tv America Tonight Al Jazeera January 3, 2016 9:30pm-10:01pm EST
loudly. >> fault lines: al jazeera america's hard-hitting& >> today they will be arrested. >> firing canisters and gas out of& >> emmy-award winning investigative series. on america tonight hospital hoax. an incredible story of id theft and how it nearly ruined this young mother's life. >> her meth addiction were put into my medical reports as you? >> yes lisa fletcher with a story you won't believe and questions about protecting your identity from risks you never imagined thanks for joining us. at this time of year when we've
spent so much on holiday gifts and shopping, identity theft makes us think of credit card numbers and bogus charges. there has been a turn by criminals making use of your good name to commit medical identity theft. lisa fletcher investigates what that means and why it is so frustrating to try to fix when someone has stolen your identity for their medical care. >> this mother of four lives just outside salt lake city. >> this was the one that was stolen? >> yes in 2006 her driver's licence was stolen from her car. for her and her family, it was the beginning of an ordeal which continues to this day. >> a couple of months after my driver's licence was stolen i got a call from child protective services and they basically said that they were investigating me and that the child that i just
had tested positive for methamphetamine. >> reporter: there was one big problem. she hadn't just had a baby. her youngest twin boys were already two. >> i was already thinking this has something to do with my driver's licence and that being stolen and so i tried to explain to the child protective officer it has to be some type of mistake or an error. >> reporter: did they believe you? >> no. not at all. their response was "we know that you're a drug addict. don't try to change the subject. this has to do with the baby you left at the hospital. you're using methamphetamine and all four of your children are in danger". they told me that they had the paperwork filled out to take all four of my children into custody. they said that they were essentially fishing up their vision. -- finishing up their investigation. >> reporter: she was a victim of a growing problem.
medical identity theft >> popt bills, ambulance pills, ultrasound bills. >> reporter: her name taken from hur stolen drivers's licence had been put on someone's else new born >> i have spent nights crying on the bathroom floor. i would wake up in a panic in the middle of the night worried that someone was going through my car or worried that somebody was going to take my kids. it turned my life upside down. >> reporter: medical identity crimes take many form, insurance information hacked and used for fraudulent billing, stolen prescriptions, data abreaches. often the crimes are committed electronically, but not always. in andrea's case it was routine crime, a stolen id that threatened to ruin her family's life. do you remember how you felt? >> i felt panicked. >> reporter: her daughter was pulled out of class and questioned by child protective services
>> you know, like i had no idea what was going on. my mum comes into the kitchen and she is "they're here to take you". >> reporter: her problems didn't end there. >> in court that's where they referred to me as the legal mother, so i had to get an attorney. >> reporter: despite the fraud, she was now legally the mother of the new born child. yet medical privacy laws prevented her from untangling the mess >> one of the tricky things is once you have become a victim of medical identity theft and you report that to the hospital, they don't actually - they wouldn't let me see my medical records. they knew that there had been a breach to my medical records. so they're protected health information. they didn't want their protected health information to be leaked to me. so it becomes the hospital is trying to protect the perpetrator of the crime instead of the victim of the crime >> reporter: so the woman who impersons natured you is now -
impersonated by you were protected by the hospital? >> yes. not only were her records intermingled with my records, by my records are intermingled with the pay bee's records. her meth addiction was put in my records. >> reporter: as you? >> yes. as me. hospital shares so much information haven't though i can go back to the original hospital where it hand and say let me see the records, it is deleted out. i don't know if things got transmitted electronically or if things will show up somewhere else at some future point in time. >> the one thing about patient data which is different to credit card data, we can issue a new card as many times as we want. you can't do that with medical history. you can't say we lost your data, we will give you a new set of data like you can for a credit card >> reporter: this man is an expert in cyber security. understanding how medical information is accrued and how it is used >> once that is out there, it's out there. you can't change it.
you can't revoke someone's patient history. the decisions that are being made are based on that data are really important, so it's a system of things connected together. you can't have security in one without the other otherwise the system will fall apart >> a bill nor an epidural which i did not have. >> reporter: she was also being asked to pay the new born's medical bills >> an ambulance ride. >> reporter: this is adding up >> reporter: her life became a series of endless phone calls to medical managers. >> an you will extra sound. >> reporter: there was d.n.a. testing, lawyers, court. >> we know who the mom is. we have taken dna tests. i'm still getting reminders to take this child in for a follow-up. i had a really hard time trusting. i still do have a hard time trusting that my name has been removed from the child's medical record. >> reporter: medical identity fraud and the problems addressing it when it happens is an unintended consequence of new
requirements about information sharing. under the law, medical information is increasingly available and exchangeable through electronically shared health records or ehrs. >> a lot of hospitals have requirements to make it sure they can share data that was passed last year from the u.s. government. it's not that they want to do this. they have to do it from an information sharing point >> i don't know what information got transmitted to electronically to some other database. >> reporter: every ounce of personal information about you that matters, the hospital has. don't you expect more of them? >> i do expect more of them. i would expect them to have as much security as credit card companies. i still don't know what's put in the baby's medical records. i don't know if the baby's medical records say she was a meth addict and had this baby. >> reporter: do you worry about the baby? >> i do worry about the baby.
you know, it felt different to be called the legal mom of a child and there was some emotional responsibility if there's no mom any more >> reporter: did you think about bringing this child home? >> i did think about it. the child had to go somewhere. there was a part of me saying i am the legal mom, maybe this is what is supposed to happen. >> reporter: you've flipped this and then you multiply. >> reporter: it took her several years to feel like she for the most part had her life back, but still when she least expects it, there are reminders. >> still to this day sometimes i will go to a pharmacy and along with my kids this child will pop up, and so it will be my kids and this extra chald that kind of p pops up and is-- child that kind of pops up. >> reporter: still in the system >> yes. there's no way to be sure that the electronic information is fixed. you can ruin my credit, steal a
credit card, but have my kids and have the threat of my family ripped apart, that is the absolute worst thing lisa fletcher is here. this souns like sounds like an anomaly. >> this has happened to a lot. health care data is proving far more valuable than credit card data. it is estimated that it's ten to 20 times more valuable. here is why. it gives criminals access to bank accounts, insurance accounts, the ability to pain prescriptions. there is a huge lag time between when the information is stolen and when the victim actually realises that it's being used and, frankly, criminals are hearing what the f.b.i. has been telling hospitals for years and that is that they are an easy target. they are far more susceptible to cyber attacks than other sectors like banking or retail i would never have thought of this, but i would not have
thought, hey, you can use somebody's identity to, what, get surgery, to have a baby? >> it's unbelievable. the number of victims that we talked to in addition to her told us stories like, we started getting sons for my son's broken leg. the another guy had his data stolen and used it to get surgery and buy a prosthetic. it is just across the board. a lot of times it takes a year or 18 months to two years to figure out that their data has been hacked if this is so common, i'm just trying to imagine i go into a hospital, i go to the emergency room, i give my driver's licence. is there some way to track them to make sure that i am who i claim to be? >> you are trusting the hospital to do due diligence and they're protecting your information. they can do more and they should do more everyone agrees. that said, there are some things
out of their control we have talked about these wifi enabled devices. they'res tens of thousands of them. they come to the hospital with pass codes that are hard coded in. it means the hospital can't change them and they're at the mercy of criminals who know how to hack in that is stuff we have never thought about. it is quite serious. another health care prices. the truth on why they are going up. later price out when the cost of a cure is too great to save a life. hot on america tonight's website now, danger at the tap. a water crisis in flint michigan and the residents who depend on
here is another way health care can be out of reach. those who may - for those who need it. americans pay more for prescription drugs than any other nation. there are growing questions why. is it really just the hand in the marketplace or is something more nefarious at work. answers now from michael oku with a big one telling how harris scarfe. >> reporter: martin shkreli might be one of the most honest besanko man around, but me is also one of the most reviald. -- he. the backlash started in september when his former company turing pharmaceuticals raised the price of a treatment used by hiv patients called daraprim. from $13.50 a fill pill to an
ass tonnishing $750. a 5500% mark-up practically over night. over waivering on whether or not to drop the price, mt said said why. >> no-one wants to say it, no-one is proud of it. my investors expect me to maximum eyes profits while it may have been frankly appalling, the price hike was not illegal. >> it is legal. that is the bottom line. >> reporter: this man is the ceo of another pharmaceutical company. he took america tonight behind the scenes at their laboratory in california to help us to understand how drug companies come up with their prices. >> to the outsider it looks like they've got a product and they basically stick a label on it
that is the most expensive price that they can come up with. >> most drugs will try and get as much money for a drug farce they can. >> reporter: this company took an industry by surprise by releasing a fill similar to daraprim at $1 per peel. >> reporter: why $1? >> we need people who need-- deal with people who need these medicines. >> reporter: is turing pharmaceuticals a bully in the playground? >> i think they're taking an advantage of a monopoly opportunity of. that's not the way pharmaceutical companies should behave. >> reporter: he says that martin shkreli isn't the only one to blame. >> there are many out there that are doing this. >> reporter: the turing incident provided an opportunity for a different approach, one that he says is ethical and prudent. how do you reconcile the fact
that you're a businessman in a business trying to make a bottom line on the one hand and that you have a moral obligation to the patient on the other. >> we don't do with any of our drugs what you've seen turing do. we just don't do that as a company. it's against our value system as a business. the danger of exploitation looms larger than in a whole host of businesses. >> particularly with these life-saving medicines. i have to tell you i think there are many, many pharmaceutical companies though that are e empathetic but i haven't seen that as part of the discourse with martin shkreli or with a lot of these other ceos. >> reporter: his company has its critics. you know there are cynics out there who will say that your pricing of daraprim is a pr stunt. >> that's absurd. anybody that says that needs to
get in the car, drive over to a hospital and meet a patient that is suffering from one of these diseases. these people can't afford these drugs. this is not a joke for them. >> reporter: what's your most expensive drug? i have to assume they're not all a buck a pishgs ill. -- pill >> we have drugs that the patient spends several thousand dollars a month for. nothing that is $282,000 companies-- $80,000. we're not one of those companies. >> reporter: should there be some sort of over sight? >> i don't think price fixing, price caps are necessary. i think companies should be free to price things how they wish. if someone like turing wants to charge $750 for a medicine that the day before might have been $13 a fill, they have ever right
to do that. every right to do that. we want to have the right to pry ours at 99 cents. >> reporter: martin shkreli was arrested this month and charged with fraud. while the charges are not related to the infamous price hike, it could serve as a lesson for other leaders. if not it is consumers who will continue to pay the price next, another look at high drug prices and lives in the balance. can a prescription that could save lives be out of reach? fill pill
year. we will show you that next we have heard the snoof we have heard now the explanation from an industry insider and what he is trying to do to keep the price of drugs within reach. we know the sophisticated medical treatments can also come with some very high price tags and the sickest patients, the ones most desperate to be saved, are also vulnerable to price fixing. one deadly disease can be now stopped in its tracks. >> reporter: the end stage of the disease is horrible. it can take decades for cirrhosis to destroy the liver, but unchecked it eventually will. >> there aren't a lot of pleasant ways to to do, but this is a very unpleasant way. the bleeding that it happen internally and then outside can be extremely difficult to
control. >> reporter: two of the most common causes of liver disease in the u.s. are alcoholism and hepatitis c, a blood born illness spread through dirty needles often. an estimated three million americans have the hepatitis c virus. experts warn most of those infected don't know it >> i didn't know until i had a hip replacement in 05. they had to do blood work, blah, blah, that's when i came up hepatitis c positive. >> reporter: she said she traced her infection back to a tattoo she got years ago. at first she didn't recognise how severely her health had been compromised. >> reporter: have you begun to feel sick? >> every now and then i feel lethargic. almost like an flu-like feeling.
>> reporter: your big fear is your liver? >> yes, because cirrhosis, if you get that, it's-- that's it. i'm not ready to die. >> reporter: under treatment for other unrelated health problems, she asked her doctor about a new hep c drug she saw on tv >> he explained how much, it's the latest thing and everyone is using it and it can treat you in between eight and 12 weeks. >> reporter: it's awe krur. >>-- you're. it's a cure. >> yes. i got really excited about it. >> reporter: what did you think about the drug? >> i thought that i want it now. i want it now. >> reporter: before you get sicker. >> yes. >> reporter: harvone and salvadi have proven to be much more
effective than older hep c therapies. it cures it well over 90% in three months of treatment or less. the cost of the cure is nearly $100,000 per patient. >> it is very expensive. so even if there is a cut rate discount, it is still very expensive. >> reporter: this man is her doctor. like most of his low-income patients at the john bell health center in philadelphia, her health care is covered by medicaid. >> we treat predominantly low-income, either insured through public assistance or public patients. >> reporter: that means taxpayers are left to foot the bill. across the nation states have quietly thrown up road blocks. most states have added restrictions that delay or make
it difficult for hep c medicaid patient to get their treatment. her treatment application was declined four times. >> it is not medically necessary because you do not need the hepatitis c criteria. >> reporter: the provider is telling her it won't pay for the miracle drug until her liver disease gets worse. her experience isn't uncommon. doctors find both private insurers and medicate frequently reject hepatitis c patients who are not deemed sick enough. to a patient like this woman, it is a cruel and possibly life-threatening rejection. for medicaid programs which provide health care for the poor, it is a pragmatic and necessary decision. this man's organization represents the nation's medicaid directors. >> if we were to simply open up the doors and say, yes, everyone
who is suffering from this disease at any stage, at any condition, everyone gets it, we would be spending as much on that one drug as we would on every other single drug in the program combined. >> reporter: you're going to bankrupt the system >> we would bankrupt the system. we would have to figure out a way to stop providing as much nursing home care for frail seniors, stop providing as much prenatal care for pregnant women or something else. >> reporter: so you're telling society we've got to choose. >> medicaid has to choose every day. we cover 70 million americans and we do so under very, very constrained budgetary parameters. >> reporter: he says even though pharmaceutical companies are required by law to negotiate with medicaid programs, the maker of the break through hepatitis c treatment resisted giving the states much of a de
>> they didn't really want to play because they didn't have to, because they knew that they had the product, the law-- >> reporter: the only product >> the only product. >> reporter: that works this well. >> so they can sort of say, no, we think you will pay the price because we think you have to >> reporter: the drug matter gilead declined an interview but in an email defended the price of the treatment. arguing that the one time cost appeals in comparison to the life time cost of treating the disease. with drug costs already as much as 15% of state medicaid budgets, add more miracle drugs being invented, analysts say hepatitis c drugs could be the first test of how america's budget can be stretched and whose cure society is willing to pay for. this woman who has no history of iv drug use sees the repeated denials as proof insurers don't care if she lives or dies.
>> i think that's what the insurance companies want you to do. they want you to get discouraged. >> reporter: she isn't about to give up. >> i'm worth having this drug. i'm worth it. >> reporter: even if it's a hundred thousand dollars. >> even if it's a hundred thousand dollars. my life is worth saving. >> reporter: she is right. sips we first told you her story, she appealed the fourth denial and has now finally been approved. weeks from now, she hopes that the treatment will finally leave her hepatitis c free. that's america tonight. tell us what you think at al jazeera.com/america tonight. you can talk to us on facebook or twitter and come back. we will have more of america tonight tomorrow.
>> previously on hard earned. >> happy birthday! and here's your whistle for when you've fallen and you can't get up. >> bitch. >> i was sad. >> we didn't get the loan. >> we even put it on our calendar, a little picture of a house. >> today was another terrible day at walgreens. just happy to get home and get to my little ones. >> i always wanted to be a midwife. but i just can't be a full time student, worker andom