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President Bush Signs Genetic Nondiscrimination Act
artemis67 writes "This past week, President Bush signed the Genetic Information Nondiscrimination Act (GINA), which would prevent health insurers and employers from discriminating against individuals on the basis of their genetic information. GINA is the first and only federal legislation that will provide protections against discrimination based on an individual's genetic information in health insurance coverage and employment settings.'"
Sure you can legislate that you cant discriminate but if your employer or insurance company has access at all, they can just 'backdoor' you out the door.
( and no i didn't read it, it would be to large to wade thru on a holiday weekend )
---- Booth was a patriot ----
I tend to look on such legislation as likely to have the reverse effect to the one stated, because it is frequently written to provide cover, loopholes and exceptions for the powerful, well-connected industries it is supposed to govern.
And even with the best of intentions, it often has the effect of limiting an individual's rights to whatever is covered at the time, regardless of scientific and technological advances that can render such rights and protections woefully obsolete.
I've calculated my velocity with such exquisite precision that I have no idea where I am.
As much as I hate the current situation in which the insurance industry has had far too much power over healthcare, this legislation was absolutely necessary for our society to continue to function in anything like a normal way as genetic information becomes more commonplace.
As for loopholes, we the public must start an intolerable outcry the moment we hear of any such pending. This needs to be an across-the-board absolute, not a political game.
We need protection though from other forms of medical discrimination. Banning the Archaic BMI would be a good start. Limiting pre-existing conditions. Its amazing the things that will still get you disqualified. A yeast infection and even too many pimples as a kid... More needs to be done. I will take this small victory though.
I'm sure his primary reason is because there is no Consitutional authority for this sort of thing, in general.
But the reason none of them should have supported this is that the result can and will drive up the cost of health care for everyone.
If someone knows they are genetically disposed to malady "x", there is now a law which guarantees that they can get insurance coverage at the same price as someone who is at less risk. What does Congress expect them to do, not take advantage of that fact? If insurance companies can't set pricing based on full knowledge and actuarial statistics, but people can, it will increase costs.
Finally, why shouldn't people at greater risk pay more? Discrimination is not necessarily a bad thing. People discriminate all the time - employers discriminate by choosing more skilled workers over less skilled ones, consumers tend to discriminate against higher priced retailers, the President discriminates against the proles by shutting down traffic as his motocade makes it's way though a city. (Well, maybe that last one is bad discrimination).
In fact, this law discriminates against those who are at less risk for genetically identifiable diseases, by forcing them to pay higher insurance rates than they otherwise would.
"National Security is the chief cause of national insecurity." - Celine's First Law
Actually, I just rethought my position a bit. What is fundamentally wrong with hiring policies that prohibit smoking? Again, I'm a smoker, and I really can't see much wrong with the idea.
You can't compare this to genetic discrimination. People have no say in what genes they're born with, but they most certainly have a say in whether they choose to engage in behaviors that drive up healthcare costs.
Maybe the answer would be to charge higher insurance premiums for such behaviors, maybe it's something else. But it's definitely not on par with genetic discrimination.
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I just finished teaching a bioethics course at Harvard College and we studied this topic in detail; it was one of the questions on the final exam. I am convinced that this is a well-intentioned but bad law.
The problem with this law is that it creates adverse selection in health insurance. Health insurers won't be able to get genetic info on the people they're covering, but the people themselves will. That creates asymmetric information, and is ripe for abuse. Think about it: if I get my DNA sequenced and find out that I'm a walking health hazard, then I'll buy the most comprehensive policy out there. If I find out I'm genetically clear, I scale down my coverage, or drop it completely. Meanwhile, the insurer can't adjust my premium to accurately reflect my risk. The result: only genetically unhealthy (and risk-averse) people will buy into health insurance pools, or the genetically health will only buy insurance for physical accidents. And when the insurance pools are small, and the insurers can't accurately price risk, they pools collapse: nobody gets health insurance.
Of course, the obvious alternative--let both buyers and sellers of health insurance use DNA analysis to accurately price risk--is unpalatable because people will suffer from higher premiums through no fault of their own (i.e. because they have bad genes), and people will benefit through no effort of their own (i.e. because they have good genes). This concern (coupled with privacy concerns) is why GINA passed overwhelmingly, and I don't mean to diminish it.
Insurance works best when the risks aren't ascertainable in an individual case but are ascertainable in the aggregate. DNA sequencing really threatens the concept of health insurance, because it greatly decreases the uncertainty surrounding an individual's health future. The best way to keep insurance alive is to insure before it is possible to determine a person's health risk. Now, you could do that by banning DNA testing for individuals unless they are willing to permanently waive their ability to buy or modify their health insurance policies, but DNA testing is so cheap that the ban will be hard to enforce, and a permanent waiver seems rather harsh. You could require people to buy insurance for their kids before conception, but that has the same problem that the kid will be stuck with the same health insurance for ever (and that there might not be a kid in sad circumstances)
The ultimate, fool-proof solution: social gene insurance. Essentially, when any private insurer wants to charge you more than the base rate because of your genes, you just pay the base rate and society picks up the difference. The gene insurance would be funded through taxes, much like social security is now, though none of that "lockbox" BS. Socialized health insurance would work, too, being a superset of social gene insurance. The idea behind social insurance schemes is that they in effect force citizens to buy in before anyone has any knowledge of their genetic risk, making it a sound insurance product. And the solution works from the view of liberal theories of justice, e.g. Rawls, because it is essentially a redistribution of social resources from those who happen to be born with (and hence do not deserve) such resources to those who happen to be dealt a bad hand, through no fault of their own.
Just pass a law that says health insurance companies can't discriminate for any reason. There has to be a community rate for health insurance (like there was 50 years ago.)
Then we can say just mandate that everyone has to carry individual coverage so we solve the uninsured problem. Plus we would insure that the young and healthy were in the pool - thus keeping the overall rates down.
Of course it would be a lot easier to deduct it from people's paychecks rather than have a whole system whereby we monitor citizen's compliance with the law. So it would just be an amount deducted from your pay.
And we would need to make it something people who were poor could afford, so there would be subsidies so that the poor paid less... and the wealthy paid proportionately more. So it would be a progressive deduction from your taxes.
Plus we could save a LOT if in addition to providing preventative care instead of what we do (ER care as a last ditch effort when diseases are harder and more costly to treat) we got rid if the thousands of insurance providers and just had one large provider. I know as a physician I spend a lot of money on hiring people just to fill out insurance forms for me. If there was one form that was consistent, I would be able to provide care a lot more economically. And if everyone was in the same system, we would have better assurance that the care would be reasonable since the people with the most power would also have to have that same insurance... no way to make what the poor get be shoddy. So we would just cover everyone under one large pool.
And then.... well we'd have the most humane and cost effective system possible: a single payer national health service funded by an income tax spread fairly on the population. Or as the nutters refer to: socialized medicine.
Gasp!
I think this post, more than any other, called for: [citation needed].
http://www.skullsecurity.org/blog/
TOBACCO ADDICTION IS NOT A DISEASE. Results of tobacco addiction, like emphysema, lung cancer, THOSE are diseases. Addiction is a precursor, and nothing more.
Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
Literalism isn't a form of humor, it's you being irritating.
STARTING smoking is a lifestyle choice - one which is often made at an age where you're too young and headstrong to know better. Continuing to smoke is not always a lifestyle choice.
As someone who is a smoker and has tried many times to quit, I do NOT feel that I have control over it without medical aids. That effectively puts it in the "disease" category (as another poster has pointed out). I do not CHOOSE to continue smoking, I simply continue to do it because I can't not do it. I know that some people quit smoking very easily, and then go on at the rest of us about how you just "need to be strong" and so on. That's a load of crap - the addiction is different in different people, and many of us could much more easily give up FOOD and WATER than we could cigarettes. The most extreme hunger and the most dire thirst are NOTHING compared to the craving I have for a cigarette if I don't have one every few hours.
I will very soon be seeing a doctor to get something prescribed, since the "over the counter" stuff helps somewhat, but not enough. I am fearful for my life, and yet still I light up. Tobacco addiction is a disease, and I would never wish it on anyone.
(I do apologise for this rather "personal" rant here, but I can't let this little thread pass as is - I fully expect flames and derision for my comments here from those who couldn't possibly know what it's like. I will happily read and perhaps reply to any sensible replies, but will ignore the flames, so don't bother trying to get a rise out of me)
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Public health issue? So they don't smoke in the office, nor anywhere except designated smoking areas, where us non-smokers will never go anyway. "They smell bad" is about as valid as complaining about your coworker's BO, both are issues that you have to sort out within your own office environment.
The problem with alcoholics is that being drunk precludes you from doing useful work, as well as being a disruptive force in the office. You cannot possibly make that case with smoking. A smoker is NOT impaired, nor is he disruptive unless he's puffing smoke in your face.
I cannot believe you're seriously suggesting discrimination against smokers "because they smell bad". What's next, not hiring the Indian dude because he smells like curry? Get real.
we should work more on prevention (the minimum age for buying cigarettes should get progressively higher, for instance).Ugh, age limits have NEVER solved ANY problems. Around here they keep raising the driving age, and accidents have never decreased. All they've done is have a bunch of 20 year-olds killing themselves in cars, instead of 16 year-olds. The smoking problem, drinking problem, and any other social ill is NOT solved by limiting access to the vice, it is solved from the root of it - cultural perceptions. Funny how France has no realistic drinking age, but alcohol abuse is a FAR smaller problem for them. It's all in the culture, m'boy.
I think his point was that the law does not authorize that but Bush acts as if it did.
Justice is the sheep getting arrested while an impartial judge declares the vote void.
This also means we need to start planning our cities and communities around mass transit instead of driving, which means mixed use zoning to create pedestrian-friendly core destinations instead of decentralized urban/suburban grid sprawl. Mass transit doesn't work in a decentralized population.
In other words, we literally need to plan our communities to look more European. Any help convincing Americans to do that is much appreciated.
Oh noes! $4/gallon gas and it's teh liberals! As if electing a bunch of Texas oilmen really got us anywhere.