Security Notes: Health Care: The Next Challenge

Gideon Samid • Gideon@BitMint.com

Whether you like Oba- ma­care or you want it repealed, you must agree that health-care payments are a major issue in need of fixing. One-seventh of the U.S. economy is stuck with choking complexity, only highlighted by the pathetic collapse of the Obamacare Web site that, among other things, could not figure out a payment schedule for its customers. The designers of Obamacare are purportedly experts in the maze of health-care payment procedures, but as far as I can tell, they are not versed in the payments industry per se. Indeed, in health care, our industry has been AWOL.

Think for a moment of the considerable sophistication that we bring to quick checkout, to account visibility, to state-of-the-art security, to customer money control, and to exploiting the benefits of competitive advantage. Our solutions are helping Americans get in and out of a fast-food restaurant, buy remotely with one-click checkout, and walk through a department store while pushing a shopping cart and scanning its load. Yet all that knowhow has not been leveraged to think creatively about the health-care challenge.

Why haven’t we knocked on their doors? Much as in nominal shopping, payment procedures require customers to expose sensitive private data. We have good solutions. Admittedly, the chain of custody from the merchant to the processor to the various banks to the network is being hacked, and too often. But let’s not lose perspective. Visa and MasterCard handle over $5 trillion in transactions annually. Their procedures have had half a century to be perfected. That is a powerful body of knowledge and wisdom. All that is needed is the leadership to apply this asset to the challenge at hand.

Few would disagree that, if we could engage the health-care consumer as a market force, shopping for advantage, then the constant upward spiral of prices could be tamed. The widespread industry of loyalty money and reward points could be adapted to put in the hands of the health-care consumer prepaid health-care dollars that could be accumulated in a healthy year towards a “sick” year. These dollars could be shared familywide or businesswide, and could induce doctors and hospitals to offer advantage packages, including early detection, routine physicals, and so on.

Using digital money, for example, we can put together a system where designated health-care dollars are handled in a closed loop. These dollars would be worthless in Vegas, and they won’t put you on a cruise. They would only pay for your doctor, your medications, and your hospital bills. They would be stored in a separate account, and they would be engineered to be completely traceable, providing statistics that would allow forensic experts to spot fraud and abuse. A phone applet would carry both our personal medical information (medical issues, history, medications) and our digital medical dollars, which would be paid in real time to the next health-care professional who takes care of us.

Our industry knows how to secure data at rest and data in movement. End-to-end encryption, identity-based encryption, anti-fraud protocols—we have them all. And once the health-care provider realizes that his or her patient is the one who clicks “Pay My Doctor” on the phone applet, and that he or she can walk off to a more appealing provider, the familiar incentives to treat that patient with respect and give him or her a sense of comfort will take over.

To realize this vision, we need to stand up and be counted. We need the initiative to organize, say, a conference entitled “Health Care Payment Technology 2014” and bring our heavyweights to the fore, together with the health-care procedural experts. Technology is America’s strong suit, so let’s apply it with creativity and force to an issue that all agree is badly broken and needs fixing.

With challenges aplenty, I don’t argue it will be easy. Most of the developed world languishes under a slow and inefficient “health care for all” system. Our previous system neglected the bottom of the socio-economic ladder, which is what Obamacare professed to rectify.

We have never successfully copied failing, old-world solutions. We need to be original, to join forces to invent the solution others will follow. Robert Oppenheimer was smart enough to assemble diverse experts in science and engineering to meet the Manhattan Project challenge. Doesn’t it look like we have an analogous need? It is up to our industry to ensure we contribute our fair share.