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Bill Prohibiting Genetic Discrimination Moves Forward
An anonymous reader writes "The bill to ban genetic discrimination in employment or insurance coverage is moving forward. Is this the death knell of private insurance? I think private health insurance is pretty much incompatible with genetic testing (GT) for disease predisposition, if said testing turns out to be of any use whatsoever. The great strength of GT is that it will (as technology improves) take a lot of the uncertainty out of disease prediction. But that uncertainty is what insurance is based on. If discrimination is allowed, the person with the bad genes is out of luck because no one would insure them. However, if that isn't allowed, the companies are in trouble. If I know I'm likely to get a certain condition, I'll stock up on 'insurance' for it. The only solution I can see is single-payer universal coverage along the lines of the Canadian model, where everyone pays, and no one (insurer or patient) can game the system based on advance knowledge of the outcomes. Any other ideas? This bill has been in the works for a while."
they call it.
But no one takes the law seriously.
Ice Cream has no bones.
We've had private insurance with no genetic testing for a long time how.
How is keeping the second condition going to mandate the end of the first? It's ridiculous.
Tom Swiss | the infamous tms | my blog
You cannot wash away blood with blood
However, if that isn't allowed, the companies are trouble.
How on earth would that be different than how health insurance has worked since it was created? Your company now has no idea if you are more likely to get cancer. Now it might now that you had cancer within the last 6th months, but not that you might get it in 10 years. I don't understand what the submitters counter argument is?! How can you "stock up" on insurance?
What are we going to do tonight Brain?
There are very few businesses that as a rule are genuinely evil, but insurance companies are one in that category. The whole idea of the entity that has to pay for your health only benefiting when they do not is morally flawed.
Health care needs to be a right, and the risk or cost spread over everyone, with no one excluded. This also means that any benefit in savings must be good for the whole. Private profit making business can not be part of this for it to really be fair to all.
We could have had really top notch health care for everyone for less than we have spent on this silly war in Iraq, and with the give away's big political donors in the name of 911, we could all have our own Doctor.
Health care just needs to come from general revenue, like the Military, and cover every one. We spend more on weapons than the rest of the world combines, and most of that is greedy contracters gouging us. Just the waste in the Pentagon budget could cover everyone.
I really think it is time to take our government back and have it serve us.
So There
* Carthago Delenda Est *
Wasn't there a movie about this?
Because genetic planning, or whatever, exists it doesn't really matter whether genetic discrimination is allowed or not. It is simply the fact that genetically better people are more suited for things than genetically worse people. It's no more a matter of discrimination or not, but simply a matter of objectively looking at the attributes of each person.
The health insurance I pay is probably based more on phenotypic differences rather than genotypic. I don't smoke, but I do ride a motorcycle. Maybe I have the genes for some disease or another, but it's far from certain that I will develop it. OTOH, the fact that I don't smoke (or work in a popcorn factory, etc) means I am virtually assured of not getting lung cancer, and if I continue to ride often I am virtually assured of sliding down the highway at least once. The way we choose to live our lives will probably weigh more heavily in the way we continue to pay for health insurance than a nascent science whose findings will change year to year.
Tic-Tac-Toe, Global Thermonuclear War, and relationships all have the same winning move.
>If I know I'm likely to get a certain condition, I'll stock up on 'insurance' for it. The only solution
>I can see is single-payer universal coverage along the lines of the Canadian model, where everyone pays,
>and no one (insurer or patient) can game the system based on advance knowledge of the outcomes
This is sophistry: good predictive knowledge does not make disease more prevalent in the population, just more individually predictable. Insurance companies will adjust rates, and level out coverage so that even if people try to "game" their particular pre-disposition, the risk is still spread onto those without that pre-disposition. Those with few pre-dispositions will still need insurance to cover accidents, and to provide peace-of-mind. Sure, a few will pull out, but they won't be able to go shopping for cheaper policies because positive discrimination would also be prohibited.
Uncertainty isn't what insurance is based on. Insurance is based upon probability of a certain event happening to you. IE If you're a smoker, you are more likely to encounter certain health issues and thus your insurance fees are higher because, duh, your health care costs will statistically be higher. Even the almighty socialized healthcare systems can't avoid this fact and spread the cost among all the people instead of forcing the costs on the person doing the smoking.
Note also that this bill doesn't prevent companies from charging MORE for certain genetic dispositions just that they can't deny you insurance because of your genetics. So you're still free to "stock up" on insurance for your condition (and they'll probably provide incentives for you to take more preventative action.
I've said it before and I'll say it again... those who are willing to give up medical freedom for the sake of medical security deserve neither.
"if said testing turns out to be of any use whatsoever."
uh... what does that mean? Physicians make diagnoses everyday based on genetic testing.
I've often wondered how a universal, single pay system could legally be created within these United States. It seems to me that the Federal government may not have the authority to create a workable system for universal coverage. It can regulate most forms of employment and most commercial activity, but a lot of the people who need coverage are retired, unemployed, or children.
Each state certainly has the authority to do this, but I suspect some states will lack the resources or desire. This would probably make it possible for folks to "game the system" by moving between states depending on their health needs.
So, how could this work? Or would we HAVE to stick with private insurance, and just assume the rates will go up to compensate for people who game the existing system?
Trying to use sarcasm in text-based forums does not work.
> If I know I'm likely to get a certain condition,
> I'll stock up on 'insurance' for it
And when AFLAC sees their profits for Spontaneous Big Toe Combustion Coverage drop, they'll raise the price of the policy. Or find some workaround.
The casino will figure out how to tip the odds to work in their favor. Gaming the system is exactly what insurance companies do for a living, and, one way or another, they'll keep their house advantage.
The Insurance Industry really wants this because it will eventually destroy them, IMHO.
Let's say the insurance industry has free reign for genetic testing. First, they deny all the people that has "pre-existing" conditions. Now, the folks who are accepted know that they're free and clear and do not buy the insurance (OK, they'll buy the accidental death stuff). Therefore, the insurance industry loses all those folks as customers. Of course, I'm over simplifying but I think you get the idea.
Where a treatable disease becomes fatal because the waiting period for treatment is 18 months.
"Access to a waiting list is not access to health care", Canadian Chief Justice Beverly McLachlin
God, I hate editing in these text boxes!
The bill passes, everyone gets tested, then The Powers That Be[TM] get new bills passed eroding this protection and eventually genetic discrimination is completely legal again.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
Would this law help the rich few who are going to be able to increase their mental capacity and ability using genetic engineering to obtain jobs over the poor/middle class people who can't offered said enhancements?
Yeah. It's called paying for your own health care yourself. Not insurance -- the health care, directly. It's was people did up until the 1970s when the health insurance racket took over (the HMO Act) and distorted prices to the point no one can afford it.
Liberty in your lifetime
Ban insurance completely.
It's a protection racket, under guise of a protection racket. No better than mobsters did in the early 20th century.
P.S. I work in the insurance business.
Shiny. Let's be bad guys.
...but this is ridiculous.
As I understand it, the notion is that because of some possible scientific advances looming on the horizon that may or may not affect anything, it's time to scrap our entire health care system and move to socialized medicine. Whether or not you believe that universal health care is a good thing, that's a pretty big leap in logic.
Is this newsworthy? Or is it a transparent agenda post?
Insurance *by definition* only covers unknowns. To the extent that companies are already forced to cover predictable or pre-existing conditions, they are not insurance companies but welfare systems. Or, if it's you with the inside knowledge and you keep it a secret when they ask, they are fraud victims.
As for all the people calling for a big medical welfare system: I simply don't have a responsibility to expend my resources to keep you alive. This isn't a commune. My life and labor are not resources that you get to expend in an attempt to lengthen your own life. Deal.
forget all that banning sexism or racism .... simple solution is a constitutional amendment banning discrimination based on DNA - all the rest is just a subset
I can't think of anything the government runs beyond small communities that works well. I can think of plenty of national servicing companies that provide excellent service. Ok sorry our military can destroy anything to a degree of excellence that many fear. With that said the government should not be involved in the health care system. They have tons of money already in the research of medical drugs and fail to produce even ONE viable molecule on their own. Personally I would like to see people be responsible for your own health.
If you smoke, sit on your rear and generally live a poor lifestyle I would like you see you kicked off my insurance plan, government or not. You live a lifestyle that leads to diabetes and you get diabetes I see no reason why your insurance company(ie me) should foot the bill. Make sense. 90% of fat people claim its genetics yet research shows that 98% of fat people are fat due to lifestyle. Again stop wasting my money.
Insurance would generally not be needed if at the medical level if people could keep money in a rainy day fund...but they don't thus insurance is needed. The idea is not evil in itself but as with any business greed can take over.
Sorry but no i doubt the government could provide good health care. I fail to see on example of how they have done or could provide this level of service to a degree of excellence. Until that time keep it in the hands of private companies that know what they are doing.
Amen to that. I really like the Health Savings Account (HSA) concept. You contribute tax-free to an account, your employer matches (like a 401K), and you pay in cash via a debit card. Some doctors give discounts for cash so its as though everyone is chipping in. Government by NOT taxing your earnings that you spend on health care, yourself and your employer by contributing to the account, and the health care providers by making cost real, not the bloated prices that they charge because the consumer rarely sees the bill. The account collects interest, you can spend the money on health care without penalty or anything else if you pay a penalty on it. You can choose where you want to go for care, or shop around for scheduled (non-emergency) stuff. You still maintain insurance, but its called high-deductible coverage and is for major stuff. That's what insurance used to be for up until the nickel-and-dime, pay-for-everything plans started to be offered by employers to draw talent. After that there was no turning back. I can't imagine how much health insurance will be abused when its "free". If you're using money that you control from an account you can view the balance on, maybe you won't go to the dr. for that sniffle so quickly.
Sharing risk is supposed to be the goal of insurance, going back to when it was a group of shipowners getting together in Lloyd's Coffeehouse to agree to cover each other if any of their ships sank (they all made a little less profit, but none had to worry about being utterly ruined by a single event. If insurers begin to stratify the clients on the basis of genetic testing, a market will arise to insure the never-tested against bad test results (pay us $xxx up front, and we cover your increased premiums). What the proposed legislation does is force participation in that market, by essentially bundling it with all policies. That may be a good thing, because it's otherwise too easy for the insured to game the system (get a test secretly, buy "testing insurance" only if the test shows that it would pay off). The problem with the whols system is that the market appears to have failed. You can't simply pay a little bit more to find an insurer who won't tell you, go ahead and die!
Without the risk of discrimination, increased genetic testing could be a boon to both consumers and insurers. The earlier we know about a condition, the less expensive and more effective it is to treat, with likely a higher quality of life. Genetic testing would allow us to better assess who to monitor to attain this early detection. Moreover, with increased knowledge of risk factor, a patient could choose lifestyle changes that are preventative. (Even cheaper for insurers and further improved quality of life for patients!)
Take skin cancer: if you know you lack a key tumor suppressor gene that makes you more sensitive to UV damage, you'll be much more likely to use sunscreen and avoid peak sunlight hours (lifestyle/preventative); you'll also know to keep closer tabs on your freckles and moles for melanoma (monitoring).
With a level, non-discriminatory playing field, both patients and insurers benefit from the knowledge, rather than just insurers who want to drop any patient they can. -- Paul
OpenSource.MathCancer.org: open source comp bio
So what happens if researchers find a "gay gene"? Couldn't a homosexual who was worried about discrimination run the test on themselves, then make sure thier prospective employer knew what the result was?
Of course, I don't know the wording of the law; this would only work if it was vague enough.
utter bullshit. insurance is a gamble, always has been. the house (insurance companies) are simply trying to load the dice.
If you mod me down, I will become more powerful than you can imagine....
Or, how about we take tax incentives out of health care and make everyone just pay for it outright? See the comment you replied to, for instance.
-- dieman - Scott Dier
Socialized health care denies or delays treatment if you smoke, are obese, forgot the cover on your TPS report. Do you really think that such a system wouldn't do the same thing given information on your likely future ailments? The difference between that and privatized health care is that at least with a private system the only barrier is money. In the socialized system, you've got no chance at all of not being screwed because of your genes.
I for one look forward to microscopic swarms of robots that feed on excess fat and repair any disease or illness. Not holding my breath though; in the meantime, I'll just pay for health care.
Klingon programs don't timeshare, they battle for supremacy.
Just remember, the 'P' in HIPA stands for Portability not Privacy or Protection.
-Rick
"Most people in the U.S. wouldn't know they live in a tyrannical state if it walked up and grabbed their junk." - MyFirs
There are days that I think that the government shouldn't allow insurance companies from refusing to insure anyone. I also think that the behind the scenes numbers of how the insurance companies actually determine their rates and such should be required to be released to the government and the public. (I also think insurance companies shouldn't have get out of jail free cards for "acts of god." What a scam that phrase is. Everything can be an act of god. It's an act of god that I pay taxes and insurance, you shouldn't be allowed to use that to get out of paying claims.)
I'm very mixed on DNA tests and insurance rates. The thing is that even if you are predisposed to everything then you should still be able to find affordable insurance. The insurance companies shouldn't be allowed to refuse to insure that person or use crippling rates to prevent them from having insurance that's what this is supposed to prevent. I doubt it will.
The key point is that 5-10% off that those use the DNA testing will get off on their rates will be just enough to drive most those that what to save a buck to ask their insurance companies about if it's an option. Later on, your cheaper rates may come back to haunt your kids or grand kids though.
Because when/if you do get cancer, you will likely choose to screw society over rather than die. The concept of "free choice" in health care is an illusion, because when it comes down to it nobody wants to suffer/die and nobody with a conscience wants to watch others suffer/die for their lack of foresight (or quite often, the lack of foresight/caring of the parent(s)).
Why would this mean anything for private insurance? They don't use genetic testing now.
And if we're talking about making new huge, intrusive government institutions, I would reccomend against a single-payer system. Controlling costs by preventing people from charging mrore just reduces the supply of available health care.
How about instead of calling it universal health care, we just call it wellfare. And how about instead of making all health-care government funded, we just use our well-fare system to provide healthcare to people who can't afford it. I don't think we need eliminate our freedom to access medical care.
If you really want to make health insurance "fair" all you need to do is pass a law saying that health insurance providers can't turn down applicants, and they have to charge everyone the same ammount for the same level coverage, regardless of any risk-factors. This wouldn't sink insurance companies, it would just raise insurance premiums and reduce the ammount of profit they could make.
Our overlords will maintain the illusion of middle-class heathcare without having to actually provide service.
Actual healthcare will be provided based on individual abilty to pay. Healthcare is not a right, it's a personal responsibility.
"The question is what do we allow? Discrimination against obese people, smokers, alcoholics?"
I don't see how it is a hop/skip/jump away from afflictions of -choice- (obesity is debatable, as that can have medical and heck, genetical, factors) to afflictions in which you, at least, had no particular choice. Perhaps your parents did (did your mom booze up during her pregnancy - d'oh?), but you yourself didn't get a whole lot of say in that and shouldn't become a victim of it.
Insurances already 'discriminate' against so many things. Didn't wear your seatbelt? There goes a good chunk of your payout, if not -all of it-. Over here in NL, smokers -do- pay a higher premium as well.. why not? Not only are they at a higher risk of cancer (insert "my grandfather smoked 3 packs a day and lived to be 94!" anecdotal evidence here), but they're putting everybody else at that higher risk as well (or, if nothing else, afflict those with asthma and generally stink up the place).
On the flip side - There's a life payout company in NL that gives a -higher- payout to smokers. Why? Because smokers do pay a higher premium, while they live less long. So they figure they should get a higher payout each month than non-smokers. Makes sense to me.
Your unjustified assumptions:
1) The disease in question is fatal
2) The fatality occurs at such a young age that it would generally be considered tragic
3) There would be no public or private entities dedicated to helping those people
In short, reliable genetic information could go a looong way to providing society with a better allocation of resources and we could still offer a safety net when we deem it appropriate. If government has a proper role, it's as a laser. When we use it as a sledgehammer, it inevitably causes large inefficiencies and net decrease in the overall standard of living.
The loop hole for insurance is that they drop coverage for things that can be uncovered with the tests. Then they make an add hock policy that allows you to add coverage for those things one at a time.
If they offer the same price to everyone, then they have not descriminated anyone. The end result is everyone would get a test and then only cover what they needed. The prices would be much higher
Im a gamer, not a grammer major. This post is full of spelling and grammer mistakes.
You can't discriminate on the basis of a wide range of pre-existing conditions already. You can't deny group coverage (or individual coverage, depending on the state/locality/plan) to someone who's black, someone who's Catholic, someone who's Hispanic. You can't deny coverage to someone all of whose female family members have contracted breast cancer at the age of 40, or to someone who drinks groundwater contaminated with mercury and arsenic, or to someone who has privately tested positive for Huntington's. You can't adjust a rate individually or deny someone group coverage based on those characteristics, despite the fact that you can know those characteristics, and many others, well in advance. (You could drop the entire group but that's a different thing.) You can deny someone individual coverage under a pre-existing conditions clause for some medical conditions, or require them to be qualified for a group; i.e., people over 65 only.
In some localities an employee is allowed - I believe - to deny an individual coverage in a group policy if it can be demonstrated conclusively that the person's coverage will affect the *employer's* ability to provide insurance. In other words, someone who would incur $1,000,000 in expenses over a year in a company of 20 employees could be denied coverage if it would endanger the coverage applied to the business at large.
Meanwhile, most states already do not allow discrimination based on genetic factors.
I have no idea why anyone thinks that officially banning discrimination based on genetic profiles is any kind of a big deal. Insurance companies of all kinds, not just health insurers, already have access to vast amounts of actuarial data that they can't use.
Death of health insurance, my ass.
Single payer in the US? Also my ass.
have a bill that keeps the government from telling me what I can and can not put in my body.
but, they aren't worried about people not getting jobs because of drugs use because we're still just a minority, even if drug users are a large minority. But genetics on the other hand, if you say someone can't have a job because they have a certain gene that could be disastrous for the workforce and horrible for the state as a result.
and as far as insurance goes, they'll find a way to get their money while doing something borderline fucked, hire a PR firm to make them look good, and the general population will forget in 5 minutes so they can get back to work.
Dream on dude.
The annual cost of health care in the US is currently about 2.25 trillion dollars per year.
The entire war in Iraq has cost something like $500 billion.
Increasing spending on health care in the US by 10% would certainly make a difference if the money was targeted appropriately. However, the cost will rise 10% all on its own in a couple of years anyway.
I don't think banning genetic-testing based discrimination is incompatible with private health insurance. The problem is that the health insurance is trying (pretty sucessfully,it seems) to distort the notion of insurance. The basic idea of insurance is that it's a shared risk pool; we all pay $AMOUNT for health insurance, and it spreads the risk over the size of the pool. Insurers know to quite a few decimal places how many individuals/million will suffer from any given condition and use that to determine pricing.(I know that's a simplified model and a very large employer can demand better pricing, but it's the basic idea.)
The problem is that the insurance companies are trying to game that system but figuring out *who* those individuals are who are more likely to get $CONDITION and either charge them more or refuse to insure them at all, while still charging the rest of us the same amount as if those at risk individuals were still in the pool and paying the same as the rest of us. THAT is the ripoff that needs to be stopped.
Unfortunately, having lived in single-payer insurance countries and compared the level of care to that which I get here in the U.S., I can't say that single-payer is the answer. I'm quite certain it's not. That makes this all a much more difficult problem,because I don't really know that the answer is, and I don't think the politicians know, either. One solution is to mandate that no risk testing of any kind is allowed, that no one may be refused insurance, not even for a pre-existing condition, and that all members of the pool (which may be no more narrowly defined than "all the employees of a given company that we insure") pay the say rate/person, regardless of conditions, medical history, or anything.
Would that work? Maybe. It's a lot like a single-payer system, but it keeps the government out of the process. That is good. If you think HMOs are bad, just wait until you try dealing with bureaucrats who control your insurance. An HMO has minimal incentive to do what you want. A bureaucracy has none whatsoever. Would we all pay more for insurance? Maybe. OTOH,if legislation also mandated that everyone be covered, even if some or all of the price of that coverage came from tax rolls to assist the poor, the expanded size of the risk pool would help to keep costs down.
If a person knows they have a condition they'll buy insurance to protect against it. But if the insurance company doesn't know the person has a condition, then they can't charge more for people with that condition and will instead have to charge more for everyone. People who know they don't have the condition will not see the insurance as a value, and will choose not to buy the insurance. Therefore the only people who buy insurance are the ones who have the condition.
Insurance works on pooled risk - some people make claims, others don't. If everyone makes a claim, then it's no longer insurance. And this is what we're moving away from - insurance for health care - to a health "service".
A "protection racket" is bad because it's "selling" protection from itself.
Insurance companies, as flawed as they may be, are providing protection from a very real threat.
"And if I choose NOT to pay the government for this program, I can be held against my will and/or deported at gun point."
you're funny.
Anyway - yes, elderly, even those with fatal diseases, still get expensive treatment. My grandfather got cancer treatment right up to his death in the middle 80's. My grandmother got a new hip at 96 (she's now 101 - go granny), even though she's not really all that mobile to begin with (has to get around with a walker on wheels - vroom). If she -wanted- to, she could get an electric wheelchair - no cost. For some extra, she can get a 'scootmobiel'. It's like a trike, but less sporty, and has a compartment for groceries.
So no, they don't get told "no".
On the other hand, they do get told their realistic options. My grandfather was told that he would likely not recover; which was true enough; and he chose to get the treatments anyway and died a withered old man who was really not my grandfather anymore. His choice, but there are plenty who choose not to get the treatments.
In addition, in Socialist The Netherlands, a good portion will choose the exact opposite: euthanasia - legally.
For what it's worth - I haven't made an insurance claim since in well over 15 years, yet I pay a high premium every year. Do I feel this is 'unfair'? No. If it means some kid from a poor family getting hit by an uninsured driver can still get his leg fixed, then I -gladly- pay my premium.
( Note that the Dutch insurance system changed a year or two ago and less goes through the government now, and more through the insurance companies; with a minimum level of insurance from each insurance company for the same price we used to pay the government in our taxes. Of course most insurance companies don't really offer that minimum, luring people with supposed extras, and thus we all actually end up paying more while actually getting much the same coverage. Huh. )
No more discrimination against the people who might have leukemia!
And as for the homosexuals... oh well. Go ahead and fire someone for being bisexual in America, it's not illegal everywhere yet!
Random Thoughts From A Diseased Mind (Not For Dummies)
Why should people with genetic predisposition to health problems be entitled to affordable insurance? Let them die, and get those inferior genes out of the gene pool. Darwinism at work.
Better yet: Perform mandatory genetic testing at birth, and if they have problems, kill them. Then insurance companies won't have to worry about them.
> Instead, modern medical insurance has degenerated into a sort of payment plan for routine medical expenses.
Exactly. What we call 'insurance' in the medical world is more like a maintaince agreement or extended warranty anywhere else.
Your homeowner's policy doesn't pay every home repair AND routine maintaince expense. Your auto policy, even 'comprehensive' coverage, only covers accidents and serious unexpected damage. Extended warranties for cars are a routine thing these days but nobody confuses it with insurance.
This sort of blurring of terms is dangerous because we are on the brink of doing something really stupid, nationalizing the entire medical industry. As if the outright socialism of it doesn't scare ya, or the drop in quality that has occurred EVERY time it has been tried around the world doesn't disuade you from supporting this BS then I got one last argument.
Look at the latest (but totally predictable) development in countries that have gone this way. Because they pay for your poor decisions they are claiming the power to totally control your life. Diet police ascendent. In AU they are actually sitting around and talking like civilized people (when they are nothing but, as this is pure fascism) about mandatory assessment of everyone and taxing people differently based on their results as a way to enforce norms of behaviour less stressful on their overloaded nationalized health system. Britain is talking about denying people access to medical care if their BMI exceeds government limits, they smoke, etc.
And the sick part is it actually makes perfect sense if one accepts the premise. If the government is responsible for your care then they should be able to tell you how you can live. The downside of being a 'dependent' is that you aren't Free.
Given a choice I'd rather live a short life as a Free man than a long healthy one as a slave but the whole idea is that Democrats want to make the decision for me at gunpoint. There won't BE any opt out, accepting payment for medical services outside of Hillarycare will be a felony. They already TRIED it in Canada, thankfully a few judges weren't quite ready to go there yet. Yet.
Democrat delenda est
"Gattaca! Gattaca! Gattaca! Gattaca!"
I can see how that might be a slight (attitude?) adjustment to make WRT your thinking about why insurance companies exist, but why is that "what is wrong with the system today"?
Is the system offended by our considering it a necessary evil? Are you?
Or is it the thought of people actually using their insurance's worth that offends you?
Actually, I'm fairly convinced the reason the insurance industry exists is not the one you mention, but actually one that will sound quite a bit more callous: Insurance (companies) exist(s) because countries don't function very well if too large a part of the population (that does all the grunt work) continually dies off too soon after having been spent money on (through education) for that investment to be recouped, and for the economy as a whole to keep running at the current pace (whatever that is), thus making the country a 'richer' place for everyone to live in.
Now, while i'm sure i've just offended every Libertarian out there, let me just say that i also do not believe the insurance company is there to make money for its executives/whoever gets the cream off every year's profits.
There, that should take care of the no-rules-necessary capitalists who weren't also Libertarians, and who hadn't already been woken up to the necessity of at least modest regulation after the sub-prime spanking.
Anyway, the point the article makes (especially in the summary) is utterly silly. insurance worked before, and (as others who were annoyed by the fact that someone where was still feeling young and invincible pointed out) accidents happen often enough for insurance to be useful to have even for those who don't have "genetic predispositions"
I'm in favor of that if it weren't for shitty manifestations of something called "Murphy's Law" which states that shit happens, *even if it's not your fault*
Should I be forced to pay for my own medical bills if some asshole runs me over and runs off to mexico?
Bull shit.
That's just plain wrong, and is a perfect example of "innocent bystander" that merits a community effort.
What do I not understand here? We buy insurance because we are uncertain about our future prospects, so we can't prepare for them. Insurance is providing a useful service, what's evil about that? Anyway, if testing is going to remove some or most of that uncertainty, we don't need insurance. Those who now now they are unlikely to get those diseases can now save the money to put toward their family, charity, etc. Those that now know that they are likely to have a disease, can adjust. They may choose to plan for these costs and save more, or they may plan to spend the money and enjoy what ever time they have. Why should the government come in and remove these choices from people. Why should you be forced to pay for your future healthcare costs if you don't want to. Or why should you be forced to pay for someone else. We should be allowed to choose. It's called freedom!
ANY age is tragic when YOU are the one doing the dying.
.. The fatality occurs at such a young age that it would generally be considered tragic"
"Your unjustified assumption
It's this type of asinine thinking that would lead a government controlled health insurance program from authorizing the treatment of a disease if you were over a certain age.
-- Terry
Source of costs of medical care is not insurance?
"Instead of arguing on how to split the outrageous costs, we should actually focus on fixing the problems leading to the high prices in the first place."
You mean, like malpractice insurance for doctors and hospitals, and liability insurance for drug companies, hospitals, and device manufacturers?
So the problem isn't actually the cost of insurance, it's the cost of insurance.
Or am I missing something obvious here?
-- Terry
If I'm not mistaken, the limitations of this bill are easily mitigated by insurance companies by simply saying: "Hey, sign this release so we can see a copy of your genetic tests and we'll knock 50% off the list price for your premiums!" While charging exorbitantly high fees for non-signers... Or are there protections in place for this kind of game playing?
I didn't read the text of the law (not that I would get much out of it anyway) so perhaps someone with more complete knowledge can correct me if I'm wrong...
Would it actually be possible for consumers to 'game the system' if insurers weren't allowed to use testing?
/if/ testing exists, insurance-visibility doesn't affect gamability that much.)
I mean, in the short term, sure, I can see a surge of consumers (who, via private testing, know they're at higher risk) getting risk-appropriate insurance which (via a lack of test information) is offered at a lower-than-appropriate (appropriate to the relevant risks) rate... but after a few decades of accumulating data, wouldn't the basic metrics change? Wouldn't the insurance companies essentially be able to see "While the risk for disease X is 5% in the population, the risk for the same disease among those who buy our disease X insurance is 70%, so we will price our disease-X insurance with the expectation we'll have to pay out for 70% of our clients, rather than 5%"?
It just seems like, in the long run, the lack of testing for insurance companies would make no significant difference. In the short run, the system could be gamed, and whenever a new disease cropped up, insurance for that particular disease could be gamed (if 'highly overpriced insurance' didn't become the norm for new things), but in the long run you'd get about the same results from second-hand testing (see who applied for your policy because they got a positive private test) as from doing first-hand testing.
Granted, I don't like the idea of such data being a standard part of my medical history... I'm not advocating that insurance companies should get to do testing... I'm just not convinced that (in the long run) the situation would look that much different with and without insurance-testing. (I certainly admit, though, that the situation where testing exists at all is different from when testing doesn't exist... just that
Discriminating against chosen conditions is a good thing, as it provides disincentives to smoking and becoming obese. Age is another matter, but does it really make sense to spend a million dollars on a heart transplant for someone who's 75 and going to die in 5 years, at the expense of curing someone who'll get a lot more time out of it?
The real danger of nationalizing health care in the US is that the courts will infer that health care is a basic right, and then such commonsense rationing decisions will *NOT* be made (because they'll be illegal). If health care is not rationed in some way (either by the market, allocating it to those who can pay, or by the government, choosing who lives and dies), the cost will be essentially infinite, as will the taxes required to pay for it.
This won't mean the end of the insurance industry, but it will mean even higher insurance premiums, as the insurance companies pass their higher costs along to the customer.
I see. So if you can't extract the payment from the actual culprit, through a lawsuit or somesuch, everyone should be forced to contribute a little to your health care. If responsibility can't be applied properly, just spread it around to the completely innocent bystanders known as taxpayers.
Liberty in your lifetime
>> medical care is a fundamental necessity
> Food is a fundamental necessity.
Actually, humans survived for millenia without medical care. They rarely survive more than a few weeks without food.
Arguably, medical care isn't a fundamental necessity. Of huge value if you'd like to live comfortably for longer and have greater odds of surviving to maturity... but not actually a necessity for the species.
The problem is we mistake medical care for being a fundamental necessity. Then, when idiots choose to make payments on a bigger car or TV, instead of their health insurance, we wring our hands and give a damn when the consequences of "I'd rather have more money now and accept the increased likelihood of suffering or dying later." come back and bite them. Instead, "Wow? You made a really dumb choice, didn't you. Hope the TV was worth it." becomes "Oh, that's tragic. Look how the system failed to provide you with your basic necessity. We must do something!"
Medical care isn't a fundamental necessity - just damn nice to have and pretty sensible. If people would own their own dumb choices, it wouldn't be such an issue. Instead, we're in a society where we make stupid short term choices then whine about how unfair it is when the consequences hurt us, expecting others to help mitigate our stupidity.
If genetic predisposition is predictive enough to kill health insurance, it would be fantastic. I;ve been trying to tell people for years that the problem with the health care system IS the insurance companies. You can follow the history quite clearly, as health insurance has become more am more prevalent, prices have risen. Unfortunately Big Insurance has a strong hold over government and media, and has everyone dancing to the same piper --i.e. mandate insurance and prices will drop. But it's a LIE! And they know it. The reason is b/c health insurance isn't insurance. Insurance is only effective for rare/emergency events. But health insurance covers every actively of health care and therefore is just payment scheme.
The only GOOD SOLUTION is to outlaw private health insurance, have the government provide life-and-limb coverage to all, and have charities shore up preventive care for the poor. This would remove the middle man and provide the best care per dollar spent.
:T:R:A:N:S:
One elegant way around is to require people who make genetic tests to report that a person has underwent a genetic test (without revealing the result). That way, someone may prove his insurer that he his unaware of his own risk and he is insurable. Once you're insured you can then take the test to make prevention. Another way is to require people to be insured to take a genetic test. However I believe it is morally unacceptable to require that (albeit much better than a compulsory socialist insurance scheme).
\u262D = \u5350
Insurance is a gambling game. The companies go around playing chicken biding lower and lower prices to a pool of individuals. The risky ones get burned and the smart ones like Buffet make a mint. Genetic testing will actualy make the market more competive. Given a group of individuals they can more closely tell what their actual risk is, allowing them to price policies more effectively. The problem will be in who can lock in the healthy people via marketing. Insurance companies will fight firecely to get individuals from healthier areas and demographics (18-40).
bash-2.04$
bash-2.04$yes "Don't you hate dialup connections?"| write USERNAME
Because insurance companies manage their rates based on trackable probabilities and their claims history.
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Maybe I'm off base here, but could this be a good thing? What if, just maybe, you happened to be blessed with a better than average set of genes? Might you negotiate a better rate? OR, for that matter, if you're just average? It seems that everyone's afraid of the dark, dirty secrets that your DNA holds, but it would seem to me that we all have certain risks, and for the most part we're all average.
Already your insurance rates (health, auto, whatever) are adjusted based on what they know about you- do you live in a bad neighborhood, do you have a lot of speeding tickets, do you smoke... to me this seems to be just more info.
I think more info is a good thing- I *want* to know. If testing shows that I have an increased risk of colon cancer, I'll get that checked more often. Or maybe things that I never would have been worried about and never would have checked, the knowledge might allow me to make some changes.
I'm afraid this is probably an unpopular thing to say- but equality is a fantasy. We're all very different and unequal. I don't think you can make us all physically equal via legislation.
Me, I seem to be blessed with good health. I take fairly good care of myself. I'd like to take more of my paycheck home, actually benefit from the effort I make to keep myself healthy. The guy in the cubicle next to me, that's overweight, chain smokes at lunch, drinks to much on the weekend, and uses a lot more sick days than I do... I'm not interested in subsidizing him.
And I think overweight people should pay more for seat on the airplane, I don't enjoy paying for a seat and having to share it with some stranger who's rolls of fat hang over the armrest into my space!
(Ok, I'm sure I've pissed a lot of folks off by now... I almost don't want to see the responses...)
Basically- what's really unfair about someone having to pay more for insurance if they're actually a poorer risk?
In the U.S. HIPPA made pregnancy an illegal preexisting condition. I think we should take it one step further and make them all illegal. Nobody should have to stay with a job to which they are poorly suited just because they have something that is considered a "preexisting condition" and would be used to deny new health insurance.
We don't have to go single payer (though I think that wouldn't be a bad thing to consider), but we can do a heck of a lot better at improving the mess of a system we have now.
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Insurance companies charge me higher rates based on my Y chromosome and its supposed predictive effects on my behavior. This is a far weaker link than other types of genes-to-outcomes linking.
Don't trust anyone under thirty.
"You mean, like malpractice insurance for doctors and hospitals, and liability insurance for drug companies, hospitals, and device manufacturers?"
How about salaries? Why do doctors need so much education to diagnose most problems? Do you really need all that staff just to take BP readings and chart notes?
Distribution of costs. My employer pays into Worker's Compensation so if I get hurt at work, my medical bills are covered. But if the state denies my claim, guess who gets billed? My insurance company.
Profits. Private companies need to make profits.
Free care. Hospitals have to subsidize coverage for the uninsured.
Waste. Does every bloody specialist need to take their own set of X-rays? Do you really need that MRI or expensive test? Or that brand name med?
Costs of insurance is low on the list, at least for most doctors.
Please explain. I, for example, have health insurance through my place of employment. If I quit this job, are you saying I'd still somehow have health insurance? How does that work?
COBRA Insurance allows some to continue their insurance between jobs.
FalconShould there be a Law?
Most people don't subscribe to the minimalist libertarian view that the government is only there to run the courts and defend the borders: they believe that government can, and in many cases should, also be a parallel system to accomplish things that the market can't or won't accomplish on its own.
That's easy to handle, amend the Constitution. Not one proposal I've heard of mentions that anywhere.
If We The People believe that everyone deserves medical care, whether they can afford it or not, well, the market sure isn't going to make that happen on its own, is it?
A free market very well could provide people with health care and insurance, however there is no free market in health care or insurance in the US.
People often just want something for nothing.
I'm sure they often do, but this isn't one of those cases. Everyone realizes that health care costs money, whether that money is funneled through private insurers or government agencies.
If people care so much about health care then why do so many eat junk food? Why are so many obese? Why are there so many diabetics?
FalconShould there be a Law?
So, if the insurance companies are allowed to dicsriminate based on genes they will exclude the weakest, who will then lose out, and they aren't, those with bad genes will abuse the system, and the insurance companies will lose profit. There are two things to say about this:
1. Universal, public healthcare will remove the problem - no one will lose out because of their genes, and no one will lose profit, because the system isn't geared towards profit anyway.
2. Insurance companies are businesses and are supposed to be clever enough to do business the given reality. If they aren't, they have no right to exist as businesses.
In most European countries this is much less of a dilemma - the public healthcare takes care of everybody, and private healthcare is simply a luxury option that gives you faster access to non-emergency treatments etc.
"How about salaries? Why do doctors need so much education to diagnose most problems?"
A lot of Education != Higher Salary; this is the big lie. As someone who is familiar with the collections business, the only people harder to collect from than doctors is dentists. Doctors tend to live ostentatiously - at or above their means - because that's expected of them. Your average GP does NOT make that much money.
"Do you really need all that staff just to take BP readings and chart notes?"
How much do you make an hour? Do you do your own laundry? The hour you spend doing laundry is worth however much you make an hour to pay someone else to do it instead. Doctors cost more per hour than support staff, so I'm pretty happy to have the doctor looking at patients rather than taking the BP and weighing people and getting an initial history and description of the complaint. Just like I'm happy to pay the people in the HR department do engineers don't waste valuable company time interviewing the idiots that HR weeds out before they get that far.
"Distribution of costs. My employer pays into Worker's Compensation so if I get hurt at work, my medical bills are covered. But if the state denies my claim, guess who gets billed? My insurance company."
Worker's Comp is a state-run insurance company for specific types of medical care and disability. So now you are complaining, once again, that the problem isn't insurance costs, it's insurance costs.
"Profits. Private companies need to make profits."
No. The IRS and the Department of State for your state only requires that they "be in business with the intent to make a profit". They only have to net $1 in profit to qualify for that. How do you think we regulate public utilities and rights-of-way for railroads, both of which are run by private companies, but using public resources to implement their services?
"Free care. Hospitals have to subsidize coverage for the uninsured."
Emergency rooms have to treat people when they show up IFF they get state or federal funding. If not, then the typical response is "stabilize them, then turf then to County". County hospitals (state run facilities, paid for by taxes) take the brunt of subsidized/state paid urgent and emergency care, but they do so out of your taxes.
"Waste. Does every bloody specialist need to take their own set of X-rays?"
It depends on what they are looking for. Sometimes, yes. Different exposure levels reveal different information. X-Rays are relatively cheap; it's the liability assumed by the X-Ray technician and the radiologist and the hospital that are what cost you.
"Do you really need that MRI or expensive test?"
Depends on your complaint. MRIs, again are relatively cheap to do in theory, but not so in practice. I worked on the console software for a G.E. Medical Systems MRI back in the late 1980's. The development costs were about 3 times higher than for a similar system not intended to qualify as a "life support system", but the biggest billable expense was the annuity to pay the liability insurance, in case we screwed up and someone died because of it. Same with a blood gas monitor I worked on, and the same for a blood oxygen sensor.
"Or that brand name med?"
Now you are complaining about the patent system and the fact that the 60+5 of the cost of any pharmeceutical goes to marketing. This is Slashdot, I think we can all agree both need reform. However, the answer in most cases is "yes", if your doctor thinks you need it, having MedCo or some other managed care company substitute your allergy medication for a generic that contains the very allergen that the medication was being prescribed to deal with in the first place is pretty stupid.
"Costs of insurance is low on the list, at least for most doctors."
The thing you are missing is that you are paying for medical inssurance, which is paying your doctor, who then turns around and buys equipment from a manufacturer that's paying liability
"Quality of care does not "always" decrease from socialization... in fact, it appears that the exact opposite occurs in most cases."
It looks to me as if on "average" health care will be better for for many people, but it will be significantly worse for people who need drugs or treatment the "system" determines is too costly.
Such a system is essentially asking many (if not most) people who already have health care to have slightly worse coverage so that society as a whole has "better" health care. You cannot make everyone's health care better with such a system. Just do the math.
You can imagine that those of us who already have very good private coverage supplied by our employers would be opposed to such a plan.
(Also, while the NHS isn't perfect, I'll take it over the US "sorry, you don't have any insurance, come back on Thursday for the free clinic and pray you don't need surgery" crap any day of the week).
Been there, done that. Go to a hospital without insurance that is. Without any means of paying my medical bills, which came to more than $120,000, I was admitted to a hospital and treated. In the US.
FalconShould there be a Law?
If nationalising food production cut the costs in half, I'd have no problem with it. Especially if millions of people had little or no access to food, the leading cause of bankrupties were food costs, and food companies could deny selling to people who were starving.
Of course Americans are in no danger of starvation so this is probably a poor analogy.
Actually food is a poor choice as an analogy because the government already gives farmers and agribusinesses billions of dollars of taxpayer money already. "House, Senate pass one-week farm bill extension".
Actually if the government didn't take so much money from tax payers they may be able to afford health insurance on their own.
FalconShould there be a Law?
If everyone only picks up their own garbage, eventually the ground will be covered in garbage, because everyone will drop something eventually, and not knowing it's theirs, they won't pick it up, and neither can anyone else. Imagine that principle carried over into all aspects of society.
Hey, that already happens. A few days ago I walked around picking up trash passersby threw down in the yard, including broken glass.
FalconShould there be a Law?
And if a food emergency hit, yes, nationalizing the food supply might be the best option.
They tried that in the Soviet Union and they could get the crop yields high enough.
If you want the government to issue patents on drugs,
I don't want patents on drugs, especially drugs created with taxpayer money.
FalconShould there be a Law?
According to Wikipedia, "The entire human genome occupies a total of just over 3 billion DNA base pairs, and has a data size of approximately 750 Megabytes[2], which is slightly larger than the capacity of a standard Compact Disc." Don't put it on a CD when it's mapped! DMCA pwns all the numbers!
The solution is to sell health insurance like homeowners insurance. If you live in a flood zone, you'd better have flood insurance. Similarly, if you have a predisposition to heart disease, you should have to by heart disease insurance or you get no coverage for it.
My rights don't end where your feelings begin.
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You think we need a Constitutional amendment for health care?
For it to be constitutional yes the constitution would have to be amended.
every other social program, including Medicare, gets along just fine without one.
And they are not constitutional.
I don't know if you've noticed, but there are over 300 million people in this country. They don't all say or do the same things.
Nor do they all want socialized medicine.
FalconShould there be a Law?
But if a doctor doesn't treat you, you DIE. You don't get a chance to try to recover. You DIE. The closest analogy I have ever heard to medical insurance in the USA is "protection money". Instead of paying to avoid having a thug blow off your kneecaps, you're paying to avoid dying sooner.
By the same logic, if you don't have it you die, food should be nationalized. Try to national food though and watch productivity fall.
FalconShould there be a Law?
I have changed from one position to the other on the question of universal health care. First let me say; I am in favor of doctors being paid fairly for their talents. Compensation should be based upon your abilities. I am not in favor of hospitals that do a wallet biopsy before providing treatment (sometimes, lifesaving emergency medicine in the ER). Insurance companies play the lottery with coverage. They pick and choose policy holders to maximize their profits (if you are never sick, never file a claim, they love you). Unfortunately there is not much choice with health care coverage. For the most part, this is provided through employers and they are watching their spending as much as the insurance companies. The quality of health care that is covered by insurance is in decline. Look at the declining life expectancy statistics that were recently announced. If I have to pay $250 a month for medical/dental/vision to an insurance carrier that is more concerned with their profit margin than my health I would rather put that money into universal care. That way, if I am sick or with a chronic condition I know that I will always be covered. It has been said that the economy is driven by consumer confidence. Flip this over, how confident are you that an insurance carrier will stay with you, even when your health takes a major downturn.
Tisha Hayes
A majority of doctors, too.
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Good luck convincing the courts of that. (And remember, the Constitution says that it's the Supreme Court who has the authority to decide such issues.)
True - money represents one person's share in a set of limited resources. For example, it's impossible for everyone to be rich enough to own lots of land, because there is limited land available.
On the other hand, some resources have become much less scarce - food, for example. It's very difficult to be poor enough in America that you can't afford to eat anything (though you might not eat well). In that sense, everyone IS rich here, compared to other places and times.
I think it's possible to imagine a future where everyone has things that only rich people have today, with the exception of resources that are inherently limited. (And though it can eliminate a lot of misery, money still won't buy happiness.)
Well... in Holland we've got general insurance (covers stuff that REALLY needs to be covered: all life-threatening stuff, things like diabetes + regular doctor checkups). Everybody is legally obliged to be insured, which works out okay here. Costs about $130 per month by the way.
In addition it is possible to apply for extra insurance, like a dental care package or therapy package. Insurers are allowed to do checkups on people applying for extra insurance (so someone with really bad teeth could in theory be rejected for the dental package).
There also is quite some (healthy!) competition between various health insurers here... and trying to lower costs, insurers are testing all kinds of preventative measures for all kinds of diseases. Some even give you a free access pass to a local sports club if you're obese...
Anyway, making health care obligatory will help a lot in the US: there are a lot of healthy people, some of which will eventually get sick and need lots of money for treatment. The more people, the lower the cost...
A very wise slashdot poster (your name escapes me, sorry) once made a post which really resonated with me because I'd never thought of it before.
Discrimination against 'the ugly' - it's something many of us do without even thinking about it, the disfigured, the disabled, the elderly, the ugly - all these people, you can visually pick the quality of their genes quite quickly with your own inbuilt instinct, no machines required.
Check out the service an ugly person with a lisp gets, no matter how polite at random stores?
Look at when famous hot people are put inside a fat suit for the day and try to deal with everyday society.
We don't need discrimination laws against people for their genes, as long as they aren't visually appealing 'enough' our instinct tells us it's not worth talking to them (to an extent)
It's terrible stuff, it's also life but it's terrible, there will always be hotter, younger people than you or I and if we're lucky there will always be uglier too - but one day if fiddling with DNA is allowed enough - you may find even average looking people are in the minority.
Who knows where we're going but overall, things don't look good from where I'm sitting.
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Have you read the Universal Declaration of Human Rights? Adopted by all UN members way back in 1948. You might check in there for verification of healthcare as a basic human right.
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Really? Your point?
When I can VOTE for members of the UN...then get back to me.
Till then, the UN is just a bunch of unelected critters, answerable to no one with free parking in Manhattan.
Unless there's a genetic predisposition for auto accidents, do what the insurance companies already do and charge more for coverage for people that have a lot of auto accidents. Let the free markets handle it.
Also, just because you have the genetic markers for a disease, it doesn't mean you'll get the disease. Besides, the actuarial tables are pretty darn spot on when it comes to figuring out how many people are likely to get a disease in the first place. This just focuses the numbers better.
On the other hand, if you have no genetic markers for a disease, you can then opt to not have any coverage at all, saving you a ton of money.
Not that any of this matters, because global warming is going to turn us all into cannibals and we're all going to die anyway. Now, if only it'd get to warming... I'm getting tired of scraping ice off my windshield in the middle of spring.
Gonzo
"I'm going to live forever... or die trying!"
High medical costs come from companies spending millions of dollars to make sure a product is 99.9% perfect, then they spend even more to cover their ass if by some reason the
Ultimately it comes back to the patients. If you want an amazingly high level of medical care, you're going to have to pay for it.
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Well, my thoughts would be that it's because neither the customers nor the insurance agency would have enough knowledge to discriminate.
However, let's say that customers can get themselves tested to see their predispositions, and find that they're about 90% predisposed to having a certain (expensive ailment). With that knowledge, they follow the odds, and go out to purchase pricey healthcare. The healthcare company can't deny them based on the same knowledge, so the playing field is a bit uneven.
Of course, saying that this will destroy private insurance is just hyperbole. Chances are the most people aren't going to bother getting genetically tested for predisposition to such health issues. Moreover, plenty of people already know their if they have a "family history" of things such as cancer, heart attacks, or other such things, so it's not really going to change the status quo that much.
So genetic testing might change things a bit, but (at least IMHO), not *that* much, or at least not anytime soon.
The only exception being retired people on government sponsored healthcare (which I know is the focus of the article), but if we're talking a 40 year old death and a 50 year old death, don't forget the 50 year old likely contributed 10 more years worth of income into the system. In fact, I wouldn't be surprised if seniors with healthier habits retire later and/or make more money throughout their lifetimes. I'd love to see a study of that.
Charisma is the measure of someone's ability to lie with a straight face.
If you have any other readily apparently congenital condition, you cannot get private insurance, or such insurance would be written to exclude anything related to the condition. The scenario is exactly as the submitter describes. So, this dystopian world would not be anything new. Just an extension of the current policy.
So, the story suggests that private insurance may be incompatible with genetic testing. Presuming that genetic testing really does give us all that it promises in the way of predictability, perhaps this is a solution: We could require insurance to be purchased prior to any genetic test. That means if parents want to genetically test their unborn child, they need insurance coverage for the child. An adult going in for testing would have to already have insurance. And then we forbid the insurance company from dropping coverage as a result of the test. Now the insurance company has to make its decision about who to cover without the GT info.
I've never understood this "universal national socialized insurance" thing. I thought this was about going to a doctor.
I'll admit I didn't grow up in the United States, but isn't medical care, going to a doctor, dentist, whatever, just another good or service?
When did a good or a service become a "right" that one has, to the extent that you have the government stick a gun in someone else's face and a hand in their pocket to force them to pay for it?
If I can't be forced at gunpoint to take a stranger to dinner and pay for it (food being a clear and present biological requirement for life), why am I forced at gunpoint to pay for someone to see a doctor (medical care being a series of theories, guesses, best practices, empirical research, and pharmacology)?
I don't understand this adherence to propoganda that everyone is talking about. If the "issue" is about medical care (which seems to be just a "class warfare" discussion from what I've observed ("THEY" pay for a good or service so "THEY" are rich/evil and the "OTHERS" don't pay for the good or service so the "OTHERS" are victims of "THEY") then WHY are you discussing insurance? Is someone going to be lying on the floor bleeding and desperately clutching an insurance contract?
I'm don't understand why people would want an insurance company (or the goverment) making the medical decisions instead of the patient and the doctor. An insurance company's primary goal is to make as much profit as possible, by paying out less in claims that in takes in from premiums. The government's primary goal is to control you as much as possible and separate you from your money. Can someone explain to me exactly WHY you want either of these organizations to control your healthcare?
At one point I remember hearing about nationalized / socialized health care from politicians. Then the language changed so the argument was about health insurance. Doesn't anyone find that a little strange? I hear all these moral and ethical stories about "helping the poor" and "so and so was turned away from the hospital because she couldn't pay" and such. Yet with such moral outrage and despair, the solution is an insurance contract? I'd think with such a horrible fate for citizens that it would be easy to set up a program like:
Immediately offer low interest student loans to encourage students to go into medicine. The loan paid in full by the government following the successful completion of the 5 year low salary (by doctor standards) employment contract in a licensed clinic/hospital, subject to oversite and auditing by the Health Department.
Anyone can go to a clinic at any time for any reason. They MUST pay an inflation adjusted $50 payment, regardless of what services they are using, or what their means are. The payment is used to offset equipment costs, doctors salaries, payback of student loans, administration, etc. This payment is tax deductible.
Local/municipal government may pass local laws determining how they wish to handle those who can't pay, those who won't pay, homeless, etc. These issues must always be controlled at the local level, not the national level. Someone in Macon, GA shouldn't have to be taxed to handle problems in Nome, AK. Local government can decide who to handle those who may require payment plans, debt forgiveness, etc.
No law will affect those who wish to contract private doctors for services, whether using cash or insurance. These payments for insurance premiums or medical fees are also tax deductible.
If healthcare is such a crisis then it affects everyone equally. We should be making it as easy and available as it can be without restricting people's access to it through government social experiments.
I'm a satanic clam.
Only to someone who hasn't yet come to terms with the fact that we shall all die eventually.
I want to be around long enough to spend some time with my future grandkids, do certain things, and see certain places. Any time I get beyond that is a bonus and my funeral will be celebration of a well-lived life. You're in for a disappoint if you expect any more than that.
I'm not a doctor. But that's sort of a point -- parents who aren't doctors don't really KNOW if the earache is something that will pass or something that is indicative of a serious infection, and at 1am when there are no experts to actively consult they're faced with the choice of either waiting to see if it will pass or taking the kid to get help. Guess what? Sometimes parents aren't willing to risk waiting to see if it will pass.
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I hate to break it to you, but the courts have ruled otherwise
Yea, and the courts have also ruled the feds can prosecute Californians for medical marijuana, even though it has nothing to do with interstate commerce, it was the interstate commerce clause that the feds used as justification.
Again, I hate to be the bearer of bad news, but a majority of Americans say the federal government should guarantee health insurance to every American, especially children, and are willing to pay higher taxes to do it.
One, that's not everyone, as you pointed out when you said "I don't know if you've noticed, but there are over 300 million people in this country. They don't all say or do the same things." Secondly most people don't know there is not a free market in health insurance, I bet if everyone knew this more would support it. Also, as I stated earlier I have been denied insurance, yet I still advocate a free market and oppose socialized medicine.
FalconShould there be a Law?
From all the "In Canada you have to wait months" stories one reads here on /. one would deduce that the Canadians are in a serious risk of extintion...
The Canuck is a hardy species.
FalconShould there be a Law?
Because it forces some to pay for the bad choices others make. Because it drives up prices. If you think health care is expensive, wait until it's free. When people have to pay out of pocket they are more willing to reduces risks whereas those who don't pay out of pocket don't have the awareness of the costs of health care.
If you look at what France or Germany or Australia or the Scandinavian countries have as a "socialized" health care system, it's dramatically better.
Oh, and by the way - they all have better health care outcomes and healthier populations that the USA.
France is recognized as having one of the best national health care system in the world. Yet a man diagnosed with cancer in France has a lower 5 year survival change than a man in the US does according to a special report done by CNN's Dr. Sanjay Gupta.
but you're (presumably) not bothered about other socialized things like roads and firefighters and police
Roads are specifically mentioned in the Constitution of the USA. However most roads are local not national. Local roads can be paid for with a tax on fuel, you drive you pay out of pocket whereas if you don't drive you don't pay out of pocket. State and national roads can be paid for the same way, via a tax on fuel. Firefighter and police, which are mainly local, budgets can and should come out of property tax.
and the military?
I've said a bunch of tymes I'd rather have the military downsized, rightsized. There should be a small professional core then have all citizens between say 18 and 55 in the citizens' militia.
2) How can you ethically justify having people die because they can't afford treatment?
A free market in health care and insurance, which the US does not have, will reduce the costs of health care and therefore insurance. Then with the money saved people can freely help those who need help. I'd voluntarily help the person who had a string of bad luck and therefore can't afford medical care. But I'd hate to be forced to pay for the medical treatment of someone who's too lazy to work, eats 5 tymes a week at McDonald's, and smokes 3 packs of cigarettes a day.
FalconShould there be a Law?
If responsibility can't be applied properly, just spread it around to the completely innocent bystanders known as taxpayers.
Yes. That's one of the functions of government. I can't opt out of school taxes because I have no children and no plans for any. I can't opt out of military spending because I believe that a well regulated militia is more important than a standing army with delusions of grandeur. And having an educated workforce is a national need such that it's required everyone contribute, so making sure the workforce is also healthy is right along the same lines. Part of the use of governments, since the begining of governments, is to create some plan for those that are in need.
Learn to love Alaska
Your municipal tap water is "socialized", but it works pretty well, I think.
Not nearly as well as after the water's gone through the products of a capitalistic filter company, it doesn't.
Except when Atlanta privatized it's water the water quality dramatically decreased. The city issued water alerts frequently. Personally I have a 5 gallon bottle I fill with filtered water at my coop.
more liberal states like California or New York could pass a universal health care law without the massive fighting that's necessary to push something like that through at a federal level.
Massachusetts is trying this. It even fines people for not having insurance. The unfortunate thing is that not everyone can afford health insurance and by not buying any they risk being fined.
FalconShould there be a Law?
Visual IRC: Fast. Powerful. Free.
Without genetic discrimination, how would we decide who to hire? If we decide based on intelligence, thats genetic discrimination.
If intelligence is a gene, this law will force us to hire the stupid people even if they aren't qualified simply because it's genetic discrimination if we don't.
So how are we going to discriminate at all if not genetically? Every human trait is a gene, so if we hire people we think may be loyal and we later find there is a loyalty gene, that is genetic discrimination.
If we hire someone who might be more naturally talented or creative, the person who isn't talented or creative could claim they are being genetically discriminated against if we find that natural talents and creativity have a genetic basis.
Can anyone refute these arguments? If personality traits have a genetic basis, and employees currently use personality tests to decide who to hire, is it genetic discrimination to refuse to hire someone who does not have the right genes for the job, whatever that job is?
I think this is a crappy law.
Wake up US - you're in a bad situation, and the rest of the world is amazed that you can't understand this.
Yea, the US is so bad we have 12 to 20 million "illegal aliens" on the country and many more risking their lives trying to get in every day. If the US is so bad why are they doing this?
FalconShould there be a Law?
Intelligence, natural talent, personality traits, all that now has to be ignored when deciding whom to hire. What if I only want to hire people with a certain personality type, and a certain level of intelligence, and I could simply ask them to submit a DNA test which will tell me all of these features and traits.
If I decide not to hire them because they have a genetic trait that makes them Klepto and more likely to steal, thats genetic discrimination. If I refuse to hire them because they have a genetic trait that while having no obvious impact on their physical health, has major impacts on their mental health, I'm supposed to still hire them else it's genetic discrimination?
This means we'd have to hire people who clearly aren't qualified for certain jobs else it's genetic discrimination.
I don't think the law is well written or properly worded, and I think its intentionally vague. The goal is to force employers to hire people, who aren't qualified to do the task because of some genetic trait.
People seem to forget that most of our behavior patterns, our intelligence, and our traits come from genes. So now we are supposed to hire someone who has the gene to have gambling problems, or hire people who have the addiction gene, when there might be someone without that gene who is more qualified?
I'm all for removing genetic discrimination from insurance companies, but what about the hiring process? I think genetic discrimination should be allowed in hiring, because lets face it, you couldn't decide who to hire if you don't at least consider the genetic potential of your employee, be it the potential to lift heavy objects, or the potential to work around money, or alcohol without stealing it, or becoming addicted to it.
Anyone who has an argument against this, present the argument, but I'm against this law and I hope it fails to pass. I think genetic discrimination is the only way to have any sorta economic efficiency in the global economy.
Healthcare is a seperate issue. If this bill were to bane genetic discrimination in the very narrow situation of insurance companies providing healthcare I'd support it, but thats NOT what this bill does and people need to read it more carefully. This bill is ANTI libertarian!
If this bill were restricted JUST to insurance companies and healthcare I'd support it, but thats not what this bill wants to do.
This bill wants to tell us who we can and can't hire. Read the bill more carefully and you'll see that it attempts to ban genetic discrimination in the hiring process. Banning genetic discrimination in hiring will reduce global economic efficiency and ruin the US economy.
Other countries will end the IQ testing and start DNA testing to see which people are the most intelligent and then hire all of those people. Other countries will start DNA testing to find who it's Mozarts and Bachs are and then it's corporations and record companies will genetically discriminate to hire or train these people.
If we ban genetic discrimination in hiring, it's going to doom the US economy to a slow death due to inefficiency and economic stupidity. The only difference between two candidates in some cases will be their personality traits, and their genetic traits/talents.
In the future we will instantly know which individuals will make the best athletes, their genetic test might tell the NFL or NBA that you'll at least have the physical capability to grow big, fast, strong, run fast, etc.
The company which wants to hire the best and the brightest should not be prevented from using every means available to determine who the best and the brightest are. DNA testing CAN help a corporation know an individuals traits and this can help in the hiring process in the same way personality testing and polygraph testing can help.
I think it's just plain dumb to ban ALL forms of genetic discrimination in ALL areas of public and private life, and thats what this bill hopes to do. It's not trying to simply ban MEDICAL genetic discrimination, read it more carefully, it wants to ban ALL forms of genetic discrimination even in hiring.
So if you currently are trying to hire the smart worker, and we someday discover the gene for intelligence, or for creativity, now you won't be able to hire all the smart people because of this law. Instead these smart people will be given jobs overseas where it's legal to genetically discriminate and you'll be able to thank your short sighted congressmen for this bill along with the rest of their stupid bills.
Neo-con am I? And other call me socialist. I am neither, instead I am a Classical liberal. I want liberty and small government.
Instead of 12 to 20 million "illegal aliens" crossing the US's southern border there's that many Americans trying to cross into Canada. These illegals don't want to immigrate into a country, the US, that has bad health care, they want Canada's great health care.
That's also why so much more medical research is done in Canada than in the US? Oops things seem to be reversed: "But the American health care system may be performing better than it seems at first glance. When it comes to medical innovation, the United States is the world leader. In the last 10 years, for instance, 12 Nobel Prizes in medicine have gone to American-born scientists working in the United States, 3 have gone to foreign-born scientists working in the United States, and just 7 have gone to researchers outside the country."
FalconShould there be a Law?
I do think privately owned corporations should have the right to discriminate anyway they like in the hiring process. If they want to genetically discriminate because they think it will help their bottom line, they should have the right.
Should your business be forced to hire people who clearly aren't qualified? And if you could do a simple genetic test to determine say, intelligence capability, why the hell should the government have the right to tell you that you can't discriminate based on intelligence?
What about creativity? What about just physical muscle building capability? If you are hiring someone who has to be able to lift heavy objects, don't you want the ability for example, to genetically test individuals to see who is most genetically fit for that job?
Some people for example just ARE going to grow bigger muscles than others and there is a genetic basis behind this. Some people just ARE going to become smarter and more intelligent than others, or more creative, or just have certain talents and these special abilities have a genetic basis.
Why should corporations be forced to hire people who don't have talent over people who do, simply to avoid genetic discrimination? If talent, intelligence, physical strength are all genetic, and we have to judge an employee on these abilities, it would be a lot easier if we could just scan their DNA rather than give them all sorts of personality tests and make them do endurance and strength testing, and make them take a pen and paper IQ test.
And even then they could make the argument that they failed these tests due to bad genes and force you to hire them.
That's not surprising. Lots of people support policies that go against their own interests.
Quite the contrary, I believe it's in my own interest, along with many others', to support a free market in medical care. Though I've asked others to prove a free market isn't better, and may be worse than other choices, no one has yet.
FalconShould there be a Law?
The US government still believes in race. It asks you for your race on the US census. Do you trust the US government to be your physician and decide which prescriptions you get?
I certainly don't want my race based medicine. How about you?
I know you claim to be libertarian, but if you are libertarian how would you feel if, once the government controls all the drugs, all the doctors, all the hospitals, and all the healthcare in the country, that it decides to ask each applicant their race, and then based on this information give out different medications to different races?
How would you feel if the government also assigned different doctors to different races and classes, so that the "good" races get the best doctors and your race gets the shitty doctor?
And to top it all off, how would you feel if the government decided to promote race based medicine for you and your children, specifically designed for your race and your tendencies?
Personally, I think the government has too much control and influence as it is, and I don't know why you'd think the government would be responsible with healthcare when the FDA is busy allowing poison pills to be doled out like Vioxx.
Another problem you and everyone refused to consider is how genetic discrimination will influence hiring practices and as a result influence the economy. What if we discover the intelligence gene or series of genes?
Now you'll be forced to hire people who are dumb and without any natural talent simply because they have a right not to be genetically discriminated against, all while other countries screen their employees for desirable genetic traits such as intelligence and hires only the qualified employees.
The result is that the USA will forever be doomed in the global economy. Other countries will genetically discriminate and use it to their advantage economically and politically while we dumb ourselves down or dilute our talent by watering it down.
Health care needs to be a right, and the risk or cost spread over everyone, with no one excluded. This also means that any benefit in savings must be good for the whole. Private profit making business can not be part of this for it to really be fair to all.
We could have had really top notch health care for everyone for less than we have spent on this silly war in Iraq, and with the give away's big political donors in the name of 911, we could all have our own Doctor.
Health care just needs to come from general revenue, like the Military, and cover every one. We spend more on weapons than the rest of the world combines, and most of that is greedy contracters gouging us. Just the waste in the Pentagon budget could cover everyone.
I really think it is time to take our government back and have it serve us.
So There
From the article
"âoeThis bill removes a significant obstacle to the advancement of personalized medicine,â said Edward Abrahams, the executive director of the Personalized Medicine Coalition. His group is an organization of drug and diagnostic companies, academic institutions and patient groups that advocate using genetic information to choose the most appropriate treatment for each patient."
Personalized medicine. PERSONALIZED.
I'm not in favor of personalized medicine. The idea disgusting to me. I'm sorry but I don't want the federal government to be creating personalized "race based" medicine. I'd rather keep the corrupt insurance companies because at least the insurance companies are reasonable.
The government is religious and irrational. The government still asks on the census what our race is while congress is busy trying to keep insurance companies from asking what our genes are!
I think the option we have is to choose whether we want the government to give us it's race based medicine, or whether we want the insurance companies to genetically discriminate.
I'd rather have genetic discrimination over racial discrimination because at least genetic discrimination is based on science and not religion and pseudo-science.
Because if you happen to have good genes and be brilliant and poor, now they can't hire you based on that. If there is a gene or intelligence and you have it, you're no better than a semi retarded person.
Of course in other countries they wont have this, so if you are smart and poor, get the hell out of the USA because you are doomed.
If you are rich, you'll be just fine because genes don't matter when you have millions or billions of dollars. Genes only matter when you are poor and the only thing distinguishing you from all the others is your extraordinary IQ.
What if we found the gene for intelligence? This law would say the employer cannot favor you because you have the high intelligence gene or set of genes.
And I think THAT IS STUPID AS HELL. This is the main reason why I'm against this bill. It favors this false idea of genetic equality
Either you will get genetic discrimination from insurance companies based on reason and science.
Or you can get race based medicine from your government that still believes in race and asks what your race is on the census.
I'd rather deal with the scientists myself.
If you are genetically cognitively impaired, do you have a right not to be genetically discriminated against?
I really wonder how your guys opinions would change if a misfortune occurred that incapacitated you so you couldn't make money, you got socked with a medical bill you couldn't pay.
Done that. While I was unemployed and without health insurance I was hospitalized. I spent about a month in the hospital then was transfered to a rehab house, where I lived several weeks. After that I spend almost 3 months in therapy. Up through then my medical bills came to more than $120,000. Because of my injury there was no expectation I'd ever be able to pay it back, heck while in a coma the docs told my family it would be a miracle if I lived. Well, it's been hell for me since then even though I spent another year in therapy.
FalconShould there be a Law?
I don't think people should ever be forced to live against their wishes, and I think it's unfortunate that medical ethics and law that's attached to it has come to another conclusion on that topic.
Thanks. While I wished I had died I realize there's nothing they could have done. It was pretty obvious I would live once I came out of the coma and I didn't have a living will. However my mom had to go to court to have a judge declare her my legal guardian so I'm not sure having the will would have had an effect.
FalconShould there be a Law?
if at all, if routine medical services were not covered. Catastrophic events would occur much more frequently due to lack of preventative care. A person who has to pay $100 out of pocket for a test or checkup may not get one. Whether it's because they think they can beat the system or because they feel they can't afford it, insurance companies would have to pay for the expensive cleanup afterwards.
First, if I were paying out of pocket I'd shop for a doctor who has reasonable rates. Then as far as catastrophic coverage is concerned, the company providing it can require the insured to have regular exams. When the doc says additional tests are needed the issuer can say either the person has them or s/he will be denied any catastrophic coverage for not having them done.
FalconShould there be a Law?
You're describing a medical payment plan, not insurance. If you are paying into a medical plan in order to have it pay for expected medical costs down the road, you would get a much better rate of return by investing the money yourself and paying for those medical costs when they happen.
In the US just as with IRAs a Health savings account can be invested. The only difference between the savings plan and just investing the money is that the plan is tax deductible. When you need the money for medical expenses you can withdraw some but if you don't need any the money just keeps building up, only faster than a regular investment plan because you're not paying taxes on it.
FalconShould there be a Law?
Actually, your insurance company pays for your losses whether or not you DO manage to sue the real culprit.
;).
And in some ways, you're not allowed to sue, at least, if your insurance pays, you can't sue for anything beyond your deductible.
I think there's a principal known as subrogation where, in exchange for covering your losses, you surrender your right to sue to the insurance company.
Of course, the fact that an insurance company gets to sue in your place and potentially recover, AND also gets paid insurance premiums for the privilege, doesn't speak well for how greedy they are to be making money coming and going. But that's a question for another arena
And spreading the risk is one of the functions of insurance. Just with government funded insurance, the "risk sharers" just also happen to be tax payers. Uncle comment by AK Marc (uid 707885) was right on the point.
The old fashioned rule of "tough shit" whenever something goes wrong is exactly the attitude adopted by people who play the dog eat dog game for keeps in the real world. It is also the attitude of insurance companies who would LOVE to use genetic testing as a way to cherry pick among their insured.
With a ban on discrimination, insurance companies won't be able to dump the people who need the coverage the most. The resulting risk sharing will be just that, risk sharing, rather than a bunch of healthy schmucks who are fattening the corporate treasury of an insurance company.
And this is an example of altruism, that endangered attitude that is so easily taken advantage of when the "other guy" decides to cheat and screw you over.
Yes, here's an idea. You have to lock in an insurance rate for your baby prior to conceiving the baby. Then it is uncertain what the phenotypes will be. Not quite, you may say: some parents are more likely to conceive a child with certain predispositions than others, especially if both parents pass on the same risk. That's alright though: you will get a quote based on the genetic merit of you two as prospective parents. That'll be part of the overall marriage deal the same way other financial aspects are. You will get an insurance discount if you are willing to subject the embryo to genetic testing. While all these sound cruel, some would have a problem with making them pay for others' reckless procreation. The other thing is, it's inevitable. There's no such thing as discovering an important correlation and then not using it for economic benefit, whether we like it or not.
Two words: "opportunity cost"
http://en.wikipedia.org/wiki/Opportunity_cost
The time you sped doing laundry can not be spent doing something else.
-- Terry
I knew there was a reason I believed government was inherently evil. Thanks for the reminder.
Liberty in your lifetime
http://www.law.cornell.edu/constitution/constitution.preamble.html
You find all those things inherently evil?
Learn to love Alaska
That's not the right question. The correct question is whether or not the government has ever actually followed that, or any of the other attempts to keep a check on its power. (It hasn't.)
Liberty in your lifetime
You complained about the purposes of the government, then the execution of those purposes. When I prove your paranoid delusions false, you just alter them to something else harder to prove. So you win, all governments are founded on evil, run by evil, and do only evil. Yet, people still feen a need to form an organizational structure and call it government, and everyone but you presumes they are better than the alternative.
Learn to love Alaska