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The Genetic Information Nondiscrimination Act (GINA) prohibits the use of genetic information to determine health insurance eligibility or premium

maxerickson 9y ago
Which is not really an ironclad guarantee it won't happen (I'm thinking in terms of the law being modified or repealed, not in terms of companies ignoring it). But the solution to the insurance problem is pretty obviously at the societal level. Once the testing is cheap enough, if they are allowed to, companies will just refuse carriage to people that won't submit the DNA (well, assuming that DNA profiling provides meaningful pricing information).
- Eridrus 9y ago
  I don't think repeal of GINA is remotely likely, just look at the political discussion about pre-existing conditions on both sides of the aisle, there is no appetite for having companies accurately price insurance. I think the fact that health insurance premiums are the #1 thing brought up in privacy discussions is basically evidence of the fact that we all know that insurance is a bad model for healthcare, but we can't bear to socialize it yet.
prepend 9y ago
But allows for life insurance, disability insurance, long term care, Amazon Prime, pretty much anything other than health insurance and employment.
- maxerickson 9y ago
  Should we be socializing the cost of Amazon Prime and life insurance? Because that's what removing information from the pricing of premiums does, it shifts costs from higher risk individuals to lower risk individuals. For life insurance, something like the US already does with Social Security (directly providing support payments to minors) probably makes more sense than forcing private insurers to omit information from their pricing. I'm a little less certain about disability and LTC, but those are also already somewhat socialized (Medicaid is the payer of last resort in both situations). But for life insurance? There's nothing pernicious about someone paying the correct actuarial price for a multi-million dollar contract.
  - prepend 9y ago
    This is a good point and I suppose it’s for society to determine. Since your genes are unchangeable (currently) it means some people in society will not be at a significant disadvantage if they can’t buy disability insurance or long term care insurance. This has ramifications throughout society. There’s a lot to be said for paying the correct actuarial price. But I suppose you could also charge different races different prices for their actuarial differences. So society needs to determine what things they distribute for justice. Social security is one form of this. But it seems unfair that one person with Alzheimer’s will suffer and die in a Medicaid nursing home because they can’t afford long term care insurance during their asymptomatic years while another with Alzheimer’s will use their long term care for appropriate end of life care. There’s a separate issue of why the poor have bad end of life care. But today the current example takes place because gene testing excludes some from insurance.
GCU-Empiricist 9y ago
How long do we expect that to stay on the books, or for it to be "missed" as a correlating input in an algorithm sourced actuarial rate?

maxerickson 9y ago

Which is not really an ironclad guarantee it won't happen (I'm thinking in terms of the law being modified or repealed, not in terms of companies ignoring it). But the solution to the insurance problem is pretty obviously at the societal level. Once the testing is cheap enough, if they are allowed to, companies will just refuse carriage to people that won't submit the DNA (well, assuming that DNA profiling provides meaningful pricing information).

Eridrus 9y ago
I don't think repeal of GINA is remotely likely, just look at the political discussion about pre-existing conditions on both sides of the aisle, there is no appetite for having companies accurately price insurance. I think the fact that health insurance premiums are the #1 thing brought up in privacy discussions is basically evidence of the fact that we all know that insurance is a bad model for healthcare, but we can't bear to socialize it yet.

prepend 9y ago

But allows for life insurance, disability insurance, long term care, Amazon Prime, pretty much anything other than health insurance and employment.

maxerickson 9y ago
Should we be socializing the cost of Amazon Prime and life insurance? Because that's what removing information from the pricing of premiums does, it shifts costs from higher risk individuals to lower risk individuals. For life insurance, something like the US already does with Social Security (directly providing support payments to minors) probably makes more sense than forcing private insurers to omit information from their pricing. I'm a little less certain about disability and LTC, but those are also already somewhat socialized (Medicaid is the payer of last resort in both situations). But for life insurance? There's nothing pernicious about someone paying the correct actuarial price for a multi-million dollar contract.
- prepend 9y ago
  This is a good point and I suppose it’s for society to determine. Since your genes are unchangeable (currently) it means some people in society will not be at a significant disadvantage if they can’t buy disability insurance or long term care insurance. This has ramifications throughout society. There’s a lot to be said for paying the correct actuarial price. But I suppose you could also charge different races different prices for their actuarial differences. So society needs to determine what things they distribute for justice. Social security is one form of this. But it seems unfair that one person with Alzheimer’s will suffer and die in a Medicaid nursing home because they can’t afford long term care insurance during their asymptomatic years while another with Alzheimer’s will use their long term care for appropriate end of life care. There’s a separate issue of why the poor have bad end of life care. But today the current example takes place because gene testing excludes some from insurance.

GCU-Empiricist 9y ago

How long do we expect that to stay on the books, or for it to be "missed" as a correlating input in an algorithm sourced actuarial rate?