After a tense driving moment, a modern car can record your abrupt braking and other microbehaviors. The authors use this everyday scenario to illustrate how telematics—minute-by-minute behavioral data captured by vehicles—has shifted insurance practices in auto markets. They argue the same surveillance logic is now being proposed for human bodies through wearables and insurance programs, with substantial ethical and policy implications.
Telematics programs have become standard in many auto-insurance offerings. These products monitor driving patterns such as braking, acceleration, time of day, and phone usage. Insurers advertise potential savings for policyholders who opt in, but evidence of net cost reductions is mixed. The authors cite a Maryland Insurance Administration report that showed varied premium changes without clear overall savings. Despite that ambiguity, insurers continue to expand telematics because the data created can be monetized and used for risk stratification.
White House health officials and some insurance executives have promoted the idea of widespread wearable adoption. Health secretary Robert F. Kennedy Jr. told members of Congress that his vision was for “every American wearing a wearable in the next four years,” describing devices that track sleep, heart rate, glucose, and other metrics as tools for people to “take control” of their health. In parallel, the MAHA strategy document aimed at improving child health proposes linking wearable data to electronic health records, signaling federal interest in integrating these streams into mainstream care.
Consumer wearables now report a wide range of physiological measures, from daily steps and heart rate to ovulation and hormone data. The article notes that wearables can have potential benefits in selective contexts, and clinicians sometimes see health-conscious patients who bring wearable data to visits. However, the authors emphasize that much of the data are of limited clinical utility, often inaccurate, and not clearly actionable for routine medical decision-making. It remains unclear whether wearables make users more health-conscious or simply attract people who already prioritize health.
Insurers and wellness programs are already offering incentives tied to device-derived behaviors. Examples include John Hancock’s Vitality (developed with Discovery Limited), UnitedHealthcare’s Wellness Rewards, and other marketplace programs that issue discounts, gift cards, or points for “good” behaviors. These mirror auto telematics models that encourage enrollment by promising lower premiums or rewards in exchange for continuous behavioral data sharing.
Regulatory posture has shifted in ways that may facilitate broader wearable adoption. The FDA reclassified certain AI-enabled wearables in January, clarifying that devices will not be treated as heavily regulated medical devices provided they do not claim to diagnose or treat disease. This change reduces the regulatory barriers for consumer-facing devices whose data could be funneled into insurance and clinical systems.
A central concern the authors raise is the privacy and security of minute-by-minute bodily data shared with corporations. In the auto context, telematics data have been sold or otherwise monetized by insurers. The authors warn the same pattern may repeat with wearable data: insurers could sell data to third parties or use it to classify policyholders as higher risk, justifying higher premiums. The metaphor used is stark: small everyday deviations—skipping a workout or adding sugar to coffee—could be recorded, aggregated, and used to label someone as “risky.”
The authors critique the wearables-based approach for promoting an individualized model of health that minimizes structural and social determinants. They argue that many lifetime risks to disease are shaped by social structures and inequalities that individual tracking does not address. Instead of investing in policies that mitigate those structural risks, the authors contend federal and industry enthusiasm for wearables risks shifting responsibility onto individuals to manage risk, even when their risk is rooted in broader social conditions.
The essay emphasizes that telematics logic fails in many scenarios. Events such as hurricanes, cancer diagnoses, or accidents are not preventable through individual optimization regimes. The insurance industry’s long track record of limiting payouts and managing risk allocation is relevant: the authors warn that giving insurers more behavioral data via wearables could strengthen their ability to avoid paying for care. They argue that surveillance plus incentives is not a substitute for comprehensive health policy or social protection.
Wearables and telematics-style insurance programs offer potential benefits in narrow cases but carry substantial unanswered ethical and practical questions. The authors call for skepticism about promises that daily biometric surveillance will reduce overall costs or substitute for structural policy responses. They caution against handing insurers greater control through data streams promoted by MAHA and federal enthusiasm, arguing this approach is neither a sound health strategy nor adequate policy for managing population risk.
Andréa Becker is an assistant professor of sociology at Hunter College and author of a book on hysterectomy politics; Paul Kamuf is a sociologist and former creative director. Their argument draws on policy documents, regulatory changes, insurer programs, and reporting about telematics and wearables as described in the source article.