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Bill Prohibiting Genetic Discrimination Moves Forward 575

An anonymous reader writes "The bill to ban genetic discrimination in employment or insurance coverage is moving forward. Is this the death knell of private insurance? I think private health insurance is pretty much incompatible with genetic testing (GT) for disease predisposition, if said testing turns out to be of any use whatsoever. The great strength of GT is that it will (as technology improves) take a lot of the uncertainty out of disease prediction. But that uncertainty is what insurance is based on. If discrimination is allowed, the person with the bad genes is out of luck because no one would insure them. However, if that isn't allowed, the companies are in trouble. If I know I'm likely to get a certain condition, I'll stock up on 'insurance' for it. The only solution I can see is single-payer universal coverage along the lines of the Canadian model, where everyone pays, and no one (insurer or patient) can game the system based on advance knowledge of the outcomes. Any other ideas? This bill has been in the works for a while."
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Bill Prohibiting Genetic Discrimination Moves Forward

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  • Genoism... (Score:5, Insightful)

    by Adambomb ( 118938 ) on Thursday April 24, 2008 @04:21PM (#23189666) Journal
    they call it.

    But no one takes the law seriously.
    • by swimin ( 828756 )
      People in certain communities definitely do take it seriously. Right now, there is a penalty (future discrimination) for proactive genetic testing if you believe you may have a gene (say one that caused a late onset heart defect in your brother).

      Many different groups advocating for patients for various genetic disorders and diseases are very interested in the progress of this bill.
  • what? (Score:2, Insightful)

    by Mr. Slippery ( 47854 )

    We've had private insurance with no genetic testing for a long time how.

    How is keeping the second condition going to mandate the end of the first? It's ridiculous.

    • Re:what? (Score:5, Interesting)

      by Adambomb ( 118938 ) on Thursday April 24, 2008 @04:27PM (#23189764) Journal
      Because insurance companies manage their rates based on trackable probabilities and their claims history. If an insurance company a show that those with genetic pre-dispositions for certain conditions have higher claim rates, this will become a metric for increasing prices without actually having a diagnosis for the conditions in question.

      Trust me, this is not a good thing for the consumer if such data becomes a standard part of ones medical history and I SELL travel medical insurance.
      • Re:what? (Score:5, Insightful)

        by Mr. Slippery ( 47854 ) <tms&infamous,net> on Thursday April 24, 2008 @04:35PM (#23189894) Homepage

        Because insurance companies manage their rates based on trackable probabilities and their claims history.

        Yes, of course. But what does that have to do with the submitter's claim that banning genetic discrimination means the end of private insurance?

        We've had private insurance for a long time without genetic discrimination, because genetic discrimination wasn't possible. This legislation bans genetic discrimination, thus keeping the status quo on this issue. How does that mean the end of private insurance?

        • Re: (Score:3, Insightful)

          by Adambomb ( 118938 )
          Because if you reduce the margins enough, you end up with a scenario where ones premiums equal exactly the cost of ones expected medical treatment. If your premiums for insurance are equal to your cost of medical care, what the hell is the point of insurance?

          at least thats the way i see it as a medical insurance salesman.
          • Re: (Score:2, Interesting)

            by timmarhy ( 659436 )
            then you don't understand your own industry very well. insurance companies are actually a FUND. they take your payments and invest the money and make MORE money on it that way, and when the time comes and you need to draw on that fund, then they pay out (and not very much i might add)

            i don't have the link but i seem to remeber the top fund in australia pays out more then 90% of it's memebers fee's in health care.

            i'm young and fit and i hardly have any need for health cover, but i could do and i WILL need

            • Re:what? (Score:4, Insightful)

              by Wyatt Earp ( 1029 ) on Thursday April 24, 2008 @05:16PM (#23190648)
              Never assume that you won't need it because you are young and fit now.

              Cancers like Leukemia or Lymphoma can strike anyone at any time. Look at the Hockey players and most recently the American Football player from the Minnesota Vikings who've come down with Leukemia.

              I say this because I was young (8) and fit and I got Leukemia. Later I relapsed, and even later I've had a Cavernous Malformations of the Brain and a non-cancerous tumor of the nerve sheath.

              Sometimes there is just a health bullet with your name on it.
              • Re: (Score:3, Funny)

                by cp.tar ( 871488 )

                I've had a Cavernous Malformations of the Brain and a non-cancerous tumor of the nerve sheath.

                OK, that's why you hang around on /.
                What's my excuse?

            • Re:what? (Score:4, Insightful)

              by molarmass192 ( 608071 ) on Thursday April 24, 2008 @05:25PM (#23190816) Homepage Journal
              i'm young and fit and i hardly have any need for health cover ...

              It only takes 1 uninsured driver not paying attention long enough to change that for you. Young and healthy is not mutually exclusive with accidental injuries.
          • Re:what? (Score:5, Insightful)

            by aardvarkjoe ( 156801 ) on Thursday April 24, 2008 @05:08PM (#23190524)

            Your comment illustrates exactly what is wrong with the medical insurance system we have today: the idea that the purpose of insurance is to save everyone money.

            With a properly functioning insurance system, you would expect to probably pay a bit more for your premiums than you would for the medical care that you actually receive. In return, you would be protected from having to foot the bill for an unlikely catastrophe.

            Instead, modern medical insurance has degenerated into a sort of payment plan for routine medical expenses.

        • Gah i misread what you meant, you're exactly correct that if this data is kept AWAY from insurance companies, it will NOT mean the end of private insurance.

          I completely agree that if this kind of detail is commonly available that THAT scenario would eventually lead to the end of private insurance.

          My bad, i'm on vacation =).
        • Re:what? (Score:5, Insightful)

          by bunratty ( 545641 ) on Thursday April 24, 2008 @04:45PM (#23190098)

          It's just like counting cards in blackjack. If you the dealer is not allowed to change strategy on knowledge, players that place their bets according to the cards left in the deck can make a killing. Likewise, if the insurance company is not allowed to charge you according to how likely to you are to get a disease, people who buy insurance with full knowledge of their genetic predispositions will tax the insurance system by making sure they are fully insured for the diseases they will likely get.

          The proposed solution of universal coverage would remove this problem.

          • Re: (Score:3, Insightful)

            by tilandal ( 1004811 )
            The basic fallacy of your premise is that you want to win at blackjack but you don't want to get cancer. Preventative treatment is far cheaper then major surgery and aftercare. Many major disorders are easily treated if found early but life threatening if caught late. The other major fallacy is the premise that people but insurance based on the likely hood they will need treatment. The main driving force with insurance has always been cost. Most people who are uninsured tend to be so because they can not
        • Re:what? (Score:5, Insightful)

          by evanbd ( 210358 ) on Thursday April 24, 2008 @04:48PM (#23190162)

          It's not the end, but it is the first step on that road.

          How long until we see companies that offer policies that don't cover specific highly testable conditions? Sure, they can't test for the condition, but you can -- and choose the policy accordingly. Then the "generic" policies cost more because all the people *with* the genetic markers buy those, and the people without buy the other policies. If the consumer has access to the information, they will try to use it to reduce their insurance costs. You can't put the genie back in the bottle, useful information like this *will* get used.

          I predict the next law will be one mandating that any health insurance policy cover certain sorts of conditions, specifically to prevent the above. The collection of patches to the insurance system will grow and grow, until it finally becomes untenable and something major changes.

          • it finally becomes untenable and something major changes,

            I find that doubtful, because tests are the first step to fixing the problem. If we can specifically identify genes that cause a certain disease, then within a generation or two we'll have a fix, at least one that can be applied to a bundle of undifferentiated cells. When it can be fixed in utero and the only people that can be born with the disposition are those whose parents chose it, the arguments against discrimination will lose a lot of their power.

            The other reason I find it doubtful that it will b

        • Yes, of course. But what does that have to do with the submitter's claim that banning genetic discrimination means the end of private insurance?

          The whole idea of insurance is that it is a less-than-perfect information game. If one party gets perfect information ( or even close to perfect ) then the game is up.
          That being said, I think that the OP's claim does not hold up. It would if one's health were only influenced by genetics, but there are accidents, and other things that affectone's health also.

        • Re:what? (Score:5, Interesting)

          by The Snowman ( 116231 ) * on Thursday April 24, 2008 @05:31PM (#23190888)

          We've had private insurance for a long time without genetic discrimination, because genetic discrimination wasn't possible. This legislation bans genetic discrimination, thus keeping the status quo on this issue.

          Sorry, but this is not the status quo. You need two look at both sides of the equation. Yes, insurance companies have never been able to discriminate based on genetic testing. However, their clients, us, will have a priori knowledge. If I know I am genetically disposed for a specific condition, I can game the system to make sure I bear as little of the cost as possible. Insurance companies either will not know about the genetic predisposition or will not be legally allowed to act on it, but I will be able to.

          The more I think about it, even being a libertarian, the more I think federalized medical care is best. Either private insurers fuck us, or the government fucks us. Either I pay lots of money out of my paycheck (including a lower salary just for participating in the plan), or the government taxes me. At the end of the day we would still have a bloated, expensive system, but if the government runs it, we have better accountability.

      • by erlenic ( 95003 )
        Well, let's look at a hypothetical. Suppose there is some decease that costs a metric shitload to treat, and occurs in 5% of people. The cost of treatment is high enough that this 5% chance increases everyone's monthly premium by $50. If I can prove that I am not genetically predisposed to this decease, then I can lower my health insurance costs by $600/year. Sounds to me like a great benefit to 95% of consumers.
        • It's a death sentence to the 5% with the disease. That seems to be OK with you, but most people wouldn't call a system like that civilized.
        • Re: (Score:3, Insightful)

          by hurfy ( 735314 )
          As long as you are not in the 5% whose premiums go up $12000 per year to make up for giving everyone else their $600 discount. A reverse lottery where losers go bankrupt?!?

          (quickie math, feel free to fix if you are so inclined )

          Obviously that means most of those people will not be insured for it, even if anyone is even willing to at any price. They will be the charitable cases that hospitals cover by overcharging those with insurance so your insurance goes up $50 to cover the increased costs.....
      • Re: (Score:3, Insightful)

        by v1 ( 525388 )
        I don't see this as significantly different than say, a car insurance company jacking your rates for getting a ticket or causing an accident. Yes they're calculating odds and trying to predict how much a given customer is going to take in on claims, and it's nothing new. If my average accident payout is say, $70/yr, and then some schmuck that can't drive sober has more of a $2000/yr payout, I don't want to help pay his $2000, I want to chip in for my $70. Let HIM pay the higher rates, as it should be. I'
      • Re: (Score:3, Insightful)

        by FooAtWFU ( 699187 )

        Because insurance companies manage their rates based on trackable probabilities and their claims history.

        Everyone should have genetic tests so they can see what sort of diseases might affect their health, and plan to prevent them.

        So, if you take your genetic test and come up with some potential condition, you may have to pay more, because - hey - you're an actual risk. Presumably the savings will be offset by people who don't have to pay more, because they came up clean. (If not, then the insurance companies are in an uncompetitive industry and that is an entirely different problem that patching up laws abo

    • Re: (Score:3, Informative)

      If you take any two insurance companies, company one is given the advantage of genetic testing with the ability to discern some general risk factors from it, and company two doesn't have the advantage of the testing. The first will be able to offer lower rates to those with lower risk and higher rates to those with higher risk. If my family's pre-disposed to skin cancer, the insurance company will raise my premium. Now, for lower rates, everyone checks with company one for insurance before trying company tw
    • Uncertainty isn't what insurance is based on. Insurance is based upon probability of a certain event happening to you. IE If you're a smoker, you are more likely to encounter certain health issues and thus your insurance fees are higher because, duh, your health care costs will statistically be higher. Even the almighty socialized healthcare systems can't avoid this fact and spread the cost among all the people instead of forcing the costs on the person doing the smoking.

      Note also that this bill doesn'
      • Over the course of a lifetime, the health costs for a smoker are lower. I don't remember what the source was or I'd cite it, sorry. Apparently dying of lung cancer at 70 is less expensive than slowly deteriorating in all ways from age, oh, 60 to 90.
    • Because when everyone can get a test to find out all the illnesses they are likely to get, they are going to take out mucho insurance to cover those things, while the insurance company is not going to have access to the same information in order to deny coverage. Because, as an insurer: if you know someone is very likely going to get breast cancer, why would you give them coverage that's going to cost you more money than they put in in payments? You are a business, not a charity. The insurance company wants
    • We've had private insurance with no genetic testing for a long time how. How is keeping the second condition going to mandate the end of the first? It's ridiculous.

      Did you read the summary? We're not keeping the second condition -- if this bill passes, millions will start getting tested so that we'll know what wonderful surprises await us in our waning years (or months, depending on the results).

      The problem, according to the OP, is the same as the one we already have. Healthy people will self-select *out*
    • by strech ( 167037 )
      The issue is "Adverse Selection [wikipedia.org]".
      Essentially, while the insurers aren't going to have any more information, people will. So the people that know they're going to need insurance are more likely to buy it and buy more of it, and the people that are less likely to need it will buy less of it.

      This makes the insurance more expensive and less profitable; it can also put companies out of business by making insurance so expensive it won't sell, or by paying out more fees than you take in via premiums.

      An example -
    • Re: (Score:3, Insightful)

      by ajs ( 35943 )

      We've had private insurance with no genetic testing for a long time how.

      How is keeping the second condition going to mandate the end of the first? It's ridiculous.

      It's not ridiculous, it's just that the summary really, really sucks. What the summary author is trying to say is that if the consumer can use GT to decide if/when they should buy insurance, but the insurance companies can't use it to determine rates/coverage, then the insurance companies will no longer be able to keep their margins up, and will ultimately fail.

      Of course, that's only true in a world where insurance companies don't adjust rates to reflect their actual profit/loss AND the primary reason that

  • However, if that isn't allowed, the companies are trouble.

    How on earth would that be different than how health insurance has worked since it was created? Your company now has no idea if you are more likely to get cancer. Now it might now that you had cancer within the last 6th months, but not that you might get it in 10 years. I don't understand what the submitters counter argument is?! How can you "stock up" on insurance?
    • Re: (Score:3, Informative)

      by Adambomb ( 118938 )

      How can you "stock up" on insurance?
      By purchasing coverage for a period of time further into the future such that medical conditions that arise mid-policy do no have an overly long stability requirement.

      those that can and know, do.

      pricey capital investment though.
    • by mea37 ( 1201159 )
      Well, if the OP's dichotomy -- either the information can be used in any way the company sees fit, or it can't be used at all -- were valid, then the difference would be this:

      The consumer would know if he/she's more likely to get cancer.

      So there would be a bias in the market from the buyers' end -- those who seek coverage would be disproportionately expensive to cover.

      Even that needn't be the end of private insurance, though. It would probably result in insurance carriers getting more clever about the pack
    • by Ossifer ( 703813 )
      How can you "stock up" on insurance?

      I think the OP is mixing health insurance and life insurance. You can't "stock up" on health insurance, but you can with life insurance.
  • Good (Score:5, Insightful)

    by kurt555gs ( 309278 ) <kurt555gs.ovi@com> on Thursday April 24, 2008 @04:29PM (#23189794) Homepage
    There are very few businesses that as a rule are genuinely evil, but insurance companies are one in that category. The whole idea of the entity that has to pay for your health only benefiting when they do not is morally flawed.

    Health care needs to be a right, and the risk or cost spread over everyone, with no one excluded. This also means that any benefit in savings must be good for the whole. Private profit making business can not be part of this for it to really be fair to all.

    We could have had really top notch health care for everyone for less than we have spent on this silly war in Iraq, and with the give away's big political donors in the name of 911, we could all have our own Doctor.

    Health care just needs to come from general revenue, like the Military, and cover every one. We spend more on weapons than the rest of the world combines, and most of that is greedy contracters gouging us. Just the waste in the Pentagon budget could cover everyone.

    I really think it is time to take our government back and have it serve us.

    So There
     
    • Re: (Score:2, Flamebait)

      Private profit making business can not be part of this for it to really be fair to all.


      Life is not fair. Deal with it.

      • Re:Good (Score:4, Insightful)

        by khallow ( 566160 ) on Thursday April 24, 2008 @04:40PM (#23189994)
        Indeed. If life were naturally fair, then everyone would have the same disposition to illness and there'd be no benefit to genetic testing.
      • by colmore ( 56499 )
        Yes but isn't it the goal of organizing as a society to improve the lives of citizens? If this is the attitude we're going to take, we might as well dissolve the government and the cops and have Mad Max rule of the strongest.

        This would also dissolve the Corporations. That manner of collective property is held together by a highly elaborate set of economically invasive (anti-invisible hand) laws.
        • Re:Good (Score:5, Insightful)

          by techno-vampire ( 666512 ) on Thursday April 24, 2008 @04:50PM (#23190196) Homepage
          Yes but isn't it the goal of organizing as a society to improve the lives of citizens?


          Here in America, that's what the goal is supposed to be. Over most of the world, during most of history, the goal has been to improve the lives of the leaders at the expense of the rest of the people.

          • by subl33t ( 739983 )

            Yes but isn't it the goal of organizing as a society to improve the lives of citizens?



            Here in America, that's what the goal is supposed to be.

            supposed to be - but it isn't

            Over most of the world, during most of history, the goal has been to improve the lives of the leaders at the expense of the rest of the people.

            and that is different from the USA how?
          • by colmore ( 56499 )
            Well, according to Hobbes, even under tyranny, people accept their fate because without their dictator, neighboring dictators would treat them even worse as nationless people sitting on valuable land (like say the Native Americans).

            Anyway, if a huge chunk of the population of the richest nation in the world is unable to access modern medicine, something is seriously wrong.

            The people most hurt by the current system are not those at the bottom of the social ladder, but rather those who have struggled to work
          • Re:Good (Score:4, Interesting)

            by alan_dershowitz ( 586542 ) on Thursday April 24, 2008 @05:07PM (#23190494)
            In America the goal was supposed to be to protect the rights of citizens so they could live their lives as THEY see fit, not to improve their lives according to some government-defined criteria. Anyway, health care could never be a right in the same manner that for example the right to free speech is, because my right to free speech doesn't obligate anyone else to listen. My presumed right to health care would require other people to pay for it, however, which makes it a peculiar sort of right that takes from someone else in equals amounts as it gives to me.
          • Re: (Score:3, Insightful)

            by Chris Burke ( 6130 )
            Here in America, that's what the goal is supposed to be. Over most of the world, during most of history, the goal has been to improve the lives of the leaders at the expense of the rest of the people.

            Yeah, and let's just ignore the part of the world that also has the same goal as America, but is doing a better job of it by providing health care for all of its people.

            Yes, most of the world for most of history has been a terrible place for the commoners. That is not and should not in any way be our goalpost.
    • Re: (Score:3, Insightful)

      by evanbd ( 210358 )

      At some point, there is a fundamental problem. Even after you magically remove all the various waste, corruption, and frivolous lawsuits, you get to a point where we know how to spend more money keeping people alive in the face of nast diseases than we can afford to, at a national level. When that happens, you have to either start rationing healthcare in some fashion, or the country *will* go bankrupt.

      That's not to say we shouldn't have national healthcare; I think it would be an improvement, and that w

    • Re: (Score:2, Troll)

      by erlenic ( 95003 )

      Health care needs to be a right, and the risk or cost spread over everyone, with no one excluded.

      What if I don't want health insurance, and am willing to run the risk of getting cancer and dieing because I can't get it treated? Why should I be FORCED to pay for it?

      • by eln ( 21727 )
        You and the other two people in the country that would actually be happy to sit in a shack in the woods and die a horribly painful death over months or years because you don't want to see a doctor can do so. However, for the rest of us, if we have a serious disease, chances are we're going to want to get some treatment for it.

        Or, if you choose to seek treatment, you had better have the money to pay in advance so you don't leave the rest of us with the burden of the cost of your medical care after you die.
      • Re: (Score:2, Insightful)

        I don't want a fire department. Why should I be FORCED to pay for it?
        I don't want police. Why should I be FORCED to pay for it?
        I don't want a standing army. Why should I be FORCED to pay for it?
        I don't want schools. Why should I be FORCED to pay for it?

        I don't want roads, clean water, clean air, FAA, FCC, or any of that other bullshit. Yet I am FORCED to pay for all of it.

        There are lots of things that we as a society have decided are essential. I think that medical care is pretty important, and deal
    • by grommit ( 97148 )
      It's true that most insurance companies try to find loopholes to keep from having to pay beneficiaries but they probably wouldn't be so bad about it if people didn't commit so much insurance fraud. Fender benders turning into massive medical bills that just so happen to amount to the total medical coverage that the at fault person has on their insurance coverage is no coincidence and happens all too often.
    • Re: (Score:3, Insightful)

      You would run into the same issues with socialized medicine as you are complaining about with the military.

      Unless we nationalize every supplier needed to run a healthcare system, there is the chance (and I'd argue the likelihood) of private companies gouging the government for supplies, services, etc. In fact, I'd say that this is considerably more likely to occur with a government health care system because private institutes typically make decisions on who to purchase from based on profitability and price
    • Re: (Score:3, Insightful)

      by j0nb0y ( 107699 )
      Health care can't be a Right. How are you going to decide what treatments are included in this mythical "Right," and which ones aren't? What if there isn't enough supply of medical care to meet the demand? Are you going to force people to become doctors? Are you going to force doctors to work more hours? If there is a limited supply, how are you going to decide who gets treatment, and who doesn't?

      Suppose that a new treatment was invented that allowed people to live healthy lives indefinitely, but the t
      • Re:Good (Score:5, Interesting)

        by LunaticTippy ( 872397 ) on Thursday April 24, 2008 @05:24PM (#23190794)

        The United States currently has the best healthcare system in the world.
        No it doesn't. Not even close. We have the most expensive system in the world, but by any measure of results you won't find us anywhere near the top 20. Not infant mortality, life expectancy, disease survival rates, nothing.
    • by qoncept ( 599709 )
      You state a lot of things as fact without any evidence there, Che. Sure, the government is incredibly wasteful, but not only would you be unable to put a definate number on just how wasteful they are, you probably have even less of a clue what it would cost to provide this perfect health care. The fact that you think a (completely off-topic) war has cost us the silver bullet for eternal life is pretty naive.
  • Gattaca anyone? (Score:3, Interesting)

    by Swizec ( 978239 ) on Thursday April 24, 2008 @04:30PM (#23189798) Homepage
    Wasn't there a movie about this?

    Because genetic planning, or whatever, exists it doesn't really matter whether genetic discrimination is allowed or not. It is simply the fact that genetically better people are more suited for things than genetically worse people. It's no more a matter of discrimination or not, but simply a matter of objectively looking at the attributes of each person.
  • The health insurance I pay is probably based more on phenotypic differences rather than genotypic. I don't smoke, but I do ride a motorcycle. Maybe I have the genes for some disease or another, but it's far from certain that I will develop it. OTOH, the fact that I don't smoke (or work in a popcorn factory, etc) means I am virtually assured of not getting lung cancer, and if I continue to ride often I am virtually assured of sliding down the highway at least once. The way we choose to live our lives wil
    • by colmore ( 56499 )
      I know a lot of 20somes who live... well, not safely.

      Between all the stupid things people do, the one I've seen fuck up more people is riding a bicycle without health insurance.

      A sudden accident and you're tens of thousands of dollars in debt.
  • Legal Authority? (Score:2, Interesting)

    I've often wondered how a universal, single pay system could legally be created within these United States. It seems to me that the Federal government may not have the authority to create a workable system for universal coverage. It can regulate most forms of employment and most commercial activity, but a lot of the people who need coverage are retired, unemployed, or children.

    Each state certainly has the authority to do this, but I suspect some states will lack the resources or desire. This would probab
    • by eln ( 21727 )
      I'm sure they could find a way to finagle this so the interstate commerce clause applies, that's how they do most everything else.
    • Re: (Score:3, Interesting)

      by fahrbot-bot ( 874524 )
      It seems to me that the Federal government may not have the authority to create a workable system for universal coverage.

      They don't have to mandate it, just make everyone eligible and the private insurance companies won't cover you as a primary -- just like Medicare.

      There already exists "universal" insurance plans for two segments of the population, Medicare for everyone 65+ and one for military personnel (I can't remember what it's called).

      There was a great special on Frontline called Sick Around The [pbs.org]

  • > If I know I'm likely to get a certain condition,
      > I'll stock up on 'insurance' for it

    And when AFLAC sees their profits for Spontaneous Big Toe Combustion Coverage drop, they'll raise the price of the policy. Or find some workaround.

    The casino will figure out how to tip the odds to work in their favor. Gaming the system is exactly what insurance companies do for a living, and, one way or another, they'll keep their house advantage.
  • by iamsamed ( 1276082 ) on Thursday April 24, 2008 @04:37PM (#23189948)

    Mark A. Rothstein, ... GINA did not cover life insurance and long-term care insurance and that there already were legal ways for prospective employers to gain a job candidateâ(TM)s health information.

    The Insurance Industry really wants this because it will eventually destroy them, IMHO.

    Let's say the insurance industry has free reign for genetic testing. First, they deny all the people that has "pre-existing" conditions. Now, the folks who are accepted know that they're free and clear and do not buy the insurance (OK, they'll buy the accidental death stuff). Therefore, the insurance industry loses all those folks as customers. Of course, I'm over simplifying but I think you get the idea.

  • The only solution I can see is single-payer universal coverage along the lines of the Canadian model, where everyone pays, and no one (insurer or patient) can game the system based on advance knowledge of the outcomes. Any other ideas?

    Yeah. It's called paying for your own health care yourself. Not insurance -- the health care, directly. It's was people did up until the 1970s when the health insurance racket took over (the HMO Act) and distorted prices to the point no one can afford it.

  • Ban insurance completely.

    It's a protection racket, under guise of a protection racket. No better than mobsters did in the early 20th century.

    P.S. I work in the insurance business.
  • ...but this is ridiculous.

    As I understand it, the notion is that because of some possible scientific advances looming on the horizon that may or may not affect anything, it's time to scrap our entire health care system and move to socialized medicine. Whether or not you believe that universal health care is a good thing, that's a pretty big leap in logic.
  • by FleaPlus ( 6935 ) on Thursday April 24, 2008 @04:49PM (#23190184) Journal

    Is this the death knell of private insurance? I think private health insurance is pretty much incompatible with genetic testing (GT) for disease predisposition, if said testing turns out to be of any use whatsoever. ... The only solution I can see is single-payer universal coverage along the lines of the Canadian model, where everyone pays, and no one (insurer or patient) can game the system based on advance knowledge of the outcomes.
    Of course, it might be nice to have laws against genetic discrimination in single-payer and nationalized health systems as well. For example, the UK's National Health Systems discriminates (some would argue deservedly) against people who are old [bmjjournals.com], obese [newsvine.com], or smoke [independent.co.uk], denying surgeries and placing them at the bottom of wait-lists. It's not too much of a stretch for such discrimination to also be applied to those with particular genotypes, as they may be an inefficient application of the limited health resources of a single-payer system.
  • forget all that banning sexism or racism .... simple solution is a constitutional amendment banning discrimination based on DNA - all the rest is just a subset
  • Sharing risk (Score:5, Insightful)

    by kennykb ( 547805 ) on Thursday April 24, 2008 @04:57PM (#23190330)
    Sharing risk is supposed to be the goal of insurance, going back to when it was a group of shipowners getting together in Lloyd's Coffeehouse to agree to cover each other if any of their ships sank (they all made a little less profit, but none had to worry about being utterly ruined by a single event. If insurers begin to stratify the clients on the basis of genetic testing, a market will arise to insure the never-tested against bad test results (pay us $xxx up front, and we cover your increased premiums). What the proposed legislation does is force participation in that market, by essentially bundling it with all policies. That may be a good thing, because it's otherwise too easy for the insured to game the system (get a test secretly, buy "testing insurance" only if the test shows that it would pay off). The problem with the whols system is that the market appears to have failed. You can't simply pay a little bit more to find an insurer who won't tell you, go ahead and die! [youtube.com]
    • Re:Sharing risk (Score:4, Insightful)

      by nickhart ( 1009937 ) <nickhart.gmail@com> on Thursday April 24, 2008 @05:17PM (#23190676) Homepage
      The ones who "game the system" are the insurance companies. They refuse to cover people when they deem it unprofitable and they intentionally deny claims that they know should cover. They increase their profits by denying care. The entire business model of private health insurance is immoral, as they profit from the illness and misfortune of others. Then they buy politicians (like Clinton, Obama and McCain) to ensure their gravy train keeps rolling. The only solution is single-payer. We're all in the same risk pool, we're all covered, and physicians make medical decisions--not bureaucrats and legislators.
  • by macklin01 ( 760841 ) on Thursday April 24, 2008 @04:58PM (#23190348) Homepage

    Without the risk of discrimination, increased genetic testing could be a boon to both consumers and insurers. The earlier we know about a condition, the less expensive and more effective it is to treat, with likely a higher quality of life. Genetic testing would allow us to better assess who to monitor to attain this early detection. Moreover, with increased knowledge of risk factor, a patient could choose lifestyle changes that are preventative. (Even cheaper for insurers and further improved quality of life for patients!)

    Take skin cancer: if you know you lack a key tumor suppressor gene that makes you more sensitive to UV damage, you'll be much more likely to use sunscreen and avoid peak sunlight hours (lifestyle/preventative); you'll also know to keep closer tabs on your freckles and moles for melanoma (monitoring).

    With a level, non-discriminatory playing field, both patients and insurers benefit from the knowledge, rather than just insurers who want to drop any patient they can. -- Paul

  • So what happens if researchers find a "gay gene"? Couldn't a homosexual who was worried about discrimination run the test on themselves, then make sure thier prospective employer knew what the result was?

    Of course, I don't know the wording of the law; this would only work if it was vague enough.
  • utter bullshit. insurance is a gamble, always has been. the house (insurance companies) are simply trying to load the dice.
  • Socialized health care denies or delays treatment if you smoke, are obese, forgot the cover on your TPS report. Do you really think that such a system wouldn't do the same thing given information on your likely future ailments? The difference between that and privatized health care is that at least with a private system the only barrier is money. In the socialized system, you've got no chance at all of not being screwed because of your genes.

    I for one look forward to microscopic swarms of robots that feed
  • There are days that I think that the government shouldn't allow insurance companies from refusing to insure anyone. I also think that the behind the scenes numbers of how the insurance companies actually determine their rates and such should be required to be released to the government and the public. (I also think insurance companies shouldn't have get out of jail free cards for "acts of god." What a scam that phrase is. Everything can be an act of god. It's an act of god that I pay taxes and insurance, yo
  • Eugenics (Score:5, Funny)

    by capologist ( 310783 ) on Thursday April 24, 2008 @05:45PM (#23191094)
    Why should people with genetic predisposition to health problems be entitled to affordable insurance? Let them die, and get those inferior genes out of the gene pool. Darwinism at work.

    Better yet: Perform mandatory genetic testing at birth, and if they have problems, kill them. Then insurance companies won't have to worry about them.
  • MAKE IT SO! (Score:3, Interesting)

    by transami ( 202700 ) on Thursday April 24, 2008 @09:10PM (#23193176) Homepage
    If genetic predisposition is predictive enough to kill health insurance, it would be fantastic. I;ve been trying to tell people for years that the problem with the health care system IS the insurance companies. You can follow the history quite clearly, as health insurance has become more am more prevalent, prices have risen. Unfortunately Big Insurance has a strong hold over government and media, and has everyone dancing to the same piper --i.e. mandate insurance and prices will drop. But it's a LIE! And they know it. The reason is b/c health insurance isn't insurance. Insurance is only effective for rare/emergency events. But health insurance covers every actively of health care and therefore is just payment scheme.

    The only GOOD SOLUTION is to outlaw private health insurance, have the government provide life-and-limb coverage to all, and have charities shore up preventive care for the poor. This would remove the middle man and provide the best care per dollar spent.
  • by haakondahl ( 893488 ) on Friday April 25, 2008 @01:58AM (#23194800)
    Insurance companies charge me higher rates based on my Y chromosome and its supposed predictive effects on my behavior. This is a far weaker link than other types of genes-to-outcomes linking.
  • by jandersen ( 462034 ) on Friday April 25, 2008 @03:58AM (#23195326)
    So, if the insurance companies are allowed to dicsriminate based on genes they will exclude the weakest, who will then lose out, and they aren't, those with bad genes will abuse the system, and the insurance companies will lose profit. There are two things to say about this:

    1. Universal, public healthcare will remove the problem - no one will lose out because of their genes, and no one will lose profit, because the system isn't geared towards profit anyway.

    2. Insurance companies are businesses and are supposed to be clever enough to do business the given reality. If they aren't, they have no right to exist as businesses.

    In most European countries this is much less of a dilemma - the public healthcare takes care of everybody, and private healthcare is simply a luxury option that gives you faster access to non-emergency treatments etc.

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