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My Genome, My Self?
Posted by
timothy
on Sat Jan 10, 2009 05:40 PM
from the nope-ain't-got-no-genome dept.
from the nope-ain't-got-no-genome dept.
theodp writes "After baring his DNA for the world to see, Steven Pinker follows up in the NYT Magazine with his take on the coming era of consumer genetics. Pinker comes away less wide-eyed than Time Magazine about the current predictive ability of $399 genetic tests, but is convinced enough to opt out of learning whether he has a gene that increases the risk of Alzheimer's and believes that genetic-testing-for-the-masses may hasten the arrival of national health insurance ('piecemeal insurance is not viable in a world in which insurers can cherry-pick the most risk-free customers'). Pinker believes that personal genomics is just too much fun to ban, but for now suggests: 'if you want to know whether you are at risk for high cholesterol, have your cholesterol measured; if you want to know whether you are good at math, take a math test.'"
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Id venture (Score:5, Insightful)
That this article will be tagged GATTACA.
All reasons aside, if you get a genetic test right now, you're screwed. Why?
There is no genetic rights. Businesses can exclude you from working for them due to it. Health insurance can disclaim all the "bad gene" illnesses, that is if they accept you at all. The government can pidgeonhole you in some god-awful plan in which you cannot escape.
And if you hide the fact that you were tested, or hide the test results, you are committing insurance fraud, or can be dismissed, with prejudice, for withholding vital employer facts.
And you thought poppy roll buns and drug tests were bad...
Add the danger off false positives... (Score:2)
For example, what good would "normal" cancer test be if it detected 100% of cancer cases, but also, for every one detected, falsely marked 3 others as having cancer when they didn't.
Now apply it to this.
Re: (Score:2)
That's a non-starter.
For one, there's more than 1 test for each ailment. Some tests are cheap with high error. Then you get to mid-grade with acceptable error. Then comes top of the line with low error. And tests are getting better as the cheap ones are getting cheaper and better ones are being made.
Back in '84, even a high-error-rate AIDS test would have been accepted with open arms. Now, some company is putting Rohypnol (sp?) in swizzel sticks.
As per your test of 1/3 false positives, we'll use that test f
Re: (Score:2)
Your math skills might need some work ...
"As per your test of 1/3 false positives, we'll use that test for the over-the-counter el cheapo test so you come to a doctor for a better test/scan. After all, if you dont have it, there's a 67% chance it will not alert you.",/i>
If 1/4 of the tested subjects actually have cancer, and the test yields 3 false positives for every true positive, there is a 100% chance it will alert you.
Now let's consider something more prosaic - a test for drunk driving. Would
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My mistake. I thought you said a 1:3 false positive. You actually said 3:1, which then shows there is test... well isnt.
And I love your little list of "what ifs".
Drunk test: Hmm.. guess the cops dont also pay attention to demeanor, pills in the seat, or plenty of other tell-tale signs they can arrest you on Intoxicated Driving. Hint: Its intoxicated driving, not just alcohol. Breathalyers are an easy, yet error-prone way of getting a BAL.
Death row test: On what? To see if they're dead yet? If a test has tha
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The lawyers are part of the problem. It's journalists who have uncovered the problem, not incompetent lawyers. That's why Illinois, a pro-death state, became the first to issue a blanket moratorium on executions in 2000 based on wrongful convictions [speakout.com]:
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[W]hat good would "normal" cancer test be if it detected 100% of cancer cases, but also, for every one detected, falsely marked 3 others as having cancer when they didn't.
We do have a lot of data on how society in general (and the corporate world in particular) deals with such data. For example, ten years ago the two most common HIV tests had 10% and 5% false-positive rates. There was a lot of PR to reassure people that this wasn't important, but the data said otherwise.
Consider the math with a simple ex
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On the other hand, if you have some gene that would make you healthier then average (which must exist, or else there could be no genes that make you less healthy then average), then you might be able to get insurance at a discounted rate. Like wise for business hiring - if you have the genes that makes you an excellent worker, then you are more likely to be hired.
By definition, the expected value for you in the test results breaks even. Thus, it is not a bad idea to get tested if you are curious about what
Appearance is a genetic trait (Score:2)
It gives plenty of outward clues as to "what makes a person tick", which we internalize over a lifetime as "rules."
An example FTFA:
Piecemeal never works. (Score:2)
'piecemeal insurance is not viable in a world in which insurers can cherry-pick the most risk-free customers'
Piecemeal insurance is not viable under any circumstances. It's the profit part of the equation that borks everything: when your money depends on not paying out benefits, you're going to do whatever you can get away with to not pay out benefits. Private, for-profit health insurance makes even less sense than private, for-profit fire departments, police forces and armies.
This will actually reverse the cost of health care (Score:3, Insightful)
Health insurance is a scam pushed on the masses through Federal tax loopholes. You don't need health insurance for MOST of your health care needs. I have health insurance for BIG stuff, hence me HUGE deductible (5 figures). I pay very little for health care, going to a cash-only doctor who asks for an up front fee annually for unlimited visits and some basic yearly lab tests. He doesn't even take insurance, Medicare, or credit cards. He's also available for house calls.
Genetic testing for predispositions will likely give people options to fight the parts of those possible diseases that nurture (lifestyle) causes, instead of just pure nature (genetics). As more people are prediagnosed, it is wise for insurers to drop them. Here's the thing, though: if insurers drop too many peoole, doctors will have to find ways to treat them, or the doctors will be out of work.
The number of doctors leaving the world of insurance and Medicare are growing. It's a good thing. They can treat you cheaply ($35 per visit, cash on the barrel), and can spend time with you helping you make choices to work towards a healthier life. It's not about taking drugs, sometimes, it's about fighting the diseases before they're serious. MANY diabetics could have prevented the disease had they known they had a predisposition. Not all, I understand, but many (see: fat diabetics). The same is true of other diseases.
As more people lose health insurance and find options for cheaper health care (it is out there, really), genetic testing will make it easier for us to work with our doctors to find ways to avoid the tragedies. We're not healthy people, because we rely on health insurance rather than preliminary lifestyle adjustments before we get sick.
Wash your hands after touching sick people. Cut back on excessive drinking and smoking. Wear a condom. Don't eat too many sugars or starches. Do some exercise. It's not so hard.
The big late-age diseases, Parkinson's and Alzheimer's, are great to diagnose risks early. Then you can SAVE YOUR MONEY when you're young to prepare for the care you'll need when you're old. Don't pass it off to insurers, save for it yourself.
Or are you too busy buying the latest video games or blowing it on a weekend of drinking that you won't remember in 6 months?
Re:This will actually reverse the cost of health c (Score:5, Interesting)
>I have health insurance for BIG stuff, hence me HUGE deductible (5 figures).
Bullshit.
Im only 33 and need insurance. My sleep apnea machine costs a few thousand dollars. No "emergency" insurance covers that, yet SA is as serious as anything else. Toss in the sleep studies and my insurance probably paid out 6 or 8 grand. I would have lost all my savings and more if I had "emergency" insurance only.
I used to be poorer and had no insurance and pretty much begged doctors for the "cash rate." All my medicines were samples. I barely scraped by and I got lucky. I was young and healthy. No major accidents. Now in my 30s I cannot do that. No way.
You sure as hell are not having a baby safely by paying cash. No emergency insurance is going to cover pre-natal, delivery, post-natal, etc.
>Wash your hands after touching sick people. Cut back on excessive drinking and smoking. Wear a condom. Don't eat too many sugars or starches. Do some exercise. It's not so hard.
Yeah, youre a moron. I do all these things. Kids born with diabetes arent going to exercise it away. Youre not going to fix a broken leg with happy thoughts. Not eating a twinkie doesnt cure a MRSA infection. Not drinking beer doesnt fix a rotted tooth.
>Then you can SAVE YOUR MONEY when you're young to prepare for the care you'll need when you're old.
My dad's CPOD and Alzheimer's treatments are in the 5 digits. In 10 years its going to be well over 500,000. Thats a lot to save on top of retirement.
How old are you? Some college student who has yet to grow up and see how your body falls apart when youre older? Its all downhere from here. If all of Europe can do national healthcare then so can we. Dont let being "college liberatarian" make you more ignorant than you already are of health matters.
Parent
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Dude, you're full of shit. $35/visit, eh? Ya. So assuming the doctor's day is full of patients (no gaps) and each "visit" is 30 minutes the doctor makes $70/hr. Now you add in business taxes and he makes ~$50/hr, maybe less. Then you factor in office space and ... oh fuck he's losing money and we haven't even factored in equipment, supplies, other staff (let's face it if his day is full of patients he's going to need at least one receptionist), etc, etc, etc.
Google: Cash Only Doctors. It's a fact. Most do
Cheapest plan for everyone (Score:2, Interesting)
1. Prenatal genetic testing.
2. Genetic counseling for prospective parents.
3. Actuarial estimate of lifetime healthcare costs at birth.
4. Mandatory front-loaded health savings accounts, funded by income withholding, until the amount saved in the account is equal to the amount necessary until end-of-life medical care, based on actuarial estimates.
5. Parents pay into the account until the child reaches adulthood, then the person covered continues until the account is fully funded.
6. Account holders can use the
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I was "almost" a subject of this experiment (Score:2, Interesting)
I used to work as a contractor for the George Church lab. My supervisor was a student of Church's. Church was his boss. I was working on bio-informatics (if anyone cares, I can tell you some tricks for regexp-searching of genetic sequences).
My family was under extreme financial duress. In light of that knowledge, my supervisor (tells me, at least) that he took my situation to George and they came up with this: "Sign up to be one of the first 10 PGP subjects. Give us all of your medical records from th
Re: (Score:3, Interesting)
No, Im not a bullshit artist. And Im certainly not that one listed there.
Case: BRCA1 gene.
Lady has herself undergo genetic testing due to breast cancer with help of University of Utah. With her and doctor, they find the gene expressed that when triggered, causes breast cancer. Because of her genetic background (Ashkenazi Jew) they were able to isolate it.
The rub: if somebody goes and has a test for BRCA1, they are required to answer if they are Ashkenazi. If they are, Myriad demands an extra license fee. Th
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Very well, my apologies for the hostility.
I had thought that the BRCA1 Gene Patent was amended allowing other people's methods for applying the test to be used without licensing fees to be paid for Myriad?
A quick Google for the topic brings up a [phgfoundation.org] few [phgfoundation.org] articles [phgfoundation.org] dated some time ago.
Do you know what the current state of play regarding this is now?
I'm curious as I'm currently studying "Regulatory, Ethical and Legal issues in Biotechnology" in anticipation of filing a Patent for one of my own implementati
Like all new Technologies... (Score:2)
Genetic testing offers a great number of benefits, and some pretty (dire) consequences too, if it's not used Ethically.
Fortunately most Genetic testing is medically vetted/requested. The old Doctors Hippocratic [wikipedia.org] Oath [wikipedia.org], theoretically means it would only be used when Medically sensible.
Part of the biggest problem faced with this type of technology/research is the "I don't want to know" factor combined with paranoia about Eugenic ideology [wikipedia.org]. I've read articles by stupid misinformed Journalists describing Genetic
Re:Isn't it, though? (Score:4, Funny)
The thing is, you seem to parse the words and glean some meaning, but the thing is, you miss the point entirely.
Parent
Re: (Score:3, Insightful)
The thing is, you seem to parse the words and glean some meaning, but the thing is, you miss the point entirely.
Not entirely unlike human genomic research :)
I'm not afraid of health insurance and genetics (Score:3, Funny)
I'll just show up with my steel-clad genes and live an extremely unhealthy life style, then use my health insurance funds to undo the damage. Take THAT "the system"!
Re:Isn't it, though? (Score:5, Insightful)
Health insurance is a way of sharing risk, a form of solidarity. It is based on the insight that nobody is at fault for certain ailments, so in a society which wants to give the same basic opportunities to everybody, it is our duty to help those who, through no fault of their own, are burdened with sickness or injury. Making people with unfavorable genetic dispositions pay a higher price for health insurance is the opposite of the purpose of health insurance.
Parent
Re:Isn't it, though? (Score:5, Insightful)
Perhaps what you said is true for a co-op, in which everybody in the co-op does for each other.
However, if we talk about the USA Medical Insurance companies, they exist for pure profit and nothing else. If they fail to treat you within the allotted time, you die. Shucks... guess we keep your money you paid for insurance services.
Parent
Re:Isn't it, though? (Score:5, Insightful)
The Dirty Little Secret is this. Everyone has a price tag. Be it from the private sector, or public Government.
Tell me, would both of these entities spend $1,000 to save your life? Cool. What about a Million? How about a Billion? Would they dare spend a Trillion on your life?
The moment you start negotiating the price for a single human being (in whole or in part) is the moment the argument still stands. We ALL have a price tag on our life.
So, what's the big deal about Insurance companies making a profit. Immoral yes, but also to be expected.
Parent
Re:Isn't it, though? (Score:5, Insightful)
So, what's the big deal about Insurance companies making a profit. Immoral yes, but also to be expected.
It's a violation of human rights when they have a monopoly on medical care. We have a right to "life". Even felons are entitled to medical care, but not free people without coverage, and no-one is obligated to cover you, but for most health issues noone will treat you in the US without coverage. Catch-22.
If you don't believe they have a monopoly, perform this experiment: write out a bogus identity on a sheet of paper. Then dial every dentist in your area and try to get an appointment to get an infected tooth extracted sometime in the next six months, but lie and tell them you have no coverage. The result will be instructive. An infected tooth is a life threatening situation you can't get treated in an Emergency room. I know - I've tried.
We need to break the monopoly on coverage for care if we are to have a chance at a humane system.
Parent
Re: (Score:2, Interesting)
Re:Isn't it, though? (Score:4, Insightful)
It is, however, some expression of socialism.
Now that the Republican Party is passing out of power in the US we can expect that there will be a good deal less socialism, so whether or not it is desirable (I believe mostly not) there is going to be a good deal less of it now that the more liberal Democratic Party is in control.
I've never been clear exactly WHY Americans call their Socialist Party "the Republican Party". This is the party that has overseen massive growth in government both in responsibilities and costs, intrusive imposition of the federal government into areas normally reserved for the states or the people, and huge transfers of risk "in solidarity" from private individuals and organizations to the public.
It has capped all of this by actually taking ownership of significant parts of your financial system, which must in today's world be counted as firmly amongst "the means of production." Now that the liberal Democratic Party is replacing the socialist Republican party perhaps free market solutions will be prescribed for some of the things that ails the US, like allowing badly-run businesses that make products no one wants to FAIL.
Parent
Re:Isn't it, though? (Score:5, Insightful)
Sure, health insurance as a business model is viable when businessmen can eliminate risk from the insured pool. It just isn't viable as a way to care for a society. I think that's the point that was being made. Costs are distrubuted in insurance because you get a very wide pool of people involved, and everybody pays in. OTOH, if you get genetic segregation of health insurance plans, you have only very risky people in a particular pool, and they all have to pay very high rates. If they can't afford that, then you wind up with a bunch of people dead, which is a higher cost to society than a few extra dollars for insurance.
I agree that most people aren't interested in "health insurance." People want health. Health care, medical care, to be healthy. Health insurance is just a particular way to try and reduce the potentially extreme personal costs of getting health. And, once you get a completely nationalised health system, you effectively have a system equivalent to insurance with the largest possible pool. You pay taxes instead of premiums, but the risk is distributed through the entire society, so the people with the lowest risk probably pay slightly more as tax, but the people with the highest risk pay substantially less. (Of course, that assumes that the *for profit* health insurance companies don't actually make a profit any higher that the cost of government stupidity, while in practice the profits of doing health insurance tend to be enormous. This is likely an invalid assumption, no matter how cockheaded the government implementation is.)
Parent
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How are a bunch of dead high genetic risk individuals costly to society?
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How are a bunch of dead high genetic risk individuals costly to society?
If one is predisposed to Parkinsons or something, which wouldn't manifest itself until late middle age, a car accident ( as early 20 year olds are prone to ) could make the difference between a successful multi-billion dollar CEO of something that benefits society ( who later dies of parkinsons ) and a bankrupt service sector wage slave ( who later dies of parkinsons )
Re:Isn't it, though? (Score:5, Insightful)
And, once you get a completely nationalised health system, you effectively have a system equivalent to insurance with the largest possible pool.
Actually, no, because there is virtually no risk involved: EVERYONE gets sick, and EVERYONE dies, and about half of EVERYONE's health care costs come in the last six months of life.
Although costs vary, they don't vary by that much, although the tail of the distribution is long. See figure B1 in this report on Canadian health care costs to see the actual distribution [secure.cihi.ca]. For something over 70% of the population the average cost of a single hospital stay is less than $10,000, and virtually everyone has a couple of those stays in their lifetime (I've had one despite being in extremely good health generally.)
This is utterly unlike true insurance models--auto, home and term life--where the majority of people who pay premiums never collect a claim.
It is interesting to note that both the Canadian and American health care systems use insurance models, and suffer from similar problems of access and spiralling costs. I believe this is due to the inherent inappropriateness of an insurance model for a service that everyone will need and everyone which has a relatively low variance of total payouts.
A reasonable model of health insurance would deal with catastrophic costs only, say in excess of $10,000 per hospital stay as indicated by these data. As not everyone falls into that category, one could actually use insurance to spread RISK, which is not really possible under an "everyone pays, everyone benefits" model because the tails are not that relevant to the overall cost of the system, so you basically have a situation where there is very little risk to be spread (closer analysis of the numbers could contradict that, but that's my impression from a first look.)
Parent
Re: (Score:2)
"A reasonable model of health insurance would deal with catastrophic costs only, say in excess of $10,000 per hospital stay as indicated by these data."
That wouldn't work, because it takes away the motivation to reduce risk to everyone for the lower-cost events. Less reason for the "insurer/halth care system" to encourage people to do preventative care that has a low risk of falling into the "catastrophic" category.
As we're seeing with the GM bankruptcy, a single health-care system has unforeseen side
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Re:Isn't it, though? (Score:4, Insightful)
In theory insurance is about customers sharing the burden of risk, not insurance companies raising their profits by mitigating risk. In practice, it's exactly the opposite.
Parent
Re:Isn't it, though? (Score:4, Insightful)
Insurance, after all, is about mitigating risk, and a fuller knowledge of one's exposure to risk is a good thing.
MEDICAL insurance is, to most people, actually all about being able to afford medical treatment. Knowing your "risk" in this situation unfortunately can often only lead to you being denied coverage and subsequently NOT afford the services you need more.
Parent
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Nothing like cutting edge 21st century technology to bring the US roaring into step with 20th century social attitudes. Way to keep up guys.
It's funny, you say that like we all got together and foolishly decided that private health insurance was the best way to go, rather than special interests setting up camp directly opposed to what is better for everyone else.
Since we're going to play that game, good job on setting up the government corruption in (insert your home country here).
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Woosh. Every country does, and it's not that the citizens choose it, just as we in the US didn't decide to go with for-profit health insurance.
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Harshly worded, perhaps, but I didn't mean it as a troll.
Why on earth should society deliberately hobble itself supporting people with severe hereditary disease? Never mind the fact that people with these diseases who have children are exceptionally (and unacceptably) selfish.
Just because the dawn of eugenics saw racists trying to justify their views doesn't mean the concept itself is bad.
Besides, once germline genetic engineering is A) possible and B) permitted to fix genetic disease, the problem goes awa
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Why on earth should society deliberately hobble itself supporting people with severe hereditary disease?
Because this is Earth, and that's what civilized people on Earth do.
Never mind the fact that people with these diseases who have children are exceptionally (and unacceptably) selfish.
Judging from your comic-book villain logic, you're no model of human evolution yourself.
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Yes, because if you have cystic fibrosis, or thalasemia, or huntington's... it's perfectly acceptable to deliberately have children knowing they have a 50% chance of a shortened lifespan with some terrible suffering.
I know people on both sides - one couple that was unaware they were carriers of a nasty resessive gene who both got 'fixed' upon the diagnosis of their firstborn, and another couple where the wife had a 50% chance of being a carrier (she was not old enough to be past the point of the first sympt
That's what abortions are for ... (Score:4, Insightful)
If you can test "in utero", you can have your cake and eat it too. If the fetus is going to result in a disaster, a quick D&C is preferable to a lifetime of crap.
Of course, this has social implications - the biggest one being that, over time, the average "genetic quality" of "true believers" - fundies who are against abortion, will trend lower than the population at large. Considering some of the mouth-breathing, knuckle-dragging moronics displayed in the last election, we've already gotten to the point where the effect is visible.
3-4 more generations ... it'll sort itself out. Just keep telling yourselves that God really wants you to breed kids that will live a shortened, painful, and meainingless life. Stupidity, like intelligence, is partly genetic.
Parent
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Just keep telling yourselves that God really wants you to breed kids that will live a shortened, painful, and meainingless life. Stupidity, like intelligence, is partly genetic.
You have by far surpassed many fundamentalists and pro-lifers in terms of stupid statements by implying that your religious beliefs and position on abortion is based on inteligence, which is based on genetics. You also just proved they're not the only ones with a tendancy to oversimplify things to black and white.
Re:That's what abortions are for ... (Score:4, Insightful)
I'm an atheist - I have no religious beliefs, you ignorant clod! :-)
Look, there's no proof whatsoever that there's a "person" in a 12-week fetus, so anyone arguing against abortion based on "it's a person" is making an argument based on wishful thinking, not the evidence.
So, tell us how you can justify people having kids that are going to have a grossly shortened, painful, and ultimately tragic life. My position on abortion is based on simple decency - I wouldn't let a dog go through what some parents put kids through by not aborting when they had plenty of time.
Same as euthenasia - I'm all for it. Why should people have to continue to suffer in pain because of someone else's religious beliefs? Anyone who put an animal through such crap would be stoned to death in a show of public outrage. But for people, "It's different - it's God's will!" Bullshit. If "God" wants people to suffer, I'd rather be in hell than sit at the same table as such an asshole. Let "God" clean up "his" act first, and get a decent set of morals and ethics.
But keep breeding those mouth-breeders - the RNC needs them. Just remember that every fetus that should have been aborted that wasn't potentially takes the place of one who could have been viable.
Parent
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I'm an atheist - I have no religious beliefs, you ignorant clod! :-)
I guess that should have actually been "...implying that an individual's religious beliefs and position on abortion is based on inteligence, which is based on genetics..."
...how you can justify people having kids that are going to have a grossly shortened, painful, and ultimately tragic life.
By not having the arrogance to assume I know what's best. That also happens to be why I'm pro-choice.
Same as euthenasia - I'm all for it.
You're really getting off topic here...
...every fetus that should have been aborted that wasn't potentially takes the place of one who could have been viable.
You're going to have to explain that one. Be sure to explain why that matters in a discussion of medical insurance as well.
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Not every Republican is religious
No just 95.6% of them according to some of latest demographic data. (GSS)
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And what happens when everybody with the name of Bob is deemed statistically dangerous to society?
These sorts of thigns aren't viable because it's difficult to draw a line as to when it's safe to remove rights of an individual. Therefore we default to giving everybody equal rights.
I mean statistically speaking Black Men should be put under far more close surveilance than white women. They're going to statistically cause more crime. But once you decide something like that you've also said that we shouldn
Re: (Score:2, Flamebait)
The basic message is simple - the DNA tests are slightly better than horseshit, and nowhere near as good as talking to some gossipy individual (prejudices and all) who knows you and your family. He quotes horrible stats like a study of 16,000 people for DNA contribution to IQ which managed to explain 2% of the variance. So if you are going to
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Wow, because you called me illiterate, I'm convinced of your opinion!
Just a suggestion, if you're really trying to convince people, name calling is a pretty good way to get them to tune you out, and thus isn't recommended. Another hint... people participating in a text-based format can probably read and write and are therefore literate by definition.
Family history is a good way to choose what tests to perform, but if the tests are inexpensive enough, you might as well test for everything. And family histo