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Biotech Science

President Bush Signs Genetic Nondiscrimination Act 527

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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President Bush Signs Genetic Nondiscrimination Act

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  • by bruce_the_loon ( 856617 ) on Monday May 26, 2008 @12:12PM (#23546023) Homepage

    Maybe there's hope for us mutants then.

    X

    • by Anonymous Coward on Monday May 26, 2008 @12:30PM (#23546245)
      Balony. As usual for Bush, this is pure self-interest. He knows that he'd never make the cut.
    • by QuietLagoon ( 813062 ) on Monday May 26, 2008 @01:02PM (#23546581)
      Maybe. I keep wonderng where the loophole is, and how big it is.
      • Re: (Score:3, Interesting)

        by TubeSteak ( 669689 )

        I keep wonderng where the loophole is,

        I'd guess it would be proving genetic discrimination.

        and how big it is.

        It's as big as employers and insurers can get away with.

        Prohibiting issuers of Medigap policies from adjusting pricing or conditioning eligibility on the basis of genetic information. They cannot request, require or purchase the results of genetic tests, or disclose genetic information.

        I'd be happier if the law said they cannot *have* the results of genetic tests.
        If someone gives the results of genetic tests to [company], the "issuers of Medigap policies" have neither requested, required, purchase or disclosed anything.

        Kinda like during that Chicago ban* on selling Foie Gras, restaurants boosted prices and served foie gras for 'free'.

        *since repealed

    • This only if you were actually born. There's still extreme prejudice from on high if you're a fetus or stem cell.
    • by PopeRatzo ( 965947 ) * on Monday May 26, 2008 @02:07PM (#23547253) Journal
      Before you start accusing George Bush of sanity, I suggest you read the signing statement that almost certainly accompanies this new law.

      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.
      • by Tom ( 822 )

        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.
        Source?
  • by nurb432 ( 527695 ) on Monday May 26, 2008 @12:15PM (#23546063) Homepage Journal
    Sure you can legislate that you cant discriminate but if your employer or insurance company has access at all, they can just 'backdoor' you out the door.

    ( and no i didn't read it, it would be to large to wade thru on a holiday weekend )
    • by aztektum ( 170569 ) on Monday May 26, 2008 @12:48PM (#23546445)
      In the linked FA it says neither insurers or employers can request, require or purchase records pertaining to someones genetic makeup.

      However, like most DRM schemes, I'm sure a "hack" will be found soon.

      What's lame is they don't even need to discontinue insurance based upon genetics. My step-fathers sister in law had her insurance dropped by her company (amongst others). Management told them straight up it was because they weren't "healthy enough." Of course on paper it was for different reasons (cost reductions I believe.).

      This is simply more feel good legislation.
      • Sure you don't need a detailed genetic work-up to deny a person health insurance or a job. You can eliminate alot of genetic conditions by running a diagnostic checklist of observable conditions though.

        Check those that apply:

        ( )Are they in a wheel chair

        ( )Do they need assistance in walking

        ( )Specific diet or allergies

        ( )Overweight or Underweight

        ( )Visible deformaties

        ( )Near sighted or far Sighted

        ( )Visible tremors or ticks

        ( )Extremely tall or short

        ( )Skin colouration

        ( )Visible melanomas

        Of cours

  • by Kingrames ( 858416 ) on Monday May 26, 2008 @12:16PM (#23546071)
    Those ATTTACAGATTAC ers deserve to be discriminated against.
    • by vux984 ( 928602 ) on Monday May 26, 2008 @02:26PM (#23547433)
      ATTTACAGATTAC

      Seeing that made me think of the movie title "Gattaca", at which point I realized that "Gattaca" was actually deliberately named using only a,t,c,g on purpose... digging in wikipedia confirms that it was named for an enzyme, EcoRI, that cuts "GAATTC"

      I'd never really thought about the significance of the title before. Makes an already great movie, just a little bit better. Thanks for that epiphany...
  • Interesting vote... (Score:5, Interesting)

    by Bake ( 2609 ) on Monday May 26, 2008 @12:17PM (#23546083) Homepage
    From the article: "Just a few weeks ago, GINA received overwhelming support in both the Senate, with a unanimous vote of approval, and the House of Representatives, where the legislation was passed by a landslide vote of 414-1."

    Who was the one who voted against this?
    • by snl2587 ( 1177409 ) on Monday May 26, 2008 @12:25PM (#23546177)

      Our good friend Ron Paul, it turns out.

      • by trolltalk.com ( 1108067 ) on Monday May 26, 2008 @12:31PM (#23546263) Homepage Journal

        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 ...

      • by wizardforce ( 1005805 ) on Monday May 26, 2008 @12:32PM (#23546269) Journal
        Here's the full details of the votes:
        http://www.govtrack.us/congress/vote.xpd?vote=h2007-261
        The three who voted agaisnt this are: Jeff Flake [R] Edward Royce [R] and Ronald Paul [R]
      • by msauve ( 701917 ) on Monday May 26, 2008 @12:49PM (#23546465)
        I'm sure his primary reason is because there is no Consitutional authority for this sort of thing, in general.

        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.
        • by Aaron_Pike ( 528044 ) on Monday May 26, 2008 @12:58PM (#23546545) Homepage
          Isn't the whole point of insurance to spread the risk evenly? Wouldn't paying more if you're more at risk defeat the purpose of insurance in the first place?
          • by tygt ( 792974 )
            I don't think so. You get insurance to pay ahead of time to cover the chance that something bad will happen. Group insurance does work to help spread the cost over a group, but insurance in general isn't a group concept.

            This is like telling the insurance companies that they can't know if you like to smoke a cigar every once in a while - something that will increase their risk of having to pay out somewhat, though not a guaranteed payout requirement.

          • No.. (Score:4, Insightful)

            by msauve ( 701917 ) on Monday May 26, 2008 @01:34PM (#23546913)
            the point of insurance is to share equal risk (to the extent that risks can be known). When some class of participant is allowed to tilt the odds in their favor, others lose.
          • by mewsenews ( 251487 ) on Monday May 26, 2008 @03:10PM (#23547881) Homepage
            Wouldn't paying more if you're more at risk defeat the purpose of insurance in the first place?

            No. If you choose to drive a vehicle with more risk of being stolen, the insurance company charges you more to be insured. You've assumed a voluntary risk and the insurance company dings you.

            When you sign up for life insurance, if you're a 63 year old smoker you won't get as favourable rates as if you were a healthy 18 year old.

            The part that makes people uncomfortable about genetic discrimination is the eugenic angle. Nobody is able to control the genes that they are born with, and discriminating against groups of people based on factors beyond their control is usually a pretty crappy thing to do.
          • by FooAtWFU ( 699187 ) on Monday May 26, 2008 @03:20PM (#23547975) Homepage

            The point of insurance is that you pay to get rid of your own risk. (Well, not to get rid of it entirely, but to get rid of the major consequence of something bad happening: having to pay a lot of money). If your risk is higher, you need to pay more. If your risk is lower, you get to pay less.

            Consider extending your analogy. People with a lot of car accidents pay more for insurance. People with a clean record pay less. What would you think of a proposal that would make everyone pay the same amount for auto insurance? I'd think it would be pretty ridiculous, and I think you should too. And while one might moralize that people can't help their health so much as their driving habits, that's not the issue of an insurance company, Health or otherwise.

            The problem is people who want some level of socialism and try to get it through insurance regulation and end up losing the free-market benefits while not even gaining much as a result. If you want other people to pay for your health care (and that of everyone else) stop beating around the bush and wagging your fingers at the insurance companies and admit you want socialized medicine. Then we can at least address it on its own terms.

        • by Martin Blank ( 154261 ) on Monday May 26, 2008 @01:06PM (#23546619) Homepage Journal
          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.

          How does it change the status quo? Insurers have been working on the basis of averages without genetic information for a very long time. There are factors driving up the cost of healthcare, but a lack of access to genetic information doesn't seem to be a major one.
          • by SlayerofGods ( 682938 ) on Monday May 26, 2008 @01:18PM (#23546729)
            Well they've been using family history for a while; which is basic an easy way to get someone's genetic profile......
            I wonder how that will fare under the law.
            • Re: (Score:3, Informative)

              by NereusRen ( 811533 )

              I wonder how [using family history] will fare under the law.

              The text of the act can be found here [loc.gov] (Version ENR is the final enrolled version).

              Here's what it has to say about family history, with my bolding:

              SEC. 101. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.
              [...]
              (d) Definitions- Section 733(d) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191b(d)) is amended by adding at the end the following:
              [...]
              `(6) GENETIC INFORMATION-
              `(A) IN GENERAL- The term `genetic information' means, with respect to any individual, information about--
              `(i) such individual's genetic tests,
              `(ii) the genetic tests of family members of such individual, and
              `(iii) the manifestation of a disease or disorder in family members of such individual.
              [...]
              `(C) EXCLUSIONS- The term `genetic information' shall not include information about the sex or age of any individual.

              It seems that requiring someone to provide family history of a disease is now forbidden.

          • by msauve ( 701917 )
            is that individuals now have reasonably priced genetic tests available to them, which they can take advantage of to tilt the odds. Insurers will now have to assume that anyone who purchases insurance for a disease for which genetic tests can show an increased risk, is in fact at increased risk of that disease. This unjustly discriminates against those at low risk for that disease, by forcing them to subsidize those at increased risk. Worst case, the coverage simply becomes unavailable, so no one benefits.
        • by bjourne ( 1034822 ) on Monday May 26, 2008 @01:15PM (#23546695) Homepage Journal

          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.

          • by kmac06 ( 608921 )

            How is someone able to take advantage of being more likely to carry a genetic disease?

            Let's say someone gets a genetic test saying there is a 99% chance they will get some disease in the next five years. Lets say the cost of top notch health care for this disease will cost $10 million over the life of the patient. The patient can then go and get coverage for this disease for some absurdly small amount compared to the cost of treatment. The insurance company is able to sell this coverage so cheaply because most people don't get the disease. If the only people that purchase coverage are now t

          • Re: (Score:3, Interesting)

            For you to be able to claim that health insurance is a fundamental right as a human being, you must also claim that the right to property is not a fundamental right. Is this what you're claiming?
        • by pesho ( 843750 ) on Monday May 26, 2008 @01:16PM (#23546715)
          Your argument puts the idea of the insurance on its head and thus makes no sense. If you are concerned about discrimination against healthy people, you should argue for dismantling the health insurance system altogether. This way everybody would pay the exact cost of the healthcare services they use. Besides there is a very good scientific reason not to descriminate. We can't conclude defenitevly that a particular mutation is 'bad'. For example mutations causing betha-thalassemia are protective against malaria. Having genetic diversity is more beneficial for the population as a whole, than having what someone would percieve as 'healthy' genes.
          • Re: (Score:3, Insightful)

            by FooAtWFU ( 699187 )

            If you are concerned about discrimination against healthy people, you should argue for dismantling the health insurance system altogether.

            And if you're concerned about safe drivers, you should argue for dismantling the auto insurance system altogether.

            Except, even safe drivers have accidents, or have their cars struck by lightning while sitting in the driveway (true story!) and unexpected things come up with regards to peoples' health. Risk is always out there.

            And risk carries a price! A 1% chance of getting sick or injured this year and needing $100,000 dollars in treatment is worse than a 100% chance of spending $1000 a year on insura

        • by weston ( 16146 ) *
          If insurance companies can't set pricing based on full knowledge and actuarial statistics, but people can, it will increase costs.

          Because this would *totally* throw off the existing delicate balance of information symmetry that currently exists between insurance companies and consumers, right?

          Finally, why shouldn't people at greater risk pay more? Discrimination is not necessarily a bad thing.

          The more efficient discrimination becomes, the less what we're talking about here is actually insurance anymore.

          But
    • http://projects.washingtonpost.com/congress/110/house/1/votes/261/ [washingtonpost.com]

      Some didn't vote as well, how does that count?
    • I know this is going to get modded -1 in about 30 seconds, and really anger people, but this bill seems like one of those "Let's make ourselves look good" bills more than anything else. I think the guy voting against it may have been in the right.

      If my dad was a drunk, can I drink at work or right before work and claim it's in my genes? Technically they can't discriminate against me in that case.

      What about smoking? If I claim the genes for addiction run in my family, and that's why I smoke 3 packs

  • by hyades1 ( 1149581 ) <hyades1@hotmail.com> on Monday May 26, 2008 @12:20PM (#23546117)

    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.

    • Re: (Score:3, Insightful)

      by kaltkalt ( 620110 )
      Exactly! Most people simply can't get beyond the happy-sounding name (which usually involves "Children/s") of the bill (which is why they do that). Who could possibly be against something called the PATRIOT Act? Antiterrorism and Effective Death Penalty Act? That sounds good! Digital Millennium Copyright Act? Sounds good, a new copyright act for a new digital millennium! Yay! If this law didn't help insurance companies at the expense of the insured, Bush would veto the fuck out of it.
    • Re: (Score:3, Insightful)

      by no-body ( 127863 )
      In essence, it's hogwash!

      If you apply for insurance and on the phone the rep tells you that you can't have insurance because they are not taking applications right now from your zip code area/state (or some other "good" reason) when he sees information on a screen about you not to be insuarable - are you having any leverage to sue because of DNA discrimination, not even to talk about financial resources?

      The US health insurance system is totally hosed. It is based on profit maximazing of individual insuran
  • by R2.0 ( 532027 ) on Monday May 26, 2008 @12:22PM (#23546145)
    Gina? Please tell me it isn't administered by the VA...
  • About Time (Score:5, Insightful)

    by Jane Q. Public ( 1010737 ) on Monday May 26, 2008 @12:28PM (#23546219)
    As much as I hate the current situation in which the insurance industry has had far too much power over healthcare, this legislation was absolutely necessary for our society to continue to function in anything like a normal way as genetic information becomes more commonplace.

    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.
  • by peter303 ( 12292 ) on Monday May 26, 2008 @12:37PM (#23546321)
    An article in Nature (proprietry web) [nature.com] a month ago analyzed the genetic content of James Watson, the co-discoverer of the genetic code, and the 2nd of four known people to have their genomes fully sequenced. Dr. Watson had three thousand observed mutations of which 32 were in the database of genetic diseases. This included Retinitis Pigmentosa, kidney failure and other potentially devasting diseases. However, it is not known why they were not expressed in his case. This is all the more reason to keep insurance companies from canceling insurances to those who might have any sort of genetic defect.

    P.S. No, they did not discover the gene for making stupid racist remarks, which forced Dr. Watson into retirement last year.
    • by naasking ( 94116 )
      I think genetic profiling is a valid route for insurance companies. The problem is one of timing: we still don't know enough about when and how these genetic predispositions actually manifest, so it's a bit too early to be basing decisions on predispositions. Eventually, it could prove to be a good indicator, in conjunction with one's lifestyle choices. Just not yet.
    • Re: (Score:3, Insightful)

      P.S. No, they did not discover the gene for making stupid racist remarks, which forced Dr. Watson into retirement last year.

      "All our social policies are based on the fact that their intelligence is the same as ours â" whereas all the testing says not really."

      "There is no firm reason to anticipate that the intellectual capacities of peoples geographically separated in their evolution should prove to have evolved identically. Our wanting to reserve equal powers of reason as some universal heritage of hum

  • by gihan_ripper ( 785510 ) on Monday May 26, 2008 @12:38PM (#23546329) Homepage

    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.

    • by forgotten_my_nick ( 802929 ) on Monday May 26, 2008 @01:29PM (#23546873)
      "I must applaud President Bush for being foresighted enough to pass this legislation"

      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.

      • Re: (Score:3, Informative)

        by NereusRen ( 811533 )
        All of your actual points seem to consist of uninformed scaremongering. This should teach us that all a "casual reading" by a non-lawyer, non-biologist is only good enough for a +5 insightful, not for anything resembling facts.

        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.

        All of the 200-level sections are about employment. They have no connection to anything related to medical insurance companies (except in the sense that they, like other companies, have employees).

        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.

        Apparently you didn't read enough "bits" of the bill. I actually read the entire secti

  • Otherwise they'd have found more simian DNA than Human, and he'd be fired!
  • We all knew that Bush and GINA go together pretty plainly!

    Get it? GINA as in vagina!
  • by hyperz69 ( 1226464 ) on Monday May 26, 2008 @12:43PM (#23546385)
    We need protection though from other forms of medical discrimination. Banning the Archaic BMI would be a good start. Limiting pre-existing conditions. Its amazing the things that will still get you disqualified. A yeast infection and even too many pimples as a kid... More needs to be done. I will take this small victory though.
    • Re: (Score:3, Insightful)

      by Fjandr ( 66656 )
      Maybe I'm misunderstanding, but are you saying you think there shouldn't be limitations on pre-existing conditions?

      Not that I support the state of the insurance industry, or even anything close to it, but if all the people with severe problems could be guaranteed acceptance for medical insurance it would bankrupt the entire industry. No more health insurance for anyone.

      This is a statement coming from someone who would benefit an extraordinary amount from a lack of such limitations, and I still think it's an
  • by Zen ( 8377 )
    The article specifically states that the bill covers health insurance and employers. Most large employers just dump new employees onto their group policy and pre-existing conditions may or may not matter. So this sounds like it's geared towards the self insured and small employers who have to be choosy due to premiums.

    But what about life insurance? If I'm a perfectly normal (seemingly healthy) person who has never been diagnosed with anything, and then I apply for life insurance and they find something i
  • by superwiz ( 655733 ) on Monday May 26, 2008 @01:47PM (#23547065) Journal
    Now that discrimination is illegal on the books, one cannot use privacy concerns as a legitimate reason for withholding this information. It will now be demanded under all kinds of security concerns. In the end it will be used for the purposes of discrimination in the wink-wink-nudge-nudge manner. But hey, the Civil Rights Act ended racism, right? It didn't prolong it by another 50 years by drawing a legal distinction between races. This belief that the government can force egalitarianism is how the West is choosing fall. Oh, well. Life will go on. We are not equal other than in the eyes of the creator (if you believe in such a thing). We certainly are not equal in the eyes of the fellow human beings with whom we associate. To create a law that pretends that an untruth is true is to make all laws absurd. It undermines and thus destroys the legal system. But hey, the right-hemisphere-people rejoice. I fail to see why slashdot should join them.
  • Adverse selection (Score:5, Insightful)

    by rgoldste ( 213339 ) on Monday May 26, 2008 @02:23PM (#23547409)
    I just finished teaching a bioethics course at Harvard College and we studied this topic in detail; it was one of the questions on the final exam. I am convinced that this is a well-intentioned but bad law.

    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.
  • by NIckGorton ( 974753 ) * on Monday May 26, 2008 @02:33PM (#23547493)
    Just pass a law that says health insurance companies can't discriminate for any reason. There has to be a community rate for health insurance (like there was 50 years ago.)

    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!
    • Re: (Score:3, Insightful)

      The thing is about socialized medicine is that, as it's practiced throughout much of Europe, once you hit the age of 64/65, the level of coverage you qualify for is cut dramatically. 64 and need an organ transplant, too bad. At 64 you are no longer as seen as contributing to the economy. Even then, countries in Europe were having trouble keeping the programs funded, along with all the other entitlement problems they have.

      As far as I can tell, a certain percentage of the population gets screwed by health

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