Health care decisions are meant to be private. In fact, in the United States there are federal laws aimed at ensuring confidentiality between patients and their health care providers, which prevent most companies from accessing their employees' private medical information.
Legally, your employer isn't supposed to know if, say, you're a woman who's thinking about going off your birth control, whether it's because you're trying to get pregnant or because the hormones are giving you mood swings or because you simply forgot to refill your prescription this month.
But this is the era of "big data" — which means, apparently, your boss might be asking big data firms to check to see if you're still taking the Pill anyway.
According to the Wall Street Journal, third-party "wellness firms," which collect data from insurers as well as consenting employees, are determining which workers might be at risk for certain conditions or procedures.
Billed as a cost-saving effort, the data mining examines all sorts of employee behaviors. Employers aren't necessarily getting access to individual employees' health information, but they can see data aggregations that tell them how many of their workers might experience a certain health condition or seek a given procedure, like back surgery.
Employees' past insurance claims are one guide, but wellness companies can also check whether people spend money at fast-food restaurants or vote in midterm elections. Additionally, they can see which prescriptions employees are and are not getting filled — like birth control, for instance.
As the Journal notes, one of the conditions the data miners look for is (surprise!) pregnancy:
To determine which employees might soon get pregnant, Castlight [one of the wellness firms] recently launched a new product that scans insurance claims to find women who have stopped filling birth-control prescriptions, as well as women who have made fertility-related searches on Castlight's health app.
That data is matched with the woman's age, and if applicable, the ages of her children to compute the likelihood of an impending pregnancy, says Jonathan Rende, Castlight's chief research and development officer. She would then start receiving emails or in-app messages with tips for choosing an obstetrician or other prenatal care. If the algorithm guessed wrong, she could opt out of receiving similar messages.
So, not only are companies getting information that runs them the risk of straight-up violating employees' privacy; they're also using that information to try and steer individual workers in a given (cheaper) direction as they're making major health decisions, like whether or not to get pregnant.
That employers would feel they have a right to know what any female employee plans to do with her uterus makes sense, given that we live in a world where women's health decisions are generally believed to be up for public debate. As is almost inevitably the case when it comes to reproductive health, however, women don't need help understanding which choices are right for them and their families, unless that help comes from their doctors or perhaps from their partners.
Deciding whether or not to try to get pregnant is personal, private, often complicated and not always easy; it's not exactly the sort of thing you want to go over with your boss. Regardless of what a woman decides about pregnancy — whether it's when she wants to get pregnant or if she wants to get pregnant at all — it's not a decision about which anyone is entitled to know, ask or share an opinion just because they have one.
Society's prevailing opinion is that if someone has a uterus, it should be occupied at some point. Society's opinion is wrong: Pregnancy and parenthood are not for everyone, and they're not the only reasons women stop using prescription contraceptives either. Data alone isn't enough to tell us about the nuances of women's health decisions, their bodies, their lives. It's also not there for employers (or anyone) to look at just because they can.
Feb. 25, 2016, 10:26 a.m. Eastern: This story has been updated.