Doctor Threatens Medical Board; Hospitals Give Facebook Data; 100M in Medical Debt

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Doctor-Candidate Threatens Minnesota Medical Board

Scott Jensen, MD, Minnesota’s Republican gubernatorial candidate, is threatening to retaliate against the state medical board after it opened an investigation into him for the fifth time, according to a report from the Associated Press.

Jensen, a family practice physician and former state senator, said in a video he posted to Twitter last week that the Minnesota medical board is a “massive, inexorable force” that has been turned against him for political reasons. He added that “this juggernaut will be dealt with” if he’s elected governor, previously noting his ability to appoint medical board members if elected.

Jensen is a COVID-19 vaccine skeptic, the AP previously reported. He has encouraged civil disobedience over mask mandates and promoted ivermectin as a COVID treatment, even though there is an overwhelming amount of evidence that it is not effective. The physician won the GOP endorsement to run against incumbent Gov. Tim Walz (D), and has criticized his opponent for his pandemic response.

The Minnesota Board of Medical Practice did not respond to a request for comment, as it does not remark on investigations unless corrective action is needed. Jensen said that the medical board has opened — and dropped — four previous investigations into him, which he says have been based on anonymous reports.

Hospitals Send Patient Data to Facebook

Many hospitals have been using a tracking tool on their websites that collects patients’ sensitive health information, including details about their medical history, prescriptions, and doctor appointments — and subsequently sending that data to Facebook, according to an investigation co-published by STAT and The Markup.

Reviewing a list of Newsweek’s 100 top U.S. hospitals, The Markup found that 33 of those hospitals used a tool called Meta Pixel, which sent data to Facebook every time a patient scheduled a doctor appointment. Patients’ data is connected to their IP address — which can be linked to an individual person or household. The Health Insurance Portability and Accountability Act (HIPAA) lists IP addresses as one of 18 identifiers that, when linked to a patient’s health data, can qualify as a protected piece of health information.

Health systems that used Meta Pixel on their websites included University Hospitals Cleveland Medical Center, Johns Hopkins Hospital, Brigham and Women’s Faulkner Hospital, Scripps Memorial Hospital La Jolla, and others.

“I am deeply troubled by what [the hospitals] are doing with the capture of their data and the sharing of it,” David Holtzman, a health privacy consultant who previously served in the U.S. Department of Health and Human Services’ Office for Civil Rights, told The Markup. “I cannot say [sharing this data] is for certain a HIPAA violation. It is quite likely a HIPAA violation.”

Meta Pixel is a piece of code that tracks users as they navigate through a website. It’s one of the most ubiquitous tracking tools on the internet, present on around 30% of popular websites, the investigation noted.

The Markup was unable to identify whether Facebook used the data to target advertisements, train algorithm recommendations, or profit in other ways. Additionally, the report noted that this analysis was only based off of 100 hospitals across the country, stating that data sharing likely affects many more patients and institutions than identified.

100 Million Americans Drowning in Medical Debt

There are more than one million people in the U.S. who have medical debt, encompassing about 41% of all adults, according to an investigation by Kaiser Health News and NPR.

While previous reports have underestimated medical debt in the U.S., this investigation shows just how pervasive the issue is. Using a nationwide poll conducted by the Kaiser Family Foundation, the report portrays not only healthcare bills that patients can’t afford, but also other sources of borrowing used to cover debt. To account for the true extent of medical bills, KHN and NPR reporters looked into the hidden places where debt accrues, including credit card balances, loans from family members, or payment plans to hospitals or providers.

More than half of adults in the U.S. have gone into debt from medical or dental bills, the poll found. A quarter of adults who have healthcare debt owe more than $5,000, and almost 20% say they don’t expect to ever pay back their debts.

Medical debt hits hardest for patients with cancer or chronic illnesses, with debt levels in counties with the highest rate of disease totaling up to three to four times the amount in healthier counties, the report noted. Healthcare costs also disproportionately fall on people in ethnic minority groups, widening racial disparities.

The issue drives millions of people into bankruptcy, depletes retirement savings, and tarnishes credit reports, making it difficult for people to find employment or housing, the report noted.

While the U.S. government has recognized the burden of medical debt on Americans, few federal protections have been put in place, leaving states to introduce their own initiatives. North Carolina, for example, may pass a bill to “de-weaponize” medical debt requiring hospitals to offer financial assistance to patients based on their income and restricting the ways that health systems and debt collectors can pursue unpaid bills.