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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."
If you take any two insurance companies, company one is given the advantage of genetic testing with the ability to discern some general risk factors from it, and company two doesn't have the advantage of the testing. The first will be able to offer lower rates to those with lower risk and higher rates to those with higher risk. If my family's pre-disposed to skin cancer, the insurance company will raise my premium. Now, for lower rates, everyone checks with company one for insurance before trying company two. If they don't get a good rate, then they have to go to company two, who makes their proposal based on less data. Pretty soon company two's rates are going up because they have everyone who dies of heart attacks at 40 while taking 15 prescription medications while company one has every one of their patients live through their 90s without taking more than 2 prescription medications.
those that can and know, do.
pricey capital investment though.
Ice Cream has no bones.
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
"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.
In other words, it doesn't matter to you that millions of people are unable to afford routine preventive health care, and are forced to wait until their problems become emergencies (because the ER can't turn them away for non-payment), driving up costs for the rest of us.
There are some who cannot afford health insurance, and there does need to be a solution for them. However, do not forget that a sizable percentage of those that don't have health coverage choose to forgo that expense, figuring that they don't need it. A third of those without it live in households of $50K or more annual income. It's possible that certain situations lead to some of those genuinely unable to afford coverage, but that's still millions that could afford it and choose not to.
In addition, there are millions eligible for government-sponsored health care intended for low-income people but who simply never sign up for one reason or another, be that lack of knowledge, laziness, or even pride at not being supported by the state.
No, apparently all that matters to you is how well the system works for the wealthiest individuals, and to hell with everyone else.
My parents were far from the wealthiest individuals when I was growing up. Dad worked in SoCal aerospace which paid well -- when he was working. It was very cyclical, and he was often driving trucks for $6 an hour in the late 1980s. A few years ago, he was hurt badly enough to go on permanent disability, leaving only my mom's income as significant. Mom worked at a hospital as a ward secretary, eventually moving into working for health insurance companies. She now works for a homeowners association management company. Despite what they've been through and what she saw from the inside of the health care system -- and it often wasn't pretty -- they still don't want a nationalized health care system.
There are about 300 million people in the US. A rough average of uncovered residents is about 45 million. That means that 255 million are covered. I'm fairly certain that 85% of the country includes a lot more than just those that are wealthy.
In America people do not wait months for basic services.
Actually, they often do. Private health insurance (especially HMO) doesn't guarantee that you'll be treated any more quickly than people in Canada or the UK.
Until recently, when I flipped to a PPO for flexibility (and ironically lower paycheck cost to me), I was on HMOs for most of my life. My brother and both parents needed arthroscopic surgery, which they were able to get within a couple of months of diagnosis (my brother actually got it within a few weeks, and before my mom started working in the health insurance field). In Canada, the median wait time for such surgeries is a significant fraction of a year, even in more heavily populated provinces. Neurosurgery patients can wait for six months from seeing a GP to getting their actual surgery. Life-threatening situations are treated much more quickly, of course, but those kinds of waits go beyond a nuisance for someone whose life is being affected by a given condition. I would find it simply outrageous to have to wait such times.
I have also read and heard anecdotally -- and this may be a misunderstanding -- that Britain's NHS has denied surgery to certain aged or extremely sick patients on the basis that they may not survive despite the treatment, or that others have a higher chance of survival and so the surgical slot is assigned to someone else. If I've been paying into the system for, say, thirty years, I'm going to have some serious concerns if coverage is denied on that basis. Yes, these things happen stateside, too, but the idea that they're unique to for-profit insurance companies in the US may be flat wrong.
On top of this, the overhead for a nationalized system is not necessarily better than in a corporation. Its budget has ballooned from £65.4 bi
You can never go home again... but I guess you can shop there.
Of course people wait. They wait to get that little problem looked at until they get a job with health insurance and the pre-existing condition exclusion period is over. Or they wait - wait forever - because they can't afford the services.
"Socialized medicine" really has nothing to do with whether you have an economic system based on the exchange of labor (socialism) or on the private ownership of economic resources (capitalism). It's entirely possible to have a health care system in a libertarian socialist system that would not be government run, and it's possible to have a capitalist government run healthcare system. (Such as Clinton's latest offering, which would make us all buy from private insurers. The worst of both worlds!)
A better term - and one less likely to trigger the conditioned reflexes of Americans who don't know what socialism is other than that it's the devil's work - would be "public medicine." Like public libraries, public roads, public parks, public fire service, public police...
Tom Swiss | the infamous tms | my blog
You cannot wash away blood with blood
Completely nationalize it? No. But the means of food production, distribution, et cetera, are very heavily regulated, from farm policy to food stamps. (And if a food emergency hit, yes, nationalizing the food supply might be the best option.)
But the poster wasn't asking about a situation with no possibility of failure. Just softening the landing of one does fail.
But yet, if said asshole sets up camp on your front lawn, you want to use the power of government to move him. (To where?) And you want to use the power of government to seize the product of my labor to make me pay for the police force to do it.
Paying for a social safety net is the ante you owe if you want to play the game of private property. If you want to border off some land for your home and keep others off, use government force to turn land into real estate, the price you owe is providing everyone minimal shelter. If you want to border off some land to make a farm and keep the harvest to yourself, turn the bounty of the earth into agricultural commodities - again, using government force - the price is making sure nobody starves. If you want the government to issue patents on drugs, use government force to keep people from making copies in order to secure profits to big pharma, you have to make sure no one dies from lack of access to them.
Tom Swiss | the infamous tms | my blog
You cannot wash away blood with blood
That's true for some diseases, but others can be predicted with a much higher accuracy and there's
absolutely nothing the person in question can do about it. "All that good stuff" won't save you
from _all_ the bad stuff that can happen to you if you lose the genetic lottery.
Your kid wakes up screaming because he has an earrache at 1 in the morning... "honey, let's call up the family doctor and get him to come over here on the double!"
"Dear... doctor's don't make house calls any more."
"Then let's take the kid down to the doctor's office!"
"The Doctor won't be in till 9."
(You looks at the kid, still screaming at the top of his lungs.)
"We... could wait a few hours I guess..."
"The first they can work us in is probably 3 or 4 pm."
"... Right. Off to the emergency room."
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