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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.'"
Maybe there's hope for us mutants then.
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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 ----
Those ATTTACAGATTAC ers deserve to be discriminated against.
If you can read this, I forgot to post anonymously.
From the article: "Just a few weeks ago, GINA received overwhelming support in both the Senate, with a unanimous vote of approval, and the House of Representatives, where the legislation was passed by a landslide vote of 414-1."
Who was the one who voted against this?
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.
An article in Nature (proprietry web) a month ago analyzed the genetic content of James Watson, the co-discoverer of the genetic code, and the 2nd of four known people to have their genomes fully sequenced. Dr. Watson had three thousand observed mutations of which 32 were in the database of genetic diseases. This included Retinitis Pigmentosa, kidney failure and other potentially devasting diseases. However, it is not known why they were not expressed in his case. This is all the more reason to keep insurance companies from canceling insurances to those who might have any sort of genetic defect.
P.S. No, they did not discover the gene for making stupid racist remarks, which forced Dr. Watson into retirement last year.
It's an unusual sentiment for me, but I must applaud President Bush for being foresighted enough to pass this legislation.
I recently attended a futorological lecture at Oxford University on the possibility of genetically engineered 'persons' (not necessary human persons). The lecture was given by Nobel prize-winner John Sulston (an important figure in the human-genome project), John Harris (a bioethics expert), and was hosted by Richard Dawkins. The panel was very much in favour of continued research into genetic modification of humans, but placed a strong emphasis on the need for legislation to prevent powerful cliques from monopolising or abusing the technology.
One important point they made is that (just about) any technology can be used to give an overwhelming opportunity to those who are free to enjoy it, but that the norms of modern Western societies ensure that most people have the potential to take advantage of the majority of science's blessings. However, we can't simply trust large corporations or other powerful institutions to equitably distribute the advantages of these technologies. Regulation is needed, and Bush is providing a good first step.
So, in summary, we must continue to research and to pursue all avenues of research, but the applications of the research need to be very carefully thought through.
Phoenix, Boston, Little Rock, see a pattern?
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
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!
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.
You might consider the following question:
How much is $4/gal a price increase, and how much is it a devaluation of the dollar?
I think it's pretty clear that it's largely a devaluation of the dollar.
I think we've pushed this "anyone can grow up to be president" thing too far.
The point of insurance is that you pay to get rid of your own risk. (Well, not to get rid of it entirely, but to get rid of the major consequence of something bad happening: having to pay a lot of money). If your risk is higher, you need to pay more. If your risk is lower, you get to pay less.
Consider extending your analogy. People with a lot of car accidents pay more for insurance. People with a clean record pay less. What would you think of a proposal that would make everyone pay the same amount for auto insurance? I'd think it would be pretty ridiculous, and I think you should too. And while one might moralize that people can't help their health so much as their driving habits, that's not the issue of an insurance company, Health or otherwise.
The problem is people who want some level of socialism and try to get it through insurance regulation and end up losing the free-market benefits while not even gaining much as a result. If you want other people to pay for your health care (and that of everyone else) stop beating around the bush and wagging your fingers at the insurance companies and admit you want socialized medicine. Then we can at least address it on its own terms.
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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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Injecting, inhaling, coating yourself in, and/or swallowing something that makes you addicted to a substance does not constitute a disease. I believe, though I don't really care enough to look (for fear I'm probably wrong anyway), that the AMA called the addiction itself a disease, simply because being deprived of the addictive substance affects your body adversely.
Aside from that (and this is a stretch, but people with shiny hatwear will appreciate it), the FDA will not allow the sale of patches, pills or other methods to curb smoking habits as medical devices unless they can be used to cure a disease. It's the same thing that Kevin Trudeau guy got in trouble for. Only medicines can cure diseases, and only the FDA can approve medicines. So, unless it's a disease, these things cannot be marketed as cures, and the only way they can be marketed as cures is if the FDA approves them as medicines. How much money do you think is wrapped up in stop-smoking products?
An addiction to masturbation is quite the same way. As I'm sure many people here can attest to, without "getting the poison out," a person can be caused pain, become irritable, lose sleep, perform poorly at work or sports, can acquire jitters or shakes, and various other things that would be the same for a person who hasn't puffed on their death stick. Does that mean that I should get a fifteen minute spank break every two hours at work?
Cigarettes, alcohol, drugs, gambling, sex, MMOs, and many many other things that are considered addictions are not. They are merely a weakness of character. If they are actually addictions, then I should get my UFC tickets to be covered by my insurance, because I'm certainly ADDICTED to that.
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.