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tv   America Tonight  Al Jazeera  December 30, 2015 12:30am-1:01am EST

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canada draws up a plan to deal with emissions and atmospheric carbon. the salt lakes could be a part of it. more news on the website. you'll find it all at on america tonight, hospital hoax. an incredible story of id theft and how it nearly ruined this young mother's life >> her meth addiction was in my records lisa fletcher with a story you won't believe. the serious questions about protecting your identity from risks you've never imagined. thanks for joining us. at that time of year when we've
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spent so much on holiday gifts and shopping, identity theft naturally makes us think of credit card numbers and bogus charges, but there has been a surprising turn of criminals using your name for medical theft. lisa fletcher investigates what that means and how it is frustrating to fix once someone has stolen your identity for your medical care. >> reporter: this woman, a mother of four, lives just outside salt lake city. this was the one that was stolen? p >> yes. >> reporter: in 206 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 backachely said that they-- basically said that they were investigating me and that the child that i just
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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 this has to be some type of mistake or an error. you? >> no. their response was, "woochlt e know that you're a drug aaddict. don't change the subject. this has to do with the baby you left at the hospital. you're using methamphetamine. all four of your children are in danger". they told me that they had the paperwork filled out to take all custody. they said that they were just finishing up their investigation. >> reporter: she was a victim of a growing problem, medical identity theft. >> the hospital bills, ambulance bills, ultrasound bills.
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>> reporter: her name taken from her stolen driver's licence had been put on the birth certificate of someone else's new born. the real mother, she suspects, hoping to hide her drug addiction >> i've spent nights crying on the bathroom floor. i would wake up in a panic in middle of the night worried that someone was going through my car or worried that somebody would 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 breaches. often the crimes are committed electronically, but not always. in her 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 services. >> you know, like, i had no idea what was going on.
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may mum comes into the kitchen appeared-- my mum comes into the kitchen and she was crying saying they're here to take you. >> reporter: her problems didn't end there >> in court that's where they referred to me as 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 the victim of medical identity theft and you report that to the hospital, they don't - they wouldn't let me see my medical records. they ho knew there there had been a preach to my medical records. so they're protected health information. they don't want their protected health information to be leaked to me. 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 em% natured-- im% natured you is-- impersonated by you is
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being protected by the hospital? >> yes. our records are intermingled that i have no right to change. her meth addiction was mutt in my records. >> reporter: as you? >> yes. as me. hospitals share information, that even though i can go back to the original hospital where this happened 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 time. >> the one thing about patient data that is different, we can actually issue you a credit card number. we can do that as many times as you want. we can't do that with your medical history. we will give you a new set. >> 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 is out there. you can't change it. you can't revoke someone's
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patient history and the decisions that are being made are based on that data are really important. it is an eco system of things connected together. you can't have security in one without having security in the other, otherwise the ecosystem is going to fall apart >>. bill for what i didn't have >> reporter: she is being asked to pay for the new born's bills. her life became a series of endless phone calls u >> the ultrasound >> reporter: there was dna testing, lawyers, court >> we know who the mum is. we have taken dna tests. i am still getting remembered to take this child in for a follow-up and so i had a really hard time trusting. i still do, that my name has been removed from the child's medical records. >> reporter: medical identity fraud and the problems addressing it when it happens is an unintended consequence of new requirements about information sharing.
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under the law, medical information is increasingly available and exchangeable through electronically-shared health records eehr. >> a lot of hospitals have requirements to make it so they can share data. that was passed last year from the u.s. government. it's not that they want to do it. they have to do it from an information sharing standpoint >> 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 a baby. >> reporter: do you worry about the baby? >> i do worry about the baby. you know, it felt different to
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be called the legal mum of a child and there was some emotional responsibility if there's no mum any more >> reporter: did you think about bringing this child home? >> i did think about it. well, i'm the legal mum, 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. when she least expected it, there are reminders >> still to this day i will go to a pharmacy and along with my kids this child will pup up and so it will be my kids and this extra child that kind of pops up and is grouped in. >> reporter: still is in the system? >> yes. information gets in electronically and there's no way to really be sure that it's fixed. you can ruin my credit, steal a credit card, but have my kids and have the threat of my family
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ripped apart, that is the absolute worst thing. >> reporter: america tonight's lisa fletcher is here now. this sounds like such an anomaly. >> it has happened to a lot of people. the reason is health care data is proving to be more valuable than credit card data. it is estimated ten to 20 times more valuable. it is because it gives criminals access to bank accounts, insurance accounts, ability to obtain transcriptions. there is a huge lag time between when the information is stolen and when the victim actually realises it is being used and frankly criminals are hearing what the f.b.i.s are telling hospitals for years, that they are an easy target, they are far more susceptible to cyber attacks than other sectors like retail and banking i haven't thought this, but
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i would not have thought, hey, you can use somebody's identity to get surgery, to have a baby. >> it is unbelievable. the number of victims that we talked to in addition to this lady told us us story that we have started getting bills for my son's broken leg. he never had a broken leg. another one bought a prosthetic. it is across the board. it takes a year or 18 months or two years before people figure out that their data has been hacked if this is so common, certainly hospitals have taken steps. i imagine, i go into a hospital, to the emergency room, i give my driver's licence. is there some way to track them? make sure that i'm who i claim to be? >> you are trusting the hospital to do due diligence and protecting their information. everybody agreed hospitals can do more and they should do more. that said, there are some things out of the hospital's control.
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we have talked about the devices in hospitals. those come to the hospital by the manufacturer with pass codes that are hard coded in which mean the hospital can't change them and they're at the mercy of criminals who know how to hack into this equipment. they use the equipment as a portal into the hospital wifi system and into patient data things that we haven't thought about but it is serious. thank you very much. next, another health care crisis. those spiralling drug prices. a big phar mandela a officer tells the truth about why they're going up. another when the cost is too great to save a life. on the website, danger at the tap. a water crisis in flint, michigan, and those who depend on it.
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here is another way health care can be out of reach for those who need it. americans pay more for prescription drugs than any other nations. there are growing questions why. is it the invisible hands or from more nefarious reasons? >> reporter: this man may be one of the most honest businessmen around >> it is a capitalist society and rules. >> reporter: he is also one of the mowers reviled. the backlash started in september when his former company touring pharmaceuticals raised the price of treatment used by hiv patients from $13.70 to appear astonish
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ing-- astonishing $750. after waivering on whether or not to drop the face, he said something in an interview with forbes that is worth highlighting because it is true for any ceo of a for-profit country >> no-one wants to say it. my investors expect me to maximise profits. >> reporter: while it may have been frankly appalling, the price hike wasn't illegal >> >> it is legal. >> reporter: this man is the ceo of pharmaceutical company. he took america tonight behind the scenes at their laboratory in california to help us 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
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with. >> most companies will try and get as much money for a drug as they possibly can >> reporter: in response to touring's price hike, this company released peel. >> reporter: why only $1? >> we hear directly from patients who need this. they're taking advantage of an monopoly opportunity and that is not the way pharmaceutical companies should behave. >> reporter: he says that the screlli isn't the only one to blame >> there are many companies out there that are doing this. >> reporter: the touring 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
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line on the one manned and that you have-- hands 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 touring do. we don't do that as a company. that's against our value system as a business >> reporter: the danger of exploitation looms larger here >> particularly with the life-saving medicines. i think there are many, many pharmaceutical companies that are empathic, but i haven't seen that with martin or a lot of other ceos. >> reporter: this company has its critics. you know that there are cynics out there who will say that your pricing of dereprim is a pr stunt >> the idea that it is a publicity stunt is absurd. anybody who says that needs to get in the car, drive over to a
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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 fill >> we have drugs that are, you know, quite a bit more than a dollar fill. they do get - we have drugs that are patients spends several thousands dollars a month for. nothing that is $80,000. we're not one of those companies. >> reporter: while he believes in ethical pricing, he stopped short of calling for more regulation. should there be some sort of oversight? >> i don't think price fixing, price caps are necessary. i think companies should be free to price them as how they wish. if someone like touring wants to charge $750 for a medicine that the day before might have been $13 a fill, they have every right to do that. we just want to have the right
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to price ours at 99 cents. >> reporter: tour's former ceo was arrested this month and charged with security fraud. his saga could still serve as a cautionary tale for other industry leaders. if not, its 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? unanswered questions. a georgia teen dead after an encounter with police. why this case didn't get nationwide attention and whether his parents might be heard now. tonight.
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year. we will show you that next we have heard the explanation from an industry insider and what he is doing to keep the price of drugs within reach. we also know the sophisticated treatments that are available today can also come from high price tags and the sickest patients, the most desperate to be saved, may also be the most vulnerable to price gouging. pricing can now be stopped in its tracks at least for the patients who can afford the cost of a cure. >> reporter: the end stage of the disease is horrible.
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it can take decades for cyrhosis to destroy the liver. >> there are unpleasant ways to dies, but this is very unpleasant. the bleeding that can occur flernlly and then-- flernlly and then internally can be difficult to control. >> reporter: two of the causes are alcoholism and hepatitis c, a blood born illness spread through dirty needles. an estimated three million americans have the hepatitis c virus. experts warn most of the infected don't even know it. >> i didn't know until i had a hip replacement in 05. so they had to do preliminary blood work, dental work, blah, blah, blah. that's when it came up
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hep c positive. >> reporter: she traced it back to a tattoo she had a decade ago. had you begun to feel sick? >> evidence now and then i feel lethargic. almost like an flu-like feeling. >> reporter: your big fear is your liver? >> yes. because if you get cyrhossis, that's it. i'm not ready to die. >> reporter: treatment for other unremitted health-- related health problems, she asked her doctor about a new hepatitis c drug she saw on tv >> he explained it's the latest thing and everyone is using it and it can treat you from eight to 12 weeks >> reporter: it's a cure? >> it is aa cure. no remission about it.
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it is a cure. i got excited about it >> reporter: what did you think about this drug? >> i thought that i want it now. i want it now. sicker. >> yes. >> reporter: parvone and a related drug from the same drug maker. silvadi, have proven to be much more effective, with cure rates 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. 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, her health care is medicaid. >> we treat predominantly all inner-city, low-income, either
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insured through public assistance or uninsured patients. >> reporter: that means taxpayers and cash-strapped states are left to foot the bill. across the nation states have quietly thrown up roadblocks. it makes hepatitis c patients to get treatment. her application was rejected four times. >> denied completely because harrvone is not necessary because you do not meet the hepatitis c treatment. >> reporter: they're saying they 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 possibliy
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life-threatening rejection. for medicaid programs which provide health programs for the poor as 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 sim >> yes. we would have to figure out a way to-- bankrupt the system. -- to stop providing nursing health for frail seniors, prenatal care for pregnant women or something else >> reporter: you're telling society we've got to choose? >> medicaid has to choose every day.
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weep cover 70 million-- we cover 70 million americans and we do so understand 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 deal >> they didn't really want to play because they didn't have to, because they knew that they had the product, the law was-- >> reporter: the only product >> the only product that works this well >> to make them say we think you will pay the price because we think you will have to >> reporter: the drug maker gilead denied to comment, but they argued that the one-time cost: with drug drugs already as much as 15% of state medicaid budgets, more are being
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invented. these can could be the first test says of how far america's health care 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 wrorth it. >> reporter: even if it's a hundred thousand dollars >> yes. even if it's a hundred thousand dollars. my life is worth saving. >> reporter: she is right. since 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
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