5 ms·

If their results are accurate to a degree, why are their tests not being subsidized by insurance companies. How much would an insurance co save by alerting a pa

by sami36 14y ago

If their results are accurate to a degree, why are their tests not being subsidized by insurance companies. How much would an insurance co save by alerting a patient to her chances of getting diabetes, not to mention the money the patient would itself save.

gnaritas 14y ago
Who on earth would share their genetic profile with their insurance company? That's just asking for trouble.
- apaprocki 14y ago
  The same people who would install driving monitoring devices to lower their auto insurance[1]. Not everyone cares about privacy. [1]: http://www.nytimes.com/2012/11/25/business/seeking-cheaper-insurance-drivers-accept-monitoring-devices.html http://www.nytimes.com/2012/11/25/business/seeking-cheaper-i...
  - mrtron 14y ago
    It is not just privacy...how about human rights? "Sorry sir your infant child is not eligible for that heart operation due to the genetic marker we discovered in your profile."
    - mhb 14y ago
      It's not just privacy or human rights; it's an apparently pervasive misconception about what insurance is. The premise of insurance is that you are insuring against the unknown. If you know that something is the matter with you, then it's no longer insurance. It's getting someone to pay for a treatment that you know you will need. Whether other people should be paying for that is another discussion.
      - jerf 14y ago
        While I think it is important for people to understand the difference between health insurance and a health care plan, there's no actual problem with people banding together and creating health care plans that are no longer, strictly speaking, insurance. I do think a nontrivial amount of the mess in the health care system is the confusion between the two. People want to create health care plans, but they are trying to make it out of insurance companies, which is going to be problematic at best. Further, people want health care plans but don't want to think about it from an actuarial perspective... because they don't like the answers that come out. That doesn't prevent the answer from coming out, but it does mean we end up trying to build glorious systems that seal themselves away from reality from the get go, and that also can only be problematic at best, total failures at worst.
        mhb 14y ago
        I think that the more certainty people have about their future medical issues the less likely health care plan groups are to work. What incentive does a future-healthy person have to join with someone who is certain to have high expenses? And why would you trust someone to tell you that they haven't been tested and know what lies ahead?
        jerf 14y ago
        That's what I'm getting at. The more knowledge all the participants have (and that's both insurance and users), the more the fundamental contradictions between "insurance" and "health care plans" emerge. But closing your eyes and just remaining ignorant is a terrible choice too, because in the medical domain, knowledge isn't just power, it's life.
    - tptacek 14y ago
      That's not how insurance works now; if you already have insurance for your family, they don't render family members ineligible for therapy based on evidence of predisposition to illness. And as of 2014, regardless of the nature of the evidence, insurance companies will no longer be allowed to exclude customers based on predisposition to illness or preexisting conditions.
    - danielweber 14y ago
      Already illegal: http://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimination_Act http://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimi... In fact, HIPAA might have already forbidden that. The law wasn't clear but it's entirely moot now.
- sami36 14y ago
  Why not ? laws could be passed to forbid the use of genetic profiles in establishing premium rates the same way gender or ethnicity are not allowed for use when calculating credit scores. We're talking about a win-win-win (consumer, insurance company, state/ fed) situation for everybody if only we could learn to trust a lil bit. Why does every relationship between a consumer & a service provider has to be rooted in mistrust ? EDIT : Why is this being down-voted ?
  - gnaritas 14y ago
    > Why does every relationship between a consumer & a service provider has to be rooted in mistrust ? Because of money.
  - apaprocki 14y ago
    The law was already passed in the U.S.: "`(A) IN GENERAL- For purposes of this section, a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information."
- tejaswiy 14y ago
  This might be the way we're going even if people don't want to share their genetic profile with their insurance company.. what if 23AndMe and UHC (insurance co.) get into a deal where they provide this service for free? And what if UHC raises premiums on everyone that does not take this test? What if employers require their employees to do this much like drug / background checks?
  - gnaritas 14y ago
    > And what if UHC raises premiums on everyone that does not take this test? Don't think that's legal. > What if employers require their employees to do this much like drug / background checks? Also don't think that's legal.
    - nathos 14y ago
      In which case they could make it a "voluntary" check. Like the shady employers that demand candidates' Facebook credentials.
      - gnaritas 14y ago
        Sure, and you say no. Just like you say no to the checkout clerk asking for your phone number when you make a purchase. Same way you so no to a cop when he asks to search your vehicle.
        hickory 14y ago
        I don't disagree, and that is an easily imaginable scenario. But much like the cop they can still make things at best, uncomfortable, or at worst, nearly intolerable, for you. Creating that sort of de facto requirement is where the real problem lies (there's no legal obligation, but most of those vehicle search requests are performed anyway). We already have employers requesting "voluntary" disclosure of health information (e.g., cholesterol check) as a condition of continuing group insurance coverage. Since it's illegal to require this information, they make it voluntary - but anyone who opts-out also opts-out of a hefty premium "discount". In reality, the "discounted" rate is closer to what employers would expect to pay for comparable group plans, while the non-discounted premium is high enough that 99% of employees line right up to have their blood drawn by the visiting nurse (conveniently stationed in the conference room down the hall).
maratd 14y ago
There are really 3 sets of results they provide. 1. Genetic disorder. Tay–Sachs, etc. This stuff is priceless, because in the past, you had to pay thousands of dollars to get these same tests tone. These are accurate and very worthwhile ... but the majority of people will come back with all negative results, which is actually a good thing. 2. Your "increased risk" to certain diseases, like heart disease, etc. IMHO, these aren't worth much. A substantial portion of the risk for these types of diseases is related to lifestyle, so take it with a grain of salt. 3. Fun info, like telling you your eye color, where your ancestors came from, etc. > why are their tests not being subsidized by insurance companies. Insurance companies really only want #1. And guess what? That's info that I really don't want them to have.
- sami36 14y ago
  Yes , but wouldn't Nbr 2 in itself be worth a lot if the patient would make lifestyle changes in response to increased risks highlighted in their genetic profile. Suppose you have a genetic proclivity for alcoholism, wouldn't most people watch their consumption a lot more if provided with that information.
  - carbocation 14y ago
    But if one is predisposed to alcoholism, they might think, "Why even try to fight it? I'm going to succumb at some point anyway, might as well give up now and just enjoy it." This is just to say that that sword has two edges. EDIT: Made it abundantly clear that this is not my own personal fatalistic perspective.
    - sami36 14y ago
      yours is a fatalistic perspective. I would change my behavior if I knew.
      - carbocation 14y ago
        This is clearly not my perspective. I'm just illustrating the opposite viewpoint of the one you espoused for the purpose of reminding you that there is an unhappy alternative viewpoint.
travisp 14y ago
It depends what you mean by "results". The genetic results are very accurate (a >99% call rate and >99.9% reproducibility rate). However, medical knowledge isn't at a high enough level for these accurate genetic results to translate into truly meaningful medical results except for a handful of conditions. What does a 10% increased risk of getting diabetes mean to the average person? In practice, it means nothing, because you would act the same with or without this risk. Second, 23andMe is already walking the fine line of not needing FDA approval. If insurance companies were to pay for it, there's a good chance it would require this. There are several conditions that can be self diagnosed through 23andMe that require genetic tests that cost more than $99 through your doctor, but each of those tests has gone through a medical approval process.
khomenko 14y ago
Broadly speaking, because there are laws on the books that prohibit using genetic information for health insurance discrimination.
furyofantares 14y ago
What are the chances my current insurance company has to pay for treatment many years down the line? If I change jobs there is a good chance I will change insurance.

by sami36 14y ago

gnaritas 14y ago

Who on earth would share their genetic profile with their insurance company? That's just asking for trouble.

apaprocki 14y ago
The same people who would install driving monitoring devices to lower their auto insurance[1]. Not everyone cares about privacy. [1]: http://www.nytimes.com/2012/11/25/business/seeking-cheaper-insurance-drivers-accept-monitoring-devices.html http://www.nytimes.com/2012/11/25/business/seeking-cheaper-i...
- mrtron 14y ago
  It is not just privacy...how about human rights? "Sorry sir your infant child is not eligible for that heart operation due to the genetic marker we discovered in your profile."
  - mhb 14y ago
    It's not just privacy or human rights; it's an apparently pervasive misconception about what insurance is. The premise of insurance is that you are insuring against the unknown. If you know that something is the matter with you, then it's no longer insurance. It's getting someone to pay for a treatment that you know you will need. Whether other people should be paying for that is another discussion.
    - jerf 14y ago
      While I think it is important for people to understand the difference between health insurance and a health care plan, there's no actual problem with people banding together and creating health care plans that are no longer, strictly speaking, insurance. I do think a nontrivial amount of the mess in the health care system is the confusion between the two. People want to create health care plans, but they are trying to make it out of insurance companies, which is going to be problematic at best. Further, people want health care plans but don't want to think about it from an actuarial perspective... because they don't like the answers that come out. That doesn't prevent the answer from coming out, but it does mean we end up trying to build glorious systems that seal themselves away from reality from the get go, and that also can only be problematic at best, total failures at worst.
      - mhb 14y ago
        I think that the more certainty people have about their future medical issues the less likely health care plan groups are to work. What incentive does a future-healthy person have to join with someone who is certain to have high expenses? And why would you trust someone to tell you that they haven't been tested and know what lies ahead?
        jerf 14y ago
        That's what I'm getting at. The more knowledge all the participants have (and that's both insurance and users), the more the fundamental contradictions between "insurance" and "health care plans" emerge. But closing your eyes and just remaining ignorant is a terrible choice too, because in the medical domain, knowledge isn't just power, it's life.
  - tptacek 14y ago
    That's not how insurance works now; if you already have insurance for your family, they don't render family members ineligible for therapy based on evidence of predisposition to illness. And as of 2014, regardless of the nature of the evidence, insurance companies will no longer be allowed to exclude customers based on predisposition to illness or preexisting conditions.
  - danielweber 14y ago
    Already illegal: http://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimination_Act http://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimi... In fact, HIPAA might have already forbidden that. The law wasn't clear but it's entirely moot now.
sami36 14y ago
Why not ? laws could be passed to forbid the use of genetic profiles in establishing premium rates the same way gender or ethnicity are not allowed for use when calculating credit scores. We're talking about a win-win-win (consumer, insurance company, state/ fed) situation for everybody if only we could learn to trust a lil bit. Why does every relationship between a consumer & a service provider has to be rooted in mistrust ? EDIT : Why is this being down-voted ?
- gnaritas 14y ago
  > Why does every relationship between a consumer & a service provider has to be rooted in mistrust ? Because of money.
- apaprocki 14y ago
  The law was already passed in the U.S.: "`(A) IN GENERAL- For purposes of this section, a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information."
tejaswiy 14y ago
This might be the way we're going even if people don't want to share their genetic profile with their insurance company.. what if 23AndMe and UHC (insurance co.) get into a deal where they provide this service for free? And what if UHC raises premiums on everyone that does not take this test? What if employers require their employees to do this much like drug / background checks?
- gnaritas 14y ago
  > And what if UHC raises premiums on everyone that does not take this test? Don't think that's legal. > What if employers require their employees to do this much like drug / background checks? Also don't think that's legal.
  - nathos 14y ago
    In which case they could make it a "voluntary" check. Like the shady employers that demand candidates' Facebook credentials.
    - gnaritas 14y ago
      Sure, and you say no. Just like you say no to the checkout clerk asking for your phone number when you make a purchase. Same way you so no to a cop when he asks to search your vehicle.
      - hickory 14y ago
        I don't disagree, and that is an easily imaginable scenario. But much like the cop they can still make things at best, uncomfortable, or at worst, nearly intolerable, for you. Creating that sort of de facto requirement is where the real problem lies (there's no legal obligation, but most of those vehicle search requests are performed anyway). We already have employers requesting "voluntary" disclosure of health information (e.g., cholesterol check) as a condition of continuing group insurance coverage. Since it's illegal to require this information, they make it voluntary - but anyone who opts-out also opts-out of a hefty premium "discount". In reality, the "discounted" rate is closer to what employers would expect to pay for comparable group plans, while the non-discounted premium is high enough that 99% of employees line right up to have their blood drawn by the visiting nurse (conveniently stationed in the conference room down the hall).

maratd 14y ago

There are really 3 sets of results they provide. 1. Genetic disorder. Tay–Sachs, etc. This stuff is priceless, because in the past, you had to pay thousands of dollars to get these same tests tone. These are accurate and very worthwhile ... but the majority of people will come back with all negative results, which is actually a good thing. 2. Your "increased risk" to certain diseases, like heart disease, etc. IMHO, these aren't worth much. A substantial portion of the risk for these types of diseases is related to lifestyle, so take it with a grain of salt. 3. Fun info, like telling you your eye color, where your ancestors came from, etc. > why are their tests not being subsidized by insurance companies. Insurance companies really only want #1. And guess what? That's info that I really don't want them to have.

sami36 14y ago
Yes , but wouldn't Nbr 2 in itself be worth a lot if the patient would make lifestyle changes in response to increased risks highlighted in their genetic profile. Suppose you have a genetic proclivity for alcoholism, wouldn't most people watch their consumption a lot more if provided with that information.
- carbocation 14y ago
  But if one is predisposed to alcoholism, they might think, "Why even try to fight it? I'm going to succumb at some point anyway, might as well give up now and just enjoy it." This is just to say that that sword has two edges. EDIT: Made it abundantly clear that this is not my own personal fatalistic perspective.
  - sami36 14y ago
    yours is a fatalistic perspective. I would change my behavior if I knew.
    - carbocation 14y ago
      This is clearly not my perspective. I'm just illustrating the opposite viewpoint of the one you espoused for the purpose of reminding you that there is an unhappy alternative viewpoint.

travisp 14y ago

It depends what you mean by "results". The genetic results are very accurate (a >99% call rate and >99.9% reproducibility rate). However, medical knowledge isn't at a high enough level for these accurate genetic results to translate into truly meaningful medical results except for a handful of conditions. What does a 10% increased risk of getting diabetes mean to the average person? In practice, it means nothing, because you would act the same with or without this risk. Second, 23andMe is already walking the fine line of not needing FDA approval. If insurance companies were to pay for it, there's a good chance it would require this. There are several conditions that can be self diagnosed through 23andMe that require genetic tests that cost more than $99 through your doctor, but each of those tests has gone through a medical approval process.

khomenko 14y ago

Broadly speaking, because there are laws on the books that prohibit using genetic information for health insurance discrimination.

furyofantares 14y ago

What are the chances my current insurance company has to pay for treatment many years down the line? If I change jobs there is a good chance I will change insurance.