2007/05/08

Your Genes Belong To You...

The US House of Representatives has passed legislation making discrimination based on genetic factors--inherited illnesses or predisposition toward certain diseases--illegal. In fact, the majority in favor of the Genetic Information Nondiscrimination Act (GINA) was a stunning 420 to 3. I wonder who the three were.

Though this is great news, the cynic in me wonders how this managed to slip by the radar of the insurance industry? Did they just not know about it? Or perhaps the negative publicity associated with opposing GINA was simply too risky since opposition could only mean one thing. Either way, the bill now heads for the Senate.

13 Comments:

Where it will be well and properly gutted before being passed in an appropriately altered state. Was that too cynical?
I can just see the signing statement now: All yer genes belong to me becus Ah'm the Decider.
the insurance companies are diabolically ranting, "i'll get you yet, gina!! haahahhhhahaahaaaa!!!" all the while plotting their defusing of this castrating act. gina was introduced over ten years ago, and their lobby has managed to keep it under wraps since then.
Yeah...Don't forget this signing statement...

"Jus' incase...If they find them gays are gay cause a gene, then they can still be discriminated against...Cause they're queer."
Fashiongirl... Not so sure, supposedly Bush as already signaled his support for the bill.

All yer genes belong to me becus Ah'm the Decider.

Diva... But only if yer one of them nasty l'brul types.
RAFFI... Welcome to Blognonymous.

...gina was introduced over ten years ago, and their lobby has managed to keep it under wraps since then.

Really?! Thanks for the information. Certainly puts a new spin on this doesn't it. I was prepared to ignore what the Senate does with this. Now I'm going to have to pay attention.

Gary... Where Bu$hCo is concerned no protection could be strong enough to protect homosexuals. That particular protection needs to be written straight into the Constitution! IMHO.
Finally... some good news about our elected officials and insurance! I think you're correct that the only reason they actually did this very human act is because they would have to explain such things as the blatant discrimination against Jewish folks with Tay Sachs and minorities with Sickle Cell.... lord knows that would make for an interesting defense, huh?
kvatch, you wrote:

"Though this is great news, the cynic in me wonders how this managed to slip by the radar of the insurance industry?

This story is not news, unless by news you mean the House has once again voted nearly unanimously in favor of a bill with all the impact of renaming a national park.

The lop-sided vote should tell you something. It means the outcome is toothless. The politicians do not fear any form of backlash.

If there's any outcome, it is this: that because insurers cannot demand higher rates from people most likely to develop specific diseases, the industry will seek higher rates from everybody.

In my view, legislation like this makes everyone happy. Many citizens, especially those whose families are plagued by hereditary illnesses, are pleased with the outcome. They believe this bill will somehow benefit those who might have been charged higher rates.

The insurance companies are happy too. Premiums are guaranteed to rise now that Congress has demanded that healthcare insurers feign ignorance about statistical realities.

Rather than segregate people according to their health prospects -- like property & casualty auto insurers with good and bad drivers -- health insurers must keep all premium payers in the same risk pool, thereby enabling insurers to raise everyone's premiums to offset the higher expenses of an identifiable minority.

The insurers will not underestimate the premiums -- paid by everyone -- needed to cover the costs of the few.

Meanwhile, it's not as though there are any trends in illnesses that are unknown to healthcare insurers. The medical community knows which populations are prone to certain ailments.

However, by passing the GINA bill, Congress acknowledges what the medical community already knows: that people can be grouped according to their likely illnesses. However, now that Congress is mandating that insurers take the healthy customers with the unhealthy, insurers will face no obstacles when they raise rates to absorb the increasing expenses of those whose illnesses are costly to treat.
Kvatch,

The cynic in me wonders...well how would anyone know about your inherited diseases, isn't that supposed to be confidential to protect you?

Oh but now we have this law, so it doesn't have to be confidential, because you are protected.

We need to know what you have, we'll cover you, but you have to pay more like a fat person has to pay more for an airline ticket...

I have to read the law...but why does this seem to be flying by when other laws are not. There's got to be some creepy catch, if there weren't not the insurance companies would be going crazy and they are suspiciously silent.

Lo
Despite your arguments to the contrary, no_slappz, insurances that are affected by behavior (property auto) are not like insurances that must spread risk for factors that are not under one's control. The biggest health insurance issue the US faces now is not it's cost, but the fact that many--the poor, the sick, the indigent--cannot get insurance at any cost. The companies that offer so-called 'health insurance' don't really want to be in that business but some other where they have no obligation to actually spread risk.

Then while you're focussing on your particular peeve, you completely ignore the issue of discrimination in employment. So should we infer then that you have no problem in having hiring decisions be based on your genetic makeup?
Lo... Not sure about the first issue you raise, but with the feds moving strongly to require DNA testing for even the suspicion of criminal wrongdoing--when combined with strong bent toward politicization of every federal department--I can seem some pretty wide avenues for abuse.
kvatch, you wrote:

"Despite your arguments to the contrary, no_slappz, insurances that are affected by behavior (property auto) are not like insurances that must spread risk for factors that are not under one's control."

Please. Teenagers have more car accidents that older drivers and smokers account for almost all cases of lung cancer and emphysema. Smoking, drinking and poor diet lead to major health problems for millions of people.

In any case, I did not state that the property & casualty insurance was identical to medical insurance in the formulation of rates or the experiences of the insured populations. But there is lots of common ground.

You said:

"The biggest health insurance issue the US faces now is not it's cost, but the fact that many--the poor, the sick, the indigent--cannot get insurance at any cost."

The extreme generosity and the magnitude of our humanitarian impulse is going to bankrupt this country. We are not threatened by increasing payments to Social Security recipients. We are threatened by our ability to treat and conquer more and more ailments, which enables a rapidly growing number of citizens to live more years while battling more illnesses and medical problems until encountering one that can't be beat. The last one is often the most expensive.

Welcome to the land of exponentially increasing healthcare expenditures. The cost of healthcare accelerates as more people receive coverage.

You point out that the poor, the sick and the indigent are denied health insurance. First, you're wrong. You claim they "cannot get insurance AT ANY COST". The poor are not, by definition, unhealthy. But they may lack the money to pay the premiums on plans available to them.

Your solution seems to include free healthcare for them. Free to them, but not for those who pay the bill. In other words, YOU want to pay the HUGE bills for others. However, I think you believe that somehow the health insurance companies are evil enterprises whose goal is to rip off hapless customers.

When it comes to insurance, many people think insurance companies own the patent for the tree that grows money. They refuse to recognize that insurance companies are nothing more than organizations taking in level payments from all customers in anticipation of paying out occasional large sums for the benefit of a smaller number.

Health insurance companies are not profit machines like Microsoft. But if they don't book profits, they will collapse in bankruptcy.

You wrote:

"The companies that offer so-called 'health insurance' don't really want to be in that business but some other where they have no obligation to actually spread risk."

Who tells you these myths? There are companies whose ONLY business is healthcare insurance. Meanwhile, your statement reads as though you think health insurance companies are some form of organic life that ponder alternative careers, wishing rebirth as some new corporate soul.

You wrote:

"Then while you're focussing on your particular peeve, you completely ignore the issue of discrimination in employment."

When are health issues part of the interview process? The issue may arise. But unless someone is visibly suffering from some malady, it goes unmentioned.

On the other hand, there are jobs where one's health is crucial to performance. Airline pilot is one.

Here's the real question: Why should a self-employed person live with the reality of seeing his net income reduced by the full amount of his healthcare premium when a corporate employee receives a salary that is reduced by small subsidized healthcare insurance premiums?

A self-employed person chooses insurance coverage based on a number of individual factors. He chooses his coverage like he might choose coverage for his car.

But a corporate employee doesn't give it a thought. Family coverage is often $50 or a $100 a month. Teachers and other union workers often pay ZERO $$ for health coverage.

For corporations, healthcare insurance premiums are a deductible expense. They are not included in the compensation of the employee. This is nuts. It is a huge subsidy to employees that allows them to ignore the real costs and spend healthcare dollars like lunatics, which people do.

If healthcare were a taxable, dollar-denominated component of compensation, millions of eyes would pop and people would think twice before running to the doctor. That's how it is for the self-employed. I oppose the inequity of the situation.

I guarantee you that many people would willingly work for generous healthcare benefits and small salaries, especially older people.

You said:

"So should we infer then that you have no problem in having hiring decisions be based on your genetic makeup?"

Hiring decisions should reflect the candidate's fitness for the job. If it's clear the candidate is close to death, I think an employer must consider that fact. Like a friend of mine who received two liver transplants, which his wife's corporate insurance covered. He rallied after the second transplant, and because he was a brilliant software guy, Rational Software hired him. About two years later he died.

As for hiring based on genetic make-up, you can be sure that employers are looking for something other than the correct gene profile. And, as it stands, it's not the employer who controls the price of healthcare insurance. It's the overall experience of the population that sets things in motion.

Thus, any company that offers a healthcare plan pays premiums that reflect, not only the small population of people working for the employer, but the entire population of insured people. Therefore, nothing is gained by refusing to hire a capable employee because his genes are questionable.

However, if every person in the US were covered, rates would explode. Anyone who thinks there is an economy of scale that would drive healthcare rates DOWN is nuts.
Hello, Kvatch.
Whatever the thing with insurance, I'm glad to see this happen.
Sure, it will probably get shot down in the Senate, but the House has always been more responsive.
It will take some time to get it into law.

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