Two Companies Now Offering Personal Gene Sequencing

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."

Comments

Not yet

[Faux_Pseudo]

I wouldn't do this until some law is passed saying that if a test shows I am prone to some genetic condition that the insurance companies can't refuse me service because it is a pre-existing condition. Ignorance is financial bliss.

Re:Not yet

[CrazedWalrus]

No, they're possible conditions. You can carry genes that increase your likelihood of having a disease, but not actually express them to the extent that you actually have a problem (or at all). For example, some gene is found to increase your chances of high cholesterol and therefore heart disease. You still may never have heart disease, and may not even actually have high cholesterol.

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

[aldheorte]

Can anyone give me an good argument as to why:

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:Not yet

[Emetophobe]

My only argument is Genetic discrimination. Also, a lot more information can be found here.

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:

The Genetic Nondiscrimination Act of 2007 (GINA) was passed in the U.S. House of Representatives, by a vote of 420-3. The act will protect individuals against discrimination based on their genetic information when it comes to health insurance and employment. These protections are intended to encourage Americans to take advantage of genetic testing as part of their medical care.

Re:Not yet

[evanbd]

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:Not yet

[AxelBoldt]

Insurance companies, as private enterprises, should have the right to charge whatever they want to whomever they want,

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.

Anonymity?

[Mr. Sketch]

Is this anonymous? Namely so that if it turns out I have some risk factor for a genetic condition, that my health insurance can't find out about it and raise my premiums.

scared of your HEALTH providers?

[xtracto]

Lol, it is so funny to read the comments from this story. I found amusing how there are already various comments wondering how would that affect negatively to their health insurance... whereas this would be *great* for say, someone under the NHS as it would allow the doctors to focus on monitoring those specific genetic conditions.

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!

Insurance

[MikShapi]

How do we expect insurance companies to handle this? What about the "two publics"?

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:Insurance

[evanbd]

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.

Irrebuttable presumption of paternity

[Anonymous Coward]

And yet in most US states there is a irrebuttable presumption that a husband is the father of his wife's child if the child was born during the marriage.
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:Sure You Know Who Your Father Is?

[eli pabst]

Yeah, this is actually a significant issue in the genetics field. Depending on the population, you can have upwards of 10% non-paternity, which can really screw things up when you are trying to trace the inheritance of disease-causing mutations as they are passed through a family. With all the HIPAA regulations you could obviously never disclose any of that, but we had a medical student once take it on themselves to call a family and basically say "hey we did these genetic tests and they aren't coming out correctly, are you sure that so-and-so is the father?". I'm sure it was a quiet dinner that night.