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President Bush Signs Genetic Nondiscrimination Act
Posted by
ScuttleMonkey
on Mon May 26, 2008 01:11 PM
from the no-paring-based-on-pairing dept.
from the no-paring-based-on-pairing dept.
artemis67 writes "This past week, President Bush signed the Genetic Information Nondiscrimination Act (GINA), which would prevent health insurers and employers from discriminating against individuals on the basis of their genetic information. GINA is the first and only federal legislation that will provide protections against discrimination based on an individual's genetic information in health insurance coverage and employment settings.'"
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Politics: Bill To Outlaw Genetic Discrimination In US 353 comments
fatduck sends us a brief note from New Scientist about the overwhelming passage in the US House of Representatives of the Genetic Information Nondiscrimination Act. As written, the bill would prohibit insurance companies from charging higher rates, and employers from discriminating in hiring, based on the results of genetic tests. A Boston Globe editorial notes that the bill has been held up in the Senate by the action of a single senator, who has an (outdated) objection based on his anti-abortion stance. President Bush has said he will sign the bill if it reaches his desk.
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Your Rights Online: Bill Prohibiting Genetic Discrimination Moves Forward 575 comments
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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First time Bush has posted something sane. (Score:5, Funny)
Maybe there's hope for us mutants then.
X
Re:First time Bush has posted something sane. (Score:5, Funny)
Parent
Re:First time Bush has posted something sane. (Score:5, Interesting)
Parent
Re:First time Bush has posted something sane. (Score:5, Interesting)
This week, in Federal Court, the Bush Administration has asserted that the AUMF (the bill congress passed to give him permission to invade Iraq) also gives him the right to have the military (that's military, not police) have the right to arrest a US citizen on US soil and hold him indefinitely as an enemy combatant.
Now the Bush administration has asserted this right before, but because of inherent executive powers, which while being insane is at least consistent. But now, he's asserting these military-police dictatorial powers come from a bill passed by congress authorizing a foreign invasion.
This is astonishing, but frankly, I'm too disturbed by this new development to be astonished.
So before you start giving Bush a thumbs-up for some genetic anti-discrimination law, and start feeling comfortable that you will hang on to some shred of personal liberty, you might want to keep in mind that he's now asserting complete dictatorial powers and he could give a good god damn about the Constitution or any bill he has signed, because when it comes right down to it, he's now calling the shots and it's going to take more than some silly little election, or court, or congress to change things.
Parent
Re:First time Bush has posted something sane. (Score:5, Insightful)
You can't compare this to genetic discrimination. People have no say in what genes they're born with, but they most certainly have a say in whether they choose to engage in behaviors that drive up healthcare costs.
Maybe the answer would be to charge higher insurance premiums for such behaviors, maybe it's something else. But it's definitely not on par with genetic discrimination.
Parent
Repeat after me, physician, (Score:5, Insightful)
Parent
Re:First time Bush has posted something sane. (Score:5, Insightful)
Parent
Re:You Liberals can thank yourselves for $4/gal. g (Score:5, Informative)
How much is $4/gal a price increase, and how much is it a devaluation of the dollar?
I think it's pretty clear that it's largely a devaluation of the dollar.
Parent
Does it ban access? (Score:5, Insightful)
( and no i didn't read it, it would be to large to wade thru on a holiday weekend )
Waste of legislation. (Score:5, Funny)
Interesting vote... (Score:5, Interesting)
Who was the one who voted against this?
Re:Interesting vote... (Score:5, Informative)
Our good friend Ron Paul, it turns out.
Parent
Re:Interesting vote... (Score:5, Funny)
That's because he thought it was the Genetic Nondiscrimination in America Act, and you know what he got when he searched the web for GNAA ...
Parent
Re:Interesting vote... (Score:5, Funny)
Parent
And for good reasons... (Score:5, Insightful)
But the reason none of them should have supported this is that the result can and will drive up the cost of health care for everyone.
If someone knows they are genetically disposed to malady "x", there is now a law which guarantees that they can get insurance coverage at the same price as someone who is at less risk. What does Congress expect them to do, not take advantage of that fact? If insurance companies can't set pricing based on full knowledge and actuarial statistics, but people can, it will increase costs.
Finally, why shouldn't people at greater risk pay more? Discrimination is not necessarily a bad thing. People discriminate all the time - employers discriminate by choosing more skilled workers over less skilled ones, consumers tend to discriminate against higher priced retailers, the President discriminates against the proles by shutting down traffic as his motocade makes it's way though a city. (Well, maybe that last one is bad discrimination).
In fact, this law discriminates against those who are at less risk for genetically identifiable diseases, by forcing them to pay higher insurance rates than they otherwise would.
Parent
Re:And for good reasons... (Score:5, Insightful)
Parent
Re:And for good reasons... (Score:5, Insightful)
That's the most fucked up reasoning written on slashdot in a long time. How is someone able to take advantage of being more likely to carry a genetic disease? Why should someone born with a genetic disorder have pay premium for something that is absolutely out of their control?
Being able to aquire medical care when in need is a basic human right. If you don't like that fact, then there are plenty of third world countries you can ove to where the evil state won't "steal" your money to provide health care for the sick.
Parent
Re:And for good reasons... (Score:5, Insightful)
Parent
The Devil's In The Details (Score:5, Insightful)
I tend to look on such legislation as likely to have the reverse effect to the one stated, because it is frequently written to provide cover, loopholes and exceptions for the powerful, well-connected industries it is supposed to govern.
And even with the best of intentions, it often has the effect of limiting an individual's rights to whatever is covered at the time, regardless of scientific and technological advances that can render such rights and protections woefully obsolete.
About Time (Score:5, Insightful)
As for loopholes, we the public must start an intolerable outcry the moment we hear of any such pending. This needs to be an across-the-board absolute, not a political game.
Jame Watson has 32 "dangerous" genes (Score:5, Interesting)
P.S. No, they did not discover the gene for making stupid racist remarks, which forced Dr. Watson into retirement last year.
Research *does* need regulation (Score:5, Interesting)
It's an unusual sentiment for me, but I must applaud President Bush for being foresighted enough to pass this legislation.
I recently attended a futorological lecture at Oxford University on the possibility of genetically engineered 'persons' (not necessary human persons). The lecture was given by Nobel prize-winner John Sulston (an important figure in the human-genome project), John Harris (a bioethics expert), and was hosted by Richard Dawkins. The panel was very much in favour of continued research into genetic modification of humans, but placed a strong emphasis on the need for legislation to prevent powerful cliques from monopolising or abusing the technology.
One important point they made is that (just about) any technology can be used to give an overwhelming opportunity to those who are free to enjoy it, but that the norms of modern Western societies ensure that most people have the potential to take advantage of the majority of science's blessings. However, we can't simply trust large corporations or other powerful institutions to equitably distribute the advantages of these technologies. Regulation is needed, and Bush is providing a good first step.
So, in summary, we must continue to research and to pursue all avenues of research, but the applications of the research need to be very carefully thought through.
Re:Research *does* need regulation (Score:5, Interesting)
Personally I would hold the applause until you actually read the act. 99 times out of a 100 the bill name means nothing about the content.
Having a quick look at thomas.loc.gov it looks like the bill is [H.R.493]. Reading some bits...
While you can't discriminate based on genetic material the section 210 states that if the information is found by any other means it is permissible (even if it is a genetic related issue). So this for the most part will have no effect on Medical Insurance companies.
For example if one of my parents suffered from a genetic disease then they could discriminate against me based on that information and not on actually checking if I have the genetic markers or not.
Section 103 seems to mention that if a health company came by your genetic information via another source (3rd party) then it is permissible to use it.
Also there is mention of Genetic testing IS NOT..
"an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved."
So, IANAL or biologist but even casual reading there appears to be loads of outs for private medical companies.
Parent
Adverse selection (Score:5, Insightful)
The problem with this law is that it creates adverse selection in health insurance. Health insurers won't be able to get genetic info on the people they're covering, but the people themselves will. That creates asymmetric information, and is ripe for abuse. Think about it: if I get my DNA sequenced and find out that I'm a walking health hazard, then I'll buy the most comprehensive policy out there. If I find out I'm genetically clear, I scale down my coverage, or drop it completely. Meanwhile, the insurer can't adjust my premium to accurately reflect my risk. The result: only genetically unhealthy (and risk-averse) people will buy into health insurance pools, or the genetically health will only buy insurance for physical accidents. And when the insurance pools are small, and the insurers can't accurately price risk, they pools collapse: nobody gets health insurance.
Of course, the obvious alternative--let both buyers and sellers of health insurance use DNA analysis to accurately price risk--is unpalatable because people will suffer from higher premiums through no fault of their own (i.e. because they have bad genes), and people will benefit through no effort of their own (i.e. because they have good genes). This concern (coupled with privacy concerns) is why GINA passed overwhelmingly, and I don't mean to diminish it.
Insurance works best when the risks aren't ascertainable in an individual case but are ascertainable in the aggregate. DNA sequencing really threatens the concept of health insurance, because it greatly decreases the uncertainty surrounding an individual's health future. The best way to keep insurance alive is to insure before it is possible to determine a person's health risk. Now, you could do that by banning DNA testing for individuals unless they are willing to permanently waive their ability to buy or modify their health insurance policies, but DNA testing is so cheap that the ban will be hard to enforce, and a permanent waiver seems rather harsh. You could require people to buy insurance for their kids before conception, but that has the same problem that the kid will be stuck with the same health insurance for ever (and that there might not be a kid in sad circumstances)
The ultimate, fool-proof solution: social gene insurance. Essentially, when any private insurer wants to charge you more than the base rate because of your genes, you just pay the base rate and society picks up the difference. The gene insurance would be funded through taxes, much like social security is now, though none of that "lockbox" BS. Socialized health insurance would work, too, being a superset of social gene insurance. The idea behind social insurance schemes is that they in effect force citizens to buy in before anyone has any knowledge of their genetic risk, making it a sound insurance product. And the solution works from the view of liberal theories of justice, e.g. Rawls, because it is essentially a redistribution of social resources from those who happen to be born with (and hence do not deserve) such resources to those who happen to be dealt a bad hand, through no fault of their own.
Why not just make this obsolete? (Score:5, Insightful)
Then we can say just mandate that everyone has to carry individual coverage so we solve the uninsured problem. Plus we would insure that the young and healthy were in the pool - thus keeping the overall rates down.
Of course it would be a lot easier to deduct it from people's paychecks rather than have a whole system whereby we monitor citizen's compliance with the law. So it would just be an amount deducted from your pay.
And we would need to make it something people who were poor could afford, so there would be subsidies so that the poor paid less... and the wealthy paid proportionately more. So it would be a progressive deduction from your taxes.
Plus we could save a LOT if in addition to providing preventative care instead of what we do (ER care as a last ditch effort when diseases are harder and more costly to treat) we got rid if the thousands of insurance providers and just had one large provider. I know as a physician I spend a lot of money on hiring people just to fill out insurance forms for me. If there was one form that was consistent, I would be able to provide care a lot more economically. And if everyone was in the same system, we would have better assurance that the care would be reasonable since the people with the most power would also have to have that same insurance... no way to make what the poor get be shoddy. So we would just cover everyone under one large pool.
And then.... well we'd have the most humane and cost effective system possible: a single payer national health service funded by an income tax spread fairly on the population. Or as the nutters refer to: socialized medicine.
Gasp!