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Biotech

My Genome, My Self? 194

Posted by timothy 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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My Genome, My Self? More

My Genome, My Self?

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  • Id venture (Score:5, Insightful)

    by Creepy Crawler ( 680178 ) on Saturday January 10, 2009 @07:10PM (#26402621)

    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...

    • 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.

      • 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

        • 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

          • 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

      • Re: (Score:3, Informative)

        by jc42 ( 318812 )

        [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

        • Eureka! Finally, someone who "gets it!" As you point out, even a small false positive rate, among a large enough population, will screw things up.

          We're seeing this in other areas as well - like the "Do Not Fly" lists.

    • Re: (Score:2)

      by lee1026 ( 876806 )

      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

    • 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.

      Why don't you lie a bit more and spread some more FUD [wikipedia.org]?

      There is ALREADY LEGISLATION AGAINST THIS!!! [whitehouse.gov]

  • It gives plenty of outward clues as to "what makes a person tick", which we internalize over a lifetime as "rules."

    An example FTFA:

    Millions of people are exposed to cognitive psychology in college but have no interest in making a career of it. What made it so attractive to me?

    As I stared blankly, the interviewer suggested that perhaps it was because I grew up in Quebec in the 1970s when language, our pre-eminent cognitive capacity, figured so prominently in debates about the future of the province. I q

  • '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.

    • It's the profit part of the equation that borks everything: when your money depends on not paying out benefits

      Everyone seems to think that having something in the government removes the profit motive and really, nothing could be further from the truth. It's only a recent thing that government did not control the exclusive right to all commerce in the western world. Of course government wants to make a profit on something and then misuse them. In fact, on nearly every income stream, from social security s

      • You're confused. You seem to think taxes are "blown" on nothing and the money is shredded and scattered into thin air. It's not.

        Government takes and spends money, and yes, tjstork, the government can sometimes allocate that money better than the private sector would have. For starters, it doesn't have a three-quarter bottom line in mind.

        Government spending is a good thing.

        • Government spending is a good thing.

          You'd have an easier time convincing me of that if we weren't in a hole of debt we can never climb out of without "winning" another world war due to government spending on an illegal war.

      • Re: (Score:2)

        by Bombula ( 670389 )

        You may be misunderstanding the meaning of profit. In a strict sense (and this is going to be confusing if you're not an economist), it is the proportion of an economic surplus that is disbursed as rent to those with property rights.

        Government can't really 'profit' in this strict sense because individuals cannot claim property rights over government capital, and therefore cannot be enriched by the economic surplus (the 'rent') those assets generate - at least in modern democracies. This does not mean ther

  • 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)

      by Anonymous Coward on Saturday January 10, 2009 @09:40PM (#26403929)

      >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.

    • Re:This will actually reverse the cost of health c (Score:2, Informative)

      by Anonymous Coward

      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.

      Now as to saving for your own medical care.

      • Re: (Score:3, Informative)

        by dada21 ( 163177 )

        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

        • Re: (Score:2)

          by Reziac ( 43301 ) *

          Same principle as everywhere else -- middlemen may be a convenience in some cases, but generally they serve mainly to increase costs -- after all, they want a cut of the profits too!!

    • How do I find a doctor like this? Are there labs with similar practices? What about things like Xrays, etc? I would love to use health insurance as actual insurance and not as a health plan - but to be honest, I don't know how to do that given the high prices of medical treatment (I agree that these are the result of the universal nature of HMOs and the AMA, but they're still a reality...). So...educate me - how do I do this?

  • Cheapest plan for everyone (Score:2, Interesting)

    by Anonymous Coward

    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

    • Re: (Score:2)

      by evanbd ( 210358 )
      You know that crystal ball you have there that lets you predict the cost of common treatments for common problems 30 years in the future can probably tell you all sorts of neat things. You should try playing with it more, I bet there are all kinds of other social problems it can reduce to a paragraph of arrogantly vague policy directives.

    • I truly cannot express how vile, dangerous, pernicious, and inhumane this idea is. Either you didn't think this idea through clearly, or you want to create as much misery as possible.

      1. Prenatal genetic testing.

      2. Genetic counseling for prospective parents.

      I'm with you so far.

      3. Actuarial estimate of lifetime healthcare costs at birth.

      Here is where your plan starts to smell fishy. How are you supposed to predict lifetime healthcare costs for an individual? We can do it very well statistically, but any given

  • 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:2)

      by evanbd ( 210358 )
      How would it be dangerous? This is me being curious, not disagreeing, btw. Obviously it's an invasion of privacy, and I'd like to think I'd have said the same thing had I been in your position. But I haven't heard anything about the PGP that suggests they're doing much beyond collecting DNA and records, which doesn't sound dangerous to me. Is there more going on I don't know about?

      • 1. He said "We think we can get Harvard to agree to pay"
        2. These invasive (to his records) studies would lead to his offspring not being covered.
        3. It wasnt enough compensation.

  • 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

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