Two Companies Now Offering Personal Gene Sequencing 146
corded writes "Yesterday, deCODE genetics announced the launch of their $985 personal genotyping product, deCODEme (video), beating their competitors to market. Perhaps not coincidentally, 23andMe's website is suddenly much more informative today, and the New York Times features a preview of 23andMe's $999 offering. deCODEme and 23andMe will scan about a million and 600,000 sites across the genome, respectively and assess your risk for common diseases, along with providing information about ancestry, physical traits, and the ability to compare genes with friends and family."
Not yet (Score:5, Insightful)
Anonymity? (Score:4, Insightful)
scared of your HEALTH providers? (Score:5, Insightful)
It just show how screwed up the paradigm of insured medicine is... It is a good thing that this sort of genetic monitoring is becoming available for everybody. However, I find it unfortunate to see that it can be used against those people by the same corporations who are supposed to look for your health... go capitalism!
Re:Not yet (Score:4, Insightful)
In this example, a simple blood test can confirm the high cholesterol condition either way, and is a much more fair way of determining the insurance company's risk.
In addition, some diseases wouldn't set in from childhood. In this case, a risk factor is pre-existing, but the disease itself is not.
What this tells you is what to watch out for, not what you have.
Re:Not yet (Score:4, Insightful)
1. Insurance companies should not deny people coverage based on a genetic assessment.
2. Insurance companies should not charge a different premium based on genetic assessment.
That is not based on political correctness? Note that, if you get life insurance, they already take blood and urine tests prior to determining your premium.
Re:Anonymity? (Score:2, Insightful)
Imagine if all cancer patients knew in advance they'd almost certainly have cancer, but not the insurance companies. The latter would all go bankrupt because their payout amounts would far exceed the premium payments collected.
You can't have your cake and eat it too and all...
Re:Not yet (Score:1, Insightful)
If you give them access to genetic information that they could use to increase your payments, more then likely that is exactly what they will do. No ones genes are perfect, not after thousands of years of mixing and matching, everyone will have genes that might suggest they will develop certain conditions, which means your suggestion that they will lower premiums of certain people is ludicrous.
Genes do not tell you what conditions a person shall ever have, such information will merely become another thing held against people.
Re:Gene Patents (Score:3, Insightful)
Insurance (Score:5, Insightful)
On one hand, doomsayers here are saying insurance companies can choose to not insure someone with certain genes or charge them insane amounts.
Scary, but the solution is obvious -
[1] force insurance companies to ensure ANYONE
[2] legally define and enforce a ceiling rate they can charge, regardless of how bad your genes look.
I can already hear privacy advocates screaming and yelling "why give them our genes in the first place"? That's a moot point for two reasons -
1. It's a losing battle. Eventually, our genes (or those of our relatives) will be accessible.
2. Hiding our genes in general os shooting ourselves in the foot. Some (and I belong to this group, hence will use "we") may WANT their genes to be publicly available, much like I want source to be available. So products, offerings, solutions to problems and industry can spring due to their availability.
The most obvious reason not to hide our genes, however, is simple: people who have non-fucked genes will want to, they will pay a lower premium. Money talks.
Here is how it will most likely evolve from what we have today:
We pay today default premium X. I will assume charging >X is not financially feasible due to competition, and that X is the sweet spot.
Insurance companies will offer a genetic evaluation kit. It allows one to PRIVATELY evaluate himself, and submit the results to the insurance companies if his genes are ok, thereby halving his premium to 0.5X.
After a period of adoption, let's say several years, The percentage of "fucked genes" individuals in the default pool will be much higher, as many of the "ok genes" individuals have opted to pay less by letting their genes be known to the insurance company. The insurance expenses associated with maintaining the default pool will go up, causing X to go up to 2X, causing more and more people to abandon that pool.
At some point government regulation kicks in, and sets a government-controlled ceiling rate for the default rate (much like they control minimum wage).
Since the default rate is now at 2X, the insurance companies set the "ok genes" rate back from 0.5X to X, as it allows them to both maintain their incentive for people to abandon the default-paying group and share their genes, as well as allowing them to charge as much as the market allows - X.
It may be 0.9X (as the minority that costs the most is covering its expenses through a higher rate and possible government subsidation, hence making the competition-induced sweet-spot lower than when this included many expensive cases to treat).
I predict this will happen, as this is where the incentives are today. Note that the primary driving force here is consumer "greed", not insurance companies. People will want to pay that lower premium, even if crappy prophets such as myself predict that once the "fucked genes" people were isolated in the default group, everyone's rates will go back to what they were before (except the defaulters that will pay more). People will FLOCK once lower rates are offered, because people are damn well motivated by paying less.
Insurance companies WILL know our genes and it's a losing battle.
Think it through. Share your opinion.
It's something that requires thought and debate NOW.
Re:Not yet (Score:1, Insightful)
It's fairly simple: Because people now use health insurance as a form of pseudo-socialized medicine. There are a number of health conditions whose treatment (especially cancer) is so expensive that most people cannot afford it. This fear drives people to pay into the system, and the healthy people effectively subsidize the bills of the sick. Increased knowledge of genetic risk factors will lower some people's insurance, but at the cost of rendering health care unaffordable to the unlucky (or careless, in the case of controllable risks) few.
Faced with option of increased knowledge of their health risks and maybe lower premiums vs. ignorance but a greater probability of treatment, many people choose ignorance and treatment. This is a sign of how screwed up the system is. The "right thing" has become undesirable...
Irrebuttable presumption of paternity (Score:5, Insightful)
So, even if you can prove (DNA testing) that she had an affair and "your child" isn't your child, the courts, in the divorce, will still treat the child as yours and force you to pay support etc. This. of course, is all done in the interest of the child.
Also, paternity fraud (lying about the father of the child) is not considered domestic abuse. It is A-OK as far as the courts are concerned.
Welcome to equality
Re:Something Is Missing... (Score:2, Insightful)
The grandparent message is correct that the $1000 genome will not tell you about BRCA 1/2 or other "patented" genes. In fact, I'd have a hard time believing this tells users much about many diseases. The truth of the matter is that most genetic disease are caused by several mutations which may elevate risk. Mendelian traits -- those caused by a single mutation -- are quite rare and you're likely to know if you have one. Conditions like lupus, diabetes, heart disease, and numerous others are caused by a combination of LOTS of genes and unknown environmental factors. To give you an idea of the relative importance of the two, the identical twin of someone with lupus has something like a 25% risk of developing the disease (don't impale me if I got the number wrong, 25% is in the neighborhood). To confound matters, mutations outside of genes in parts of the genome formerly referred to as junk DNA play an ill-defined, yet important role in many (or perhaps most) complex genetic diseases. Discovering you have a rare mutation in some seemingly random spot isn't all that helpful, even if it's going to cause you to drop dead some day.
Mapping disease risk mutations is a very rich area of research. Here's a taste: some people suspect that mutations operating in pairs or general n-tuples may cause disease in specific combinations. The drag here is that when these mutations are tested individually, they may show little or no statistical association. To test even all pairs is intractable (NP complete for you CS types) and doing so introduces a statistical nightmare with lots of semi-independent tests inflating the false positive rate.
I'd suggest you save your money for a few years unless you just really want to know about ancestry, which is relatively easy to determine from many fewer SNPs than these companies are offering. I don't recall the details, but I suspect something like this [affymetrix.com] plus freely available software should do the trick. You just need to find a lab with a hyb oven and a microarray scanner and a statistician to do the analysis.
Re:Not yet (Score:5, Insightful)
No one gets to choose their genetic makeup, sex or race when they are born, so why discriminate people based on something which is out of their control?
Take a look at the Genetic Information Nondiscrimination Act of 2007 [genome.gov]:
Re:Not yet (Score:4, Insightful)
Insurance companies should charge the correct amount, given all knowledge of risk factors -- insurance should be spreading risk among your insurance pool, not about getting free medical care. The problem is that this results in morally repugnant things like denying people care for unlikely conditions they're predisposed to but had no control over.
In an ideal world, this would be an argument for socialized medicine, or at least goverment-run health insurance for such factors. At a societal level, a certain fraction of people will have genetic anomalies, and at a societal level we shouldn't discriminate against them. It's no different from a car accident -- even if you're a good, careful driver, you roll the dice every time you get behind the wheel. The difference is that the dice get rolled (at least in part) long before the healthcare bills start to appear. But, that doesn't make it any less of a "risk" -- it just means that people can attempt to opt out of paying their share after they've checked the dice roll.
The ideal solution would be to cover everyone based on a pool composed of everyone -- aka mandatory government funded insurance (or socialized healthcare, depending on how you want to look at it).
(And to wander further afield -- there are lots of issues with our current healthcare system. I'm skeptical that socialized healthcare is the answer, and I don't know that implementing government insurance for genetic conditions would actually improve anything. At the same time, I find it ethically wrong to allow people to use genetic results they know about in decisions about what healthcare coverage to buy, but not allow the providers to use the same information in decisions about what to charge. It's a difficult and many-faceted problem, and I won't pretend to have even some of the answers.)
Re:Insurance (Score:5, Insightful)
There's another interesting potential use for genetic disease screening. I don't know if it applies to any known diseases now, but I'm certain it will eventually.
Suppose there's a disease for which there is a genetic test, but also good preventative care options. Ideally, you'd want to take the test, find out that you're at risk, and have the insurance company pay for the prevantative care. In an ideal world, that's what they would want too -- the preventative care would cost them less than paying if you actually did get sick. Both parties would then want the test administered, and want the other party to know the result.
Re:Third that (Score:3, Insightful)
No thank you. Having everybody's genome in a database someplace is a monumentally BAD idea. What's to stop some unscrupulous person deciding they don't like, for instance, people with blonde hair and brown eyes? They can dig through the genome records to find what gene sequences selects for both of these traits, then cobble together a virus that targets these sequences. Impossible? Now, mebbe, but I wouldn't hold my breath that it'll be impossible forever.
Besides, our government gets all kind of info without a warrant these days. Want to give them more? Not me, unless it'll bury them in paperwork til they can't do anything else but the paperwork...
And let's look at health insurance, since you brought it up. Give them this information, and they can start dropping coverage on people at risk. People like me. Last place I worked decided to change coverage to get a 'better rate'. First thing the salesman asked when he came in was, "Who here is diabetic?" Three hands went up, mine being one of them. Second question was, "Anybody here have heart problems?" I raised my hand. He then said, "Sorry, we can't cover diabetics or people with heart problems." And since my coverage dropped with the old company when they switched over, I became uninsurable because the old insurance company wasn't going to carry me unless my premiums went from 200/month to 1500/month. And that's just for me.
And besides, private databases are under no obligation to demand to see a warrant. They can be shared for 'legitimate business reasons'. How much you wanna bet that these databases won't be sold to insurance companies, security companies, credit card companies, anybody with a vested interest in seeing that they keep somebody alive to get money out of them? Never saw a privacy agreement that didn't state that conditions of use are subject to change without notice?
Re:Not yet (Score:3, Insightful)
They have these guys working for them called actuaries. They do for insurance companies what bookies do for betting - they analyse risk and compute odds. It's a hitherto unknown science called 'statistics'. And they're good at it. Why do you think car insurance premiums are 5 times the 'going rate' for males between 16 and 25? Because statistically, the risk is MUCH greater of an accident in that age bracket.
Um, no. The insurance company's profits will go up, the premiums will remain the same. Hey, you're used to the rate now, right? By getting more info on you, they can more accurately gauge the risk you'll be that they (god forbid) actually have to pay a claim, and if your risk goes beyond a certain threshhold, they'll drop you like a hot rock. Think I'm kidding? File claims on 3 uninsured idiots backing into your car in a parking lot within a year and see how fast your premiums go up after the 2nd, and how fast they cancel you after the 3rd. Insurance companies are for-profit entities. They're in business to make money, not to pay claims. If they can figure out a way to pay zero claims, they'll do it.
Re:Insurance (Score:3, Insightful)
I disagree.
Suppose the insurance company gets the results of the test. Then the company could just drop coverage altogether, so that they have to pay neither the preventive care cost, nor the cost of the disease.
Suppose the insurance company does NOT get the results of the test. Then the company could just drop coverage as soon as the cost of the disease becomes apparent.
Dropping coverage could also involve increasing premiums to an unaffordable rate, thus having the same effect.
Relatedly, the House passed the Genetic Information Nondiscrimination Act of 2007 (H.R. 493) [genome.gov] by 420-3. The three were Republicans: Flake (AZ), Paul (TX), and Royce (CA). Well done, nutjobs. The Senate has yet to pass its version (S.358).
In any case, since the bill is not yet law, there may be nothing stopping insurance companies from discriminating against your genetic makeup.
--Rob
Re:Insurance (Score:3, Insightful)
Re:Not yet (Score:4, Insightful)
They do not now have that right, nor should they have that right in the future. Just because they are private enterprises does not mean that they should be exempt of regulation; in fact, the whole point of regulation is to make the profit motive of private enterprises work in parallel with the public interest.
It's in the public interest that people have access to affordable health insurance, in particular if their genes show that they may need it in the future. If insurers were allowed to cherry-pick, then ultimately the taxpayers would have to pay for the treatment of these people, unless you want to let them rot homelessly in the streets.
Re:Sure You Know Who Your Father Is? (Score:4, Insightful)