In George Orwell’s Nineteen Eighty-Four, the state uses ubiquitous ‘telescreens’ to monitor and control the population. Part of that control is a daily, and compulsory, programme of physical exercise.
Aren’t we lucky that we don’t live in a world like that?
Only here’s something to bear in mind: this month, John Hancock, an American life insurance company, announced that it would be expanding its Vitality programme, which enables policy holders to “record [their] everyday healthy habits, like taking a walk, to earn points and gain extra savings and rewards”. The recording is achieved through the use wearable fitness trackers, smartphones and other bit of kit.
Writing about the story for Vox, Cheryl Wischhover points out that a life insurance company has an obvious interest in its customers’ continued good health:
“….life insurance companies want to keep you alive as long as possible so that you keep paying your monthly premiums. It’s a double whammy for them when you die: not only do they lose your premiums, they have to pay your survivor(s).”
I’d say it’s also a great marketing strategy. There’s a growing number of self-quantifying health fanatics who don’t actually need much persuading to strap on a fitness tracker; rather, what’s lacking in their lives is anyone who actually wants to know how many steps they’ve walked that day. John Hancock is pressing all the right buttons.
It should be stressed that the company is not forcing anyone to take part or share their fitness data. Furthermore, they are rewarding healthy habits not punishing unhealthy ones; and if you hate the idea anyway, other life insurance providers are available.
But what if a special feature of one life insurance provider’s products becomes a general feature of all health insurance provision? Being without health insurance in America isn’t much fun – so anything generally required of policy holders is pretty much compulsory.
How does a potential choice between wearing a tracking device or losing your health cover grab you? A tad dystopian, perhaps?
Well, that might not be the half of it. Wischhover reminds us that the insurance companies could use the device data to “potentially weed out bad health-risk customers.” And let’s not forget that health monitoring technology is getting more sophisticated all the time:
“Apple announced on September 12 some new health features in its Apple Watch, including that it will be capable of taking electrocardiogram readings of your heart… Surely some for-profit health entity — like an insurance company! — will figure out how to monetize this.”
Then there’s all the health-related information that can be gathered through your online activity. What if the health insurance companies of the future require you to share data about your online purchases? Just make sure you pay for that box of donuts in cash.
Is this dystopia for Americans only? Perhaps not. Countries with socialised models of healthcare might also be vulnerable to the hi-tech enforcement of healthy lifestyles. Instead of the profit motive, the driver would be the need to keep public spending under control. One could imagine hard-up governments offering discounts on social insurance contributions or rebates on taxes in return for verifiable evidence of responsible behaviour.
So who will take this furthest – the American healthcare industry or the welfare states of Europe?
My money is on the latter. As CS Lewis said, “of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive”.