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My Genome, My Self?
theodp writes "After baring his DNA for the world to see, Steven Pinker follows up in the NYT Magazine with his take on the coming era of consumer genetics. Pinker comes away less wide-eyed than Time Magazine about the current predictive ability of $399 genetic tests, but is convinced enough to opt out of learning whether he has a gene that increases the risk of Alzheimer's and believes that genetic-testing-for-the-masses may hasten the arrival of national health insurance ('piecemeal insurance is not viable in a world in which insurers can cherry-pick the most risk-free customers'). Pinker believes that personal genomics is just too much fun to ban, but for now suggests: 'if you want to know whether you are at risk for high cholesterol, have your cholesterol measured; if you want to know whether you are good at math, take a math test.'"
1. Prenatal genetic testing.
2. Genetic counseling for prospective parents.
3. Actuarial estimate of lifetime healthcare costs at birth.
4. Mandatory front-loaded health savings accounts, funded by income withholding, until the amount saved in the account is equal to the amount necessary until end-of-life medical care, based on actuarial estimates.
5. Parents pay into the account until the child reaches adulthood, then the person covered continues until the account is fully funded.
6. Account holders can use their health savings account on any recognized treatment required, but reimbursement is limited to the rate set by the government. For example, if the limit is $5000 for a particular treatment, and the patient spends $10,000, the remainder is paid by the patient directly. This prevents draining the account, either by unscrupulous doctors or by fraud.
7. Shortfalls for necessary treatment are covered by the government, but treated as a loan with interest.
8. Money left in the account is passed on to heirs, while shortfalls are taken out of the estate in probate. Any remaining shortfall is covered by the government and paid through taxes.
9. Actions that increase medical risks (obesity, smoking, excessive drinking) are handled by increased payment into the health savings account. Actions that decrease risks, such as maintaining healthy weight and regular checkups result in lower amounts withheld for the account. Actions that benefit the community -- organ donor cards, blood donation, willing their body to medical science, etc -- get a bonus put into their account.
Of course, this won't happen as long people prefer to pass healthcare costs to the next generation in budget deficits, rather than paying for their own care.
I used to work as a contractor for the George Church lab. My supervisor was a student of Church's. Church was his boss. I was working on bio-informatics (if anyone cares, I can tell you some tricks for regexp-searching of genetic sequences).
My family was under extreme financial duress. In light of that knowledge, my supervisor (tells me, at least) that he took my situation to George and they came up with this: "Sign up to be one of the first 10 PGP subjects. Give us all of your medical records from the past and into the future. Agree to have your sequence published. We think we can get Harvard to agree to pay for your medical insurance for life. Don't you think your family deserves for you to make that trade-off?"
I said, flatly, "no." I pointed out, among other problems, some severe technical problems in the line of sequencing research we working on. Ultimately, we (me and the lab) part ways on less than amicable terms after this.
I think these people are scum.
They were eager to exploit my poverty as leverage to make me a human subject to rather dangerous experimentation based on highly dubious scientific claims - and they punished me for dissenting from this plan, as nearly as I can tell.
-t
I am young and in good health. Right now, I could not afford a $10k hospital stay -- yes, eventually I could save up for it, but right now I can't. I can, however, afford an insurance premium that will cover it. As mentioned, I'm young and in good health, so that premium isn't terribly pricey. What would you have me do?
>I have health insurance for BIG stuff, hence me HUGE deductible (5 figures).
Bullshit.
Im only 33 and need insurance. My sleep apnea machine costs a few thousand dollars. No "emergency" insurance covers that, yet SA is as serious as anything else. Toss in the sleep studies and my insurance probably paid out 6 or 8 grand. I would have lost all my savings and more if I had "emergency" insurance only.
I used to be poorer and had no insurance and pretty much begged doctors for the "cash rate." All my medicines were samples. I barely scraped by and I got lucky. I was young and healthy. No major accidents. Now in my 30s I cannot do that. No way.
You sure as hell are not having a baby safely by paying cash. No emergency insurance is going to cover pre-natal, delivery, post-natal, etc.
>Wash your hands after touching sick people. Cut back on excessive drinking and smoking. Wear a condom. Don't eat too many sugars or starches. Do some exercise. It's not so hard.
Yeah, youre a moron. I do all these things. Kids born with diabetes arent going to exercise it away. Youre not going to fix a broken leg with happy thoughts. Not eating a twinkie doesnt cure a MRSA infection. Not drinking beer doesnt fix a rotted tooth.
>Then you can SAVE YOUR MONEY when you're young to prepare for the care you'll need when you're old.
My dad's CPOD and Alzheimer's treatments are in the 5 digits. In 10 years its going to be well over 500,000. Thats a lot to save on top of retirement.
How old are you? Some college student who has yet to grow up and see how your body falls apart when youre older? Its all downhere from here. If all of Europe can do national healthcare then so can we. Dont let being "college liberatarian" make you more ignorant than you already are of health matters.