We've written before about a unique problem in Iowa's individual health insurance market: one patient whose care reportedly costs $1 million a month. It seemed hard to believe, but yesterday, the Des Moines Register gave more details that help explain why the patient's care is so expensive. The paper reported the patient has hemophilia — a disorder that keeps the blood from clotting, and can require expensive infusions of proteins.
The lesson: Insurers are sure to push Congress for changes to help them absorb the costs of expensive patients more easily, like reinsurance or a return to high-risk pools. But Iowa's insurance commissioner, Doug Ommen, told the Register that the state's insurance market problems go beyond just one patient — there's just a bad overall mix of customers, with too many sick ones and not enough healthy ones.
A privacy issue? The story also set off a lot of discussion yesterday about whether the patient's privacy under the HIPAA law was violated. It didn't name the patient, but the details — which came from a presentation from a Wellmark official — included the gender and a general idea of the age. (We've left out those details here.) We never got a definitive answer from privacy and legal experts, but safe to say they're worried about it.