Insurance Deathwatch

Private health insurance as we know it will end one of two ways: either insurance companies will have enough access to genetic information that private health insurance ceases to pool a meaningful amount of risk, or else individuals know enough about their own genome to buy only the insurance they need, thus causing provide health insurance to cease being a meaningful pool of risk.

The Genetic Information Non-Discrimination Act tells us we have chosen the second death.

But at least we will get something out of it… information that will speed up the end of meaningful private insurance:

Genetic Non-Discrimination – The Corner on National Review Online
The bill prohibits insurance companies from requiring genetic testing or using genetic information to exclude individuals from insurance eligibility, and prohibits employers from using genetic information to discriminate against employees in hiring, promotion, and the like.

The Bush Administration had been pushing hard for such a bill since 2001, and both the House and Senate have actually passed different versions in the past few years, but final passage was repeatedly held up by concerns from some employers (which were quite legitimate, and have been addressed in this latest version) and even at one point caught up in a dispute over the use of genetic information collected from fetuses and embryos, which has also been addressed.

The immediate effect of the bill will probably have more to do with scientific research than with employment or insurance. Concern about the use of genetic information has been a big barrier to getting people to participate in genetic research in recent years, and among the foremost advocates of this bill were scientists hoping to relieve potential research subjects of that worry. That was also a major reason for the administration’s advocacy of the bill (silly rumors of a Republican war on science notwithstanding).

The bill really only begins to scratch the surface of the sorts of complex problems that genetic information will present to our health care system (and to the very concept of health insurance) in the coming years. But it’s a surface that needed some scratching.

Along with gene-therapy-based cognitive doping (essentially, eugenics in less than one generation) commercial comparative genomics is the most interesting life-sciences story of the next few decades. Stay tuned.

3 thoughts on “Insurance Deathwatch”

  1. Yes and no. No matter what they find out via genetics, there’s still an irreducible risk via accidents and foul play. That’s a risk pool that can be tapped.

    Mind you, it could be tapped more easily by single-payer emergency care. Greater pool, less bureaucracy and no worries about people without insurance or proof thereof.

  2. What’s funny is hearing Obama complaining that McCain’s plan would lead to the death of employment-based insurance… when that’s exactly the reason that I support Obama’s plan!

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