounts on other fitness trackers, and “members who reach platinum status for three consecutive program years” can qualify for a year-long Amazon Prime membership.

Is John Hancock offering discounted FitBits out of some great philanthropic impulse?

No, according to a pamphlet the company released, detailing “How Insurers Gain Competitive Advantage by Better Addressing Society’s Needs,” and “Societal Needs Reframed as Innovation Hot Spots.”

As a life insurance company, it’s in John Hancock’s interests that its customers do not die. But customers—also presumably interested in not dying—do not necessarily reap the same benefits as John Hancock does from the program.

It’s advantageous for John Hancock, which might have to pay out fewer claims, Reuters noted.

In its press release, John Hancock boasted that participants in an early version of the program “live 13-21 years longer than the rest of the insured population,” and “generate 30 percent lower hospitalization costs than the rest of the insured population.”

Those customers will keep paying out longer—and paying more than other customers, if they don’t fully participate in the fitness tracker programs.

As insurance companies gamify health, consumers suggested their own ways of hacking back.

“Wearing my fitbit to jack off so I can afford chemotherapy,” read one viral tweet about the John Hancock announcement.

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