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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 ----
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.
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 must applaud President Bush for being foresighted enough to pass this legislation"
Personally I would hold the applause until you actually read the act. 99 times out of a 100 the bill name means nothing about the content.
Having a quick look at thomas.loc.gov it looks like the bill is [H.R.493]. Reading some bits...
While you can't discriminate based on genetic material the section 210 states that if the information is found by any other means it is permissible (even if it is a genetic related issue). So this for the most part will have no effect on Medical Insurance companies.
For example if one of my parents suffered from a genetic disease then they could discriminate against me based on that information and not on actually checking if I have the genetic markers or not.
Section 103 seems to mention that if a health company came by your genetic information via another source (3rd party) then it is permissible to use it.
Also there is mention of Genetic testing IS NOT..
"an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved."
So, IANAL or biologist but even casual reading there appears to be loads of outs for private medical companies.
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.
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.