Those machines in drugstores and supermarkets that let people check their blood pressure also may be selling people's contact information to insurance companies trolling for new customers.
One of these kiosks sits in aisle 10 of a Safeway grocery store in a city near San Francisco. Sitting down at the machine is like slipping into the cockpit of a 1980s arcade game. There's a big plastic seat and foot rest for measuring weight and body mass index, a window for testing vision and a blood pressure cuff.
"Make sure the cuff comes up above your elbow," says an attractive brunette on screen. She is wearing a white lab coat and she asks a lot of personal questions like, "Do you have a blood relative who was told they have a heart problem?" And, "During the past 30 days, how many days have you felt sad or depressed?"
The machines are owned by a company based near Atlanta called SoloHealth. It started installing the kiosks in Wal-Mart stores and other retail stores in 2008 to give people a way to keep better track of their health. Today there are more than 3,500 SoloHealth stations across the U.S., and the company plans to install another 1,500 this year.
SoloHealth first made money by selling ads for pharmacy items displayed near the kiosks. But it has happened on a new business model. The data it collects are suddenly very valuable to health insurance companies.
"As much as we've moved to the market, the market has really moved to us," says Bart Foster, CEO of SoloHealth. "We're able to provide much more detailed information than the health plans even know what to do with today."
In this case, it means selling information about people who have used SoloHealth kiosks. For now, SoloHealth is selling names, email addresses and phone numbers to insurers who want to market health plans directly to consumers.
Now that most Americans are required to have health coverage by March 31 or pay a penalty, insurers are looking for new ways of finding potential customers, and competing with each other to get their attention.
Anthem Blue Cross is one of them. It brokered an exclusive agreement with SoloHealth to be the sole insurance company featured on kiosks throughout California.
"We know that engaging consumers early and engaging them with our messaging helps improve the chances of them choosing Anthem as their health plan," says spokesman Darrel Ng.
As a part of that strategy, SoloHealth added a new service to its machines in October offering help with understanding the Affordable Care Act.
"If you would like to learn more about the upcoming changes to the health care system and how they affect you," a male voice now says to visitors at the kiosks, "select the 'continue' button at the bottom of the screen."
A drawing of a doctor with a stethoscope around his neck flashes and the voiceover says, "We can have an experienced professional reach out to help you find the plan that meets your specific needs."
But what the friendly voice doesn't make clear is that the "experienced professional" is not a doctor or SoloHealth representative, but an insurance rep. That is only explained after the customer enters his or her name and email.
Privacy advocates say this is misleading.
"Consumers have every reason to be shocked this is happening," says Pam Dixon, executive director of the nonprofit World Privacy Forum based in San Diego.
She says most consumers don't understand that their information is being sold. While there is a two-page health privacy disclosure on the machines, it can only be viewed by clicking a blue button at the bottom of the screen. Whether customers read it or not, they agree to all the terms when they hit a separate green button. Dixon says that's not good enough.
"The fact that they're not being told in a clear, conspicuous and prominent manner is problematic," she says.
SoloHealth says it is reviewing the customer experience of its kiosks.
After partnering with insurance companies, SoloHealth has made another recent change. Until a couple of weeks ago, the company's comprehensive privacy policy -- governing what the company can do with the data it collects -- wasn't on the machine. There was a Web address provided, but since there was no Internet connection at the kiosk, there was no way to read it.
At first, SoloHealth said it was too cumbersome to scroll through the information on the small kiosk screen. But then, in mid-December, the company added the full policy to its machines. SoloHealth said the change was made to improve transparency.
"We work with retail partners, our attorneys and our corporate sponsors to make sure that we're totally buttoned up," says Foster, SoloHealth's CEO. "We have a number of very large companies that have looked at this and are very comfortable with where we are."
But some consumers are uncomfortable with it. Stacey Winn has been using the kiosk at her local supermarket for the last six months to track her blood pressure. She doesn't remember ever seeing a privacy policy, even when she visited late last month after it was added. What she noticed for the first time were ads for a health insurance plan. Now she feels uneasy about her blood pressure records, weight, age and ethnicity being stored in SoloHealth's database.
"I wonder now what they're doing with that information when I hadn't really wondered that before," she says. "There's a saying that if a service is offered for free then you're actually the product that's being sold, and I think that this is turning into an example of that."
This story is part of a reporting partnership with NPR and Kaiser Health News.
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