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It is in no one's best interest to provide DNA to their insurance provider in the interest of "full-disclosure" in hopes of negotiating a lower rate. Let's say

It is in no one's best interest to provide DNA to their insurance provider in the interest of "full-disclosure" in hopes of negotiating a lower rate. Let's say that today you are aware of no sequences in your genome which correlate with disease. You give a sample to your provider as proof. Tomorrow, a new link is discovered between a disease and a sequence you do have. Your premiums then go up considerably. There is an unbounded number of future medical discoveries which could cause you to be considered risky. This is the fundamental problem with giving away privacy: it's fine, until one day the world changes, and it wasn't fine.

bpodgursky 6y ago
> Let's say that today you are aware of no sequences in your genome which correlate with disease. You give a sample to your provider as proof. Tomorrow, a new link is discovered between a disease and a sequence you do have. Your premiums then go up considerably. Yes, and everyone else's rates go a bit down . It's not a negative-sum game -- assuming a reasonable competitive market, you're going to get a fair rate in a maximal-information pool. You may increase risk somewhat, but if you know -- from personal and historical experience -- that your family is not especially high risk, you're still on average better off sharing as much information as you can.
- elliekelly 6y ago
  If you want to look for efficiencies in the (US) insurance market from information sharing it’s going to be far more cost effective to even out the flow of information coming the other direction: transparency of pricing. More price information about everything from drugs, to procedures, to copays and premiums. We’ll all save a lot more money by shining a light further up the chain than we will by individually offering up our DNA to save a few hundred bucks each year. And we’ll get to maintain a bit of privacy, too.
  - bpodgursky 6y ago
    I don't disagree wrt transparency (although for many people I suspect genomic data is worth a lot more than a few hundred bucks a year), but these are separate concerns. I'm just disagreeing with the OP assertion that "submitting your own DNA is always negative value" Definitely making no claim whatsoever as to what the best way to make healthcare more cost-effective is.
smabie 6y ago
It could work the other way to: new analysis on your DNA could reduce your premiums. As such, I don't think it's unreasonable for some people to want to submit their DNA.
- michaelmrose 6y ago
  Figuring out increasingly accurately who is going to get sick breaks the entire point of insurance as a cost pool based on the inherent uncertainty of who is going to be a net payer and who a net payee and at the limit your costs gets increasingly close to the cost of care + cost of administration with the added negative that the insurance industry that has taken your premiums for decades can decide they like your money too much to part with it and keep it depriving you of care perhaps because the care that may keep you alive is experimental. It is in all of societies interests to make the temporary gains you describe simply illegal and to reconsider the utility of insurance as a method to pay for medical care in the face of increasingly predictable risks.
tzs 6y ago
Are you taking into account that your genome is inherited? If you have good knowledge of your ancestors back a few generations and their health you could probably make a pretty good guess whether or not there is some factor lurking in your genome that correlates with a disease severe enough to raise your rates. This could make the potential savings worth the risk for some people. (I wonder if a new kind of insurance would develop for the risk that disclosing your genome raises your rates?)
- maxerickson 6y ago
  From a societal standpoint, we should work to make things like term life and disability insurance broadly available and relatively even priced, not rewards for good genes. (there's lots of reasons, a big one is that they are often implicated in the standard of living that children will attain) If you want to have other social programs that universally bolster standard of living, then it's fine to make insurance a stupid awful game for people to play.

bpodgursky 6y ago

> Let's say that today you are aware of no sequences in your genome which correlate with disease. You give a sample to your provider as proof. Tomorrow, a new link is discovered between a disease and a sequence you do have. Your premiums then go up considerably. Yes, and everyone else's rates go a bit down . It's not a negative-sum game -- assuming a reasonable competitive market, you're going to get a fair rate in a maximal-information pool. You may increase risk somewhat, but if you know -- from personal and historical experience -- that your family is not especially high risk, you're still on average better off sharing as much information as you can.

elliekelly 6y ago
If you want to look for efficiencies in the (US) insurance market from information sharing it’s going to be far more cost effective to even out the flow of information coming the other direction: transparency of pricing. More price information about everything from drugs, to procedures, to copays and premiums. We’ll all save a lot more money by shining a light further up the chain than we will by individually offering up our DNA to save a few hundred bucks each year. And we’ll get to maintain a bit of privacy, too.
- bpodgursky 6y ago
  I don't disagree wrt transparency (although for many people I suspect genomic data is worth a lot more than a few hundred bucks a year), but these are separate concerns. I'm just disagreeing with the OP assertion that "submitting your own DNA is always negative value" Definitely making no claim whatsoever as to what the best way to make healthcare more cost-effective is.

smabie 6y ago

It could work the other way to: new analysis on your DNA could reduce your premiums. As such, I don't think it's unreasonable for some people to want to submit their DNA.

michaelmrose 6y ago
Figuring out increasingly accurately who is going to get sick breaks the entire point of insurance as a cost pool based on the inherent uncertainty of who is going to be a net payer and who a net payee and at the limit your costs gets increasingly close to the cost of care + cost of administration with the added negative that the insurance industry that has taken your premiums for decades can decide they like your money too much to part with it and keep it depriving you of care perhaps because the care that may keep you alive is experimental. It is in all of societies interests to make the temporary gains you describe simply illegal and to reconsider the utility of insurance as a method to pay for medical care in the face of increasingly predictable risks.

tzs 6y ago

Are you taking into account that your genome is inherited? If you have good knowledge of your ancestors back a few generations and their health you could probably make a pretty good guess whether or not there is some factor lurking in your genome that correlates with a disease severe enough to raise your rates. This could make the potential savings worth the risk for some people. (I wonder if a new kind of insurance would develop for the risk that disclosing your genome raises your rates?)

maxerickson 6y ago
From a societal standpoint, we should work to make things like term life and disability insurance broadly available and relatively even priced, not rewards for good genes. (there's lots of reasons, a big one is that they are often implicated in the standard of living that children will attain) If you want to have other social programs that universally bolster standard of living, then it's fine to make insurance a stupid awful game for people to play.