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Don’t Discriminate Against Mutants Like Me
- rsync 10y ago"The legislation would enable companies to coerce employees into participating in wellness programs that could require them to undergo genetic testing and provide genetic information about themselves and their families." This is the price. There will be other prices. So-called "red state morons" who "vote against their own economic interests" often tout a hazy, poorly thought out rationale of "freedom" as the driving force behind their choices. There is, however, a decent heuristic at work here. They know that there's no such thing as a free lunch. Just because they have no idea how they'll be made to pay for it doesn't mean they're wrong.
- mcguire 10y ago'There's no such thing as a free lunch' seems to be code for 'I've got mine, screw the rest of you.'
- drzaiusapelord 10y ago> They know that there's no such thing as a free lunch. I'm already paying for health insurance. Its not, nor has it ever been, a free lunch. Diving into my genetics is completely uncalled for. Stop calling health care buyers moochers, thanks. Also somehow almost all other wealthy western nations do better than us by almost all metrics in healthcare and they don't need to do this either. What's wrong with Americans?
- rsync 10y agoCovering existing conditions is a wonderful thing. And it is a free lunch. Regular wellness checks, etc., while wonderful, are a free lunch. They are not insurable. You can't insure for regular, scheduled services. Because math.[1] If you see things like this - things that are either exorbitantly expensive or defy the bounds of underwriting or both you should expect to pay other prices, elsewhere. [1] This is insurance 101. You cannot insure against regular, universally consumed services. There is no underwriting pool there. You cannot buy an auto policy that includes regular tire replacement - and if you could, the premiums would include 100% of the tires cost (plus admin).
- Ericson2314 10y agoThink of preventative healthcare itself as insurance against ailments popping appearing only once they're far more expensive to fix.
- tghw 10y agoI'm pretty sure most people with an existing condition would prefer not to have it at all than to cost insurance companies more and have that covered. It's not a free lunch. They paid the admission fee with their health. Regular wellness checkups are also not a free lunch. They're priced into the policies. You absolutely can insure against regularly consumed services, as long as the premium is enough to cover it and to do the underwriting for the unexpected expenses. Look at dental or vision insurance. The vast majority of what they cover are regular wellness visits. Putting that aside, free wellness visits are also in the interest of the insurer. It's far cheaper to prevent disease or to treat it early than it is to deal with it later. Those savings from this so-called "free lunch" ends up right back in their pockets.
- rsync 10y ago"You absolutely can insure against regularly consumed services, as long as the premium is enough to cover it" That is called fee for service. Maybe it gets bundled with actual insurance, but it's not insurance. Regular, universal expenses are not underwritable. Insurance is a technical term that has a strict meaning. You are absolutely correct that regular wellness checkups, etc., can positively affect the outcomes of that insurance pool, but they are not, themselves, insurable. They have to be paid for somewhere.
- tghw 10y agoThey actually are underwritable. Not everyone utilizes wellness visits, just like not everyone gets an x-ray, in a given year. Insurance companies can price in the expected value of wellness visits based on the participation rate. Therefore, it fits the definition of insurance, even though the likelihood of a claim is relatively high.
- 10y ago
- fasteo 10y agoOP here. Pure corporativism. I am a mutant too. Didn't get any superpower though.
- drzaiusapelord 10y agoI think Americans are going to realize exactly what "run the government like a Trump-branded business" really means. The anti-climate change and pro-business attitude the GOP has doesn't suddenly mean jobs and wealth for all. It means rolling back protections like these. We just saw our browsing data privacy taken from us and now this is probably going to happen. Not sure what Trump voters were expecting, but this is it. I hope they're happy with it.
- nkrisc 10y agoThis is why I never understood the "run the government like a business" concept. Business and governments do very different things. You wouldn't run a business like a government and running a government like a business is no better.
- psj 10y agoIndeed. If you were to truly run the government like you'd run a business, wouldn't you "fire" all the older people who are no longer performing at an acceptable level i.e. retired?
- VLM 10y agoFrom a .gov perspective performance and production is measured not by working, but by voting, and voting rates are excellent for older people.
- psj 10y agoThat's one more way a government isn't a business. Also, didn't Trump campaign on generally minimizing government? Did (does) he also run his businesses in such as way so as to "minimize" them? Obviously there are approaches that make sense to be common to running both business and government (that probably apply to most everything else as well because they'd seem like "common sense") but, at a high level, to say "run government like a business" is one of those things that only sounds reasonable (possibly) until you think about it.
- peatmoss 10y agoIf this isn't a ringing endorsement for single-payer "medicare for all" health insurance, I don't know what is. As a society we're aghast at the notion that people might be discriminated against due to their genetic pre-conditions. Why the heck do we let our values slug it out in an inefficient, non-competitive, quasi-market? Also, because it's Hacker News and a lot of folks here are engaged in start-ups, I wonder why I hear relatively more from tech about basic income than single-payer health. While basic income goes further, single-payer health removes a major burden / friction for creating a start up. Also, from a labor standpoint, decoupling health benefits from work allows start-ups to play with less-than-full-time employment arrangements. Having more people fractionally employed might be just the safety valve we need until automation job loss is more comprehensively addressed. But I digress.
- IncRnd 10y agoWhy do you believe that the possibility that people may be discriminated against due to their dna is a ringing endorsement for single-payer "medicare for all" health insurance?
- wavefunction 10y agoWe are all a part of the human race and we owe it to ourselves and our fellow humans to take care of each other.
- tghw 10y agoBecause a single payer would, by definition, cover everyone. Private insurance companies and employers (the two places most Americans get their health insurance from) may not want to pay for the higher costs associated with higher risk people like this. Employers would be especially susceptible to this sort of discrimination if proposed legislation allowing employers to demand genetic tests of their employees passes. https://www.washingtonpost.com/news/to-your-health/wp/2017/03/11/employees-who-decline-genetic-testing-could-face-penalities-under-proposed-bill/ https://www.washingtonpost.com/news/to-your-health/wp/2017/0...
- 10y ago
- kcorbitt 10y agoBeing born with this type of genetic predisposition is unfair, but passing that risk on to an unknowing employer is also unfair. For a medium-size business that underwrites its own policies (very common), a few employees with multi-million dollar medical needs can easily make the difference between a modest profit and bankruptcy. If we care about equal protection of all American citizens -- and I believe that we should -- the solution is not to legally prohibit employers from performing genetic screenings, it's simply to cover healthcare for high-risk individuals, or ideally everyone, at the national level with single-payer care. That way there's no incentive to cheat anti-genetic-discrimination laws, business don't have to worry about getting hit with an unexpected multi-million dollar expense, and the cost of coverage to everyone shows up on the national ledger, where it honestly belongs.
- reverend_gonzo 10y agoWhat companies underwrite their own health insurance policies? I would find that to be a ridiculous risk for those not actually in the business. The whole idea behind insurance is to spread the risk among lots of people. If a medium-sized business is underwriting their own policy, I would think they would quickly go bankrupt more often than not.
- dzdt 10y agoFamily farms.
- wavefunction 10y agoIf you're concerned about family farms you would oppose things too like ag-gag laws regarding un-hygenic food production/abuse and the general anti-humane industrialization of food products both animal and other. These are far more potent threats to traditional pastoral and agricultural traditions than tax policy. If it was just a bunch of family farms competing against each other (or more likely forming co-ops given history) then it might be a bit more of a fair playing field.
- wincy 10y ago
- pdelbarba 10y agoIt seems we're racing towards the events of Gattaca. It's easy to dismiss the movie as being similar to the far fetched distopian depictions in Minority Report, but in this case we actually have the technology to make it a reality.
- Afforess 10y agoI might be alone here, but I always felt Gattaca was misunderstood. The dystopia was that society allowed non-enhanced humans to be born. Allowing an underclass to exist, voluntarily, was the mistake. Genetic-engineering healthier, better people sounds great. Let's just make sure everyone has access.
- rhcom2 10y agoI could be misremembering but I thought the character who was non-enhanced was born that way on purpose due to the choice of the mother. Gets a lot more ethically dicey when you start talking about forcing people to genetically engineer their children or face them being forced into a underclass.
- pdelbarba 10y agoYou're correct. I think the other point is that regardless of the path we choose, there will be a period where not everyone will be genetically engineered due to availability (older people who were born before it was invented, people born to poor or conservative families)
- hackeraccount 10y agoHigh risk pools are an answer to the questions posed here. A collective will to ignore reality would not seem to be an answer to me.
- Bartweiss 10y agoThere are two very different questions here, though. One is whether we should accurately assess risk and probable healthcare costs. To which: yes, obviously. But the other is whether our existing system can do that without ruining people's lives for reasons they can't control. To which: no, probably not. The article points out that for insurers (or employers who underwrite their own insurance), mandates to cover people mean that dropping/firing someone in a high risk pool makes more sense than pricing accordingly. We already have regular problems with people getting dropped as they claim, we should expect to see people dropped because they will claim too. Sure, risk pooling makes sense. But in practice we have a strikingly inefficient market that will probably respond to this information in a way that ruins a lot of lives unnecessarily.
- pnutjam 10y agoHow do high risk pools address this? Will they be subsidized more then others, passing the cost to taxpayers? Otherwise, they will be unaffordable. The only way insurance works is to pool resources of people who don't need the service to cover those that do need the service.