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Bill To Outlaw Genetic Discrimination In US
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Globe editorial notes that the bill has been held up in the Senate by the action of a single senator, who has an (outdated) objection based on his anti-abortion stance.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.
I fail to see why this is even an issue?
If Insurance Company X wants to discriminate that's fine and dandy. Big deal. Eventually some other insurance company will probably pick up the pace and find some way to offer these people insurance without outrageous prices, but what really is wrong here? It's like saying an insurance company can't charge people different rates based on sex.
It's just silly and another anti-discrimination agenda that makes people across both party lines and ideologies "feel good" about themselves when really, they're just making the economy less efficient.
the Political Inquirer
It's illegal to fire someone for trying to start a union at his place of work, but I got fired, anyway. They claimed I had quit.
Suddenly the burden of proof falls to the injured party and all the "big bad company" has to do is have some form of plausible denyability.
Big words, high ideals, changes nothing.
-Eldurbarn
(1) Who is the single senator? (whose name is apparently much more difficult to type than 'single senator')
(2) What makes his objection "outdated"? (For that matter, what *is* the objection?)
(3) What is he actually doing that's "holding up" the bill?
At least the main thrust of the article is expounded, but, geez, does this guy run around in a mask and a cape and do all his legislating at night, or why exactly did the submitter feel the need to leave his person and actions cloaked in mystery?
When things get complex, multiply by the complex conjugate.
... since there isn't enough in my current medical history to be used against me by insurance companies. Now I feel perfectly safe and secure since everyone knows every company adheres to each and every law no matter how specific.
While I agree with the spirit of the bill, they need to do something better. Genetic information should be restricted medical information only. More than the fact that employers and insurers should not be allowed to discriminate based on the information, they shouldn't be allowed to have or see that information at all. Preventing them from making decisions based on the information is an area frought with grey areas that it runs the risk of being highly ineffective because in spite of the fact that there are many criteria by which insurers are prohibited to descriminate, they manage to skirt the matter by descriminating based on "similar" and statistically related information... you know, like zip codes instead of ethnicity?
The only way to truly prevent the problem from occuring is to make it illegal for them to house the information entirely. There's no grey area there. They either have it or not. Their databases either contains provisions for it or not. If they have it, you shouldn't even have to ask why. They should be fined, reprimanded and shut down until the information is proven to be purged from their databases and database record formats.
If someone suggests "but it's about identity!" I'd have to remind them that the SSN is already being illegally abused for that purpose... it's more than enough.
1. We already allow insurance companies to perform complex calculations using family histories, lifestyle choices, income, living conditions etc. A whole industry is dedicated to the task of deciding as accurately as possible just who is likely to live long. I can already deduce with superb accuracy how long someone is likely to live. Conditions like heart disease, cancer, diabetes and hypertension can all be predicted rather well already. Genetics essentially is the icing on the cake, adding rare genetic conditions to the list of scannable factors. This is an incremental change, at best. Indeed, even with perfect genetic info, chance, will continue to play a major role. Hell, anyone can be hit by a car.
2. Perfect information about someone's future health might compromise the insurance system, but this is an institutional problem, not a moral one. (A weak analogy, I think, is webmaster vs. adblock. ) That two people, having vastly differing health prospects (one has undiagnosed Huntingtons, say) should pay similar premiums, is hardly an ethical judgment. It simply is how the industry operates now. Perhaps other ways exist? Life has existed before insurance, believe it or not. If indeed the function insurance fulfills is crucial under all situations, new ways of organizing it will emerge. We shouldn't seek to ossify technology just to protect status quo or a business model.
don't you run the risk of people getting a prognosis for some horrific and debilitating disease and suddenly wanting the gold-plated health and disability plan, which the law would say has to be issued? Like going out and buying fire insurance for your burning house?
Shouldn't an airline be allowed to deny a pilot a job based on a profile that determines he's likely to suffer seizures?
That is what's called a bona fide occupational requirement and yes, they can.
Should an insurance company have to carry and not charge extra for somebody whose genes are programmed to misfire when the applicant turns 35?
Well, the idea behind insurance is to spread risk over a large pool so when you need to pay out you have the cash; that's why gruop policies are generally cheaper than individuals. Insurance companies already do a lot of risk assessment to determine what to charge; this bill prevents them from selectively excluding people due to a possibility of an adverse outcome.
Now, they should be able to use testing results for a statistically valid sample to determine overall group risks and price accordingly; but that's what they do today.
I'm a consultant - I convert gibberish into cash-flow.
There are genetic tests under development (and a few already available, like Huntington's) that will allow much earlier detection of some diseases. In many cases, this will allow earlier treatment, extending lives and probably reducing overall medical expenses. However, no one is going to be willing to take the tests if they're going to become uninsurable because of it.
This isn't so much about discrimination or allowing actuaries to do a good job as it is about letting new tests become useful at all. After all, the insurance company has no more useful information if you don't take the test than if they're not allowed to use the results.
We do socially, anyway. First it was the divine right of monarchy, now its the high test scores of the modern day plutocracy. High test scores, or whatever the case may be, is (wrongly) attributed to inherent aptitude, aka. genetics. Those individuals lucky enough to have been deemed genetically superior are then given the best opportunities in life. Will the passing of this law do anything about this? No. I personally doubt this law will do much of anything at all. Just because its de jure does not mean it is de facto.
The problem with this is that we end up with everyone having 'perfect' genes, then we have no ginetic diversity, then BAM, a flu* comes along that kills us all in a couple days, because no one is resistant. It took a gene that causes a slightly week heart** to be resistant.
* insert infectious disease here
** insert imperfection here
Suppose I do not have any of these genetic risks. Suppose that I am celibate and therefore do not worry about aids. Suppose I do not wish to subsidize those who are subject to these risks. Can I buy insurance offshore, in say, London, excluding AIDS and allowing genetic tests, to get a lower rate? If I can, and enough people find out about it, it will effectively nullify this law and other "anti-discrimination" laws.
Despite this, your proposed market system here is still discriminatory. People, for no other reason than an insistence upon privacy, would have to pay higher rates. Forcing people to disclose their DNA in order to be insured is highly invasive and contradictory to basic civil liberties.
Privacy always has, and always will, have a price tag attached to it. Nothing new here. Once you are in public you have no right to privacy. Doing business with someone is being out in public.
Despite this, your proposed market system here is still discriminatory. People, for no other reason than an insistence upon privacy, would have to pay higher rates. Forcing people to disclose their DNA in order to be insured is highly invasive and contradictory to basic civil liberties.
I do not consider privacy of my DNA a civil liberty any moreso than my fingerprints. We already had that argument, remember? (you lost)
Just another case of where the people that have something to lose are making a lot of groundless noise.
This all reminds me of those idiots that have some major disability, like missing an arm, and they want to be lifeguards or construction workers or other such nonsense and are screaming about discrimination. People have a right to treat you differently if there are differences that are important to them, certainly if it has a financial impact on them. People are different. Everyone is different. I have a terrible memory, should I fight to get a job as a stock trader? Of course not. If someone refuses to hire me as a stock broker due to my memory, It's not discrimination, it's common sense, and they should have that right. If there is a genetic test for memory and they are looking to hire someone with a good memory, and they want me to take a DNA test to see if I should have a good memory, good for them, go for it. "But that's different..." No it's not. The only difference is that here I have something to gain (a job opportunity) and in the discussion here people instead have something to lose. The world does not have to favor helping you and disfavor hindering you.
By that same token, if I walk into an insurance company and I weigh 400 lbs I expect them to rip me on health insurance. Is it discrimination? No, I'm obese and a serious health risk, my fatness is not a privacy issue, and it's clearly going to affect our business relationship, and I will expect a high rate. Why is this any different if I have some hidden risk like a high CAG count for the Huntington's Disease trait? It's bad enough if you don't want to know if your genetic deck is stacked poorly and want the insurance company to take a blind chance on you, but it's downright dirty to know you have a high CAG and try to hide it while shopping for insurance.
People like that are at a disadvantage, but instead of just saying "that's how life goes", they instead want the world to give them things because they feel the world "owes them". Because life should be fair to them.
no.
I work for the Department of Redundancy Department.
No, no, that's not quite how it works. The insurance companies can make money by averaging over a lot of people with coarse granularity if they choose. They could just take the average rates of whatever disasters over the whole population and charge one rate for everybody.
But they find that if they have finer granularity in their bins, they can offer differing rates to various risk groups. This works as long as the bins aren't too specific. In the limiting case, the insurance knows exactly what will happen to each an every person individually, at this point insurance ceases to be a useful tool for everyone, because everyone would be paying exactly for their own care and also something for the insurance company to run itself.
Now, the problem with finer-grained risk-bins is that given the choice between a company that averages over a diverse population with affordable rates for everyone and one which has a high degree of specificity enabling low-risk people to have much lower rates than high-risk people, the low-risk people will migrate towards the high-specificity insurance, leaving the "general" insurance to cover the high-risk people at, if it is to be profitable, much the same rate as the "high-risk" group at the high-specificity company.
e.g. the existence of high-specificity insurance companies naturally forces all other companies into a high-specificity niche.
So what is to be done?
I think that for things that you can control, like where you choose to build your house, the insurance companies should be able to use whatever granularity they care to. If people living in flood-prone areas, like giant beach-houses in florida for instance, are exposed to the true cost of living there, they might choose to live further out of the flood plane or use a more robust house design.
On the other hand, for something you cannot change, you could easily end up in a situation where you could not prepare for your "true-risk" and could not afford the insurance to cover it. Anti-discrimination laws for insurance companies is really a government enforced collusion for them to keep the maximum number of people insured.
On the other other hand, if the information exists, it can be acted upon. The genie can't really be put back in the bottle, and all indicators are that the information will/already does exist.
Can you be Even More Awesome?!
I essentially agree with you, but I'd put it differently. I heard a quote on the radio a couple of years back from some representative of the insurance industry which went to the effect of: "We're okay with not having your genetic information, for as long as you don't have it either."
Basically someone who knows they are going to die or be disabled soon would pay for the insurance. Once the customer is making decisions based on that information, the insurance company will be forced to raise prices to cover their extra costs which result from paying out on someone like that. But that's not the end of the story. When the prices are raised, people who know they are very unlikely to die or be disabled soon will stop paying for the the insurance and look for alternatives. This worsens the risk distribution for the insurance company even more, forcing the prices up further.
Eventually the price of the insurance will be a realistic reflection of the real costs of whatever problems it's supposed to cover. Once that occurs, there's no reason to pay for insurance at all, since you can just as easily use a savings account. At that point there is no insurance industry for that problem anymore.
It boils down to a fairly simple general principle: when a negotiation is occuring between two parties, the party with more information has an important advantage. At some point the disparity becomes so great that it's not even worth it for the disadvantaged party to accept a negotiated agreement at all. That can be bad for both sides.