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Privacy Fears Send DNA Tests Underground

Soulskill posted more than 6 years ago | from the no-not-literally dept.

Medicine 222

biobricks writes "The New York Times is reporting that people who could benefit from genetic testing are too afraid their health insurance companies are going to raise their rates or deny them coverage to find out the health information contained in their own genes. There is a growing "genetic underground" where people pay for their own tests so they won't have to share the results with insurers, and beg doctors not to divulge their genetic status in medical records. A bill that would ban genetic discrimination by insurers and employers — and presumably make people feel safer about taking care of their health — is stalled in the Senate. We've discussed these types of personal DNA tests in the past."

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222 comments

logan's run? (4, Funny)

HalifaxRage (640242) | more than 6 years ago | (#22535414)

can they change the colour of this thing in my hand?

Re:logan's run? (-1, Troll)

Anonymous Coward | more than 6 years ago | (#22535782)

I want to fuck Nina Reiser's corpse. But only if it has been preserved well. I don't want to fuck it if it is all rotting and looking like that banana I left in the fridge for 18 weeks, that be gross. But seriously guys, when I think of necrophilia I think of Nina Reiser. She the corpse that everyone wants to fuck.

- Hans

Insurance policy (3, Insightful)

Z00L00K (682162) | more than 6 years ago | (#22535424)

is always to avoid paying out money and to aggregate money to build profit.

An insurance is a way for the insured to get an acceptable cover for risks and an insurance company also has to take a reasonable risk. Even if a certain genetic predisposition exists doesn't mean that it actually is triggered in an individual.

Re:Insurance policy (5, Insightful)

CRCulver (715279) | more than 6 years ago | (#22535452)

Isn't this just another sign that the adoption of new technology (e.g. broadband) by the American public is slowing due to governmental and societal hassles? You don't have to be a wacko like Michael Moore in Sicko [amazon.com] to admire the benefits of a public health system. If people can't lose their coverage, people might not fear DNA testing.

Re:Insurance policy (5, Insightful)

Taevin (850923) | more than 6 years ago | (#22535678)

The interesting thing is that if the US had a health care system based more around prevention rather than treatment (and that includes insurance companies as well), costs would probably be lower since it's often cheaper to 'treat' illness factors before they become a full disease. In the case of DNA testing, if it revealed I had a predisposition for a certain disease it's stupid for insurance companies to "punish" me for finding this out since I may be able to prevent it from ever becoming a really expensive problem, thus saving them money.

Re:Insurance policy (3, Interesting)

CRCulver (715279) | more than 6 years ago | (#22535710)

The interesting thing is that if the US had a health care system based more around prevention rather than treatment (and that includes insurance companies as well), costs would probably be lower since it's often cheaper to 'treat' illness factors before they become a full disease. In the case of DNA testing, if it revealed I had a predisposition for a certain disease it's stupid for insurance companies to "punish" me for finding this out since I may be able to prevent it from ever becoming a really expensive problem, thus saving them money.

Nonetheless, isn't there some kind of an economic argument that if insurance companies paid for people to avoid one big illness, with their longer lifespan they would end up costing the company more in smaller illnesses over time?

Re:Insurance policy (4, Interesting)

tomhudson (43916) | more than 6 years ago | (#22535792)

Nonetheless, isn't there some kind of an economic argument that if insurance companies paid for people to avoid one big illness, with their longer lifespan they would end up costing the company more in smaller illnesses over time?

Plus, the quicker someone dies, the less chance they have of getting one of those expensive dieseases ...

Its like social security - a REAL patriot will die on their 65th birthday!

Re:Insurance policy (4, Insightful)

legirons (809082) | more than 6 years ago | (#22535822)

"Nonetheless, isn't there some kind of an economic argument that if insurance companies paid for people to avoid one big illness, with their longer lifespan they would end up costing the company more in smaller illnesses over time?"

If your insurance premium was per-life rather than per-year, then yes it might...

An ounce of prevention... (5, Interesting)

Lorien_the_first_one (1178397) | more than 6 years ago | (#22535742)

Consider that the National Association for the Self-Employed offers the following on their policies: you pay a monthly premium from now until you're 65. Your premium never goes up. When you get there, they say, ok, lets look at your claims against the insurance. They add them up. Then add up the premiums you've paid. And they give you the difference if anything is left over. Apparently, they invest the money because i was told that if I started today, i would have about $800k in premiums paid. Then they would deduct the claims and give me the difference. They are the first company I've heard of that does this. Had I know about this, I would have done it a long time ago.

Re:An ounce of prevention... (5, Informative)

Mr. Slippery (47854) | more than 6 years ago | (#22535910)

Consider that the National Association for the Self-Employed...

...is a front for MEGA Life and Health [businessweek.com] . Though they certainly try to hide it, NASE is not an actual indepentent "association", but the marketing arm of MEGA. Fortunately, the high-pressure sale techniques of the agent I encountered were enough to tip me off that something was wrong, and I Googled before I bought and so learned how bad the "coverage" MEGA provides actually is [boston.com] .

Avoid NASE [google.com] . It's a scam.

Thanks for the tip... (1)

Lorien_the_first_one (1178397) | more than 6 years ago | (#22536048)

I would like to point out that I think there should be at least some reward for people who take good care of themselves. I guess one can only hope that sensible ideas will prevail.

Re:Thanks for the tip... (3, Insightful)

baboo_jackal (1021741) | more than 6 years ago | (#22536516)

I would like to point out that I think there should be at least some reward for people who take good care of themselves.

I like the idea of a Health Savings Account in conjunction with a High-Deductible Health Plan [opm.gov] . The idea is that you contribute a limited amount annually to a special IRA. Each year, you pay (tax-free) for your medical care out of that IRA until you hit your deductible. Then, everything's free. Next year, you contribute the same limited amount, the deductible resets, wash-rinse-repeat.

The neat thing is that you benefit from leading a healthy lifestyle, but you're still covered in case of some catastrophic health issue.

One secondary effect of using an HSA is that it makes routine healthcare decisions economic decisions. I think that's a good thing. Others might not agree. But I suspect that if everyone used these things, the cost of healthcare would decrease. Just my opinion.

Re:An ounce of prevention... (4, Insightful)

tomhudson (43916) | more than 6 years ago | (#22536038)

In other words,

  1. if the investments lose money, you have no health care - they still get their cut
  2. at age 65, we wash our hands of you, after taking our cut, so forget about all those expensive health problems old people have
  3. its not insurance - if we lose money on you, we don't average it with other people in a collective risk pool - but we still get our cut
  4. the premium never goes up - but medical expenses are increasing by 12% a year, doubling every 6 years. In 30 years, that $800k will buy $25k worth of health care in today's dollars. That will keep you in Depends in a nursing home for what, one year today?

Re:Insurance policy (0, Insightful)

Anonymous Coward | more than 6 years ago | (#22536158)

"In the case of DNA testing, if it revealed I had a predisposition for a certain disease it's stupid for insurance companies to cover their expected costs upon finding this out since I may be able to prevent it from ever becoming a somewhat less expensive problem, thus losing them less money."

There, fixed that for you.

Whilst it's true that a predisposition to a disease is not a 100% guarantee that said condition/disease will be realised, the insurance companies' actuaries do need to account for the statistical probability that it will happen. I don't understand why people complain about insurance companies. They're businesses---not charities. If you don't like your rates, then don't purchase insurance and just pay cash.

If you can't afford cash, then bummer. Life's not fair, suck it up and deal with it.

Re:Insurance policy (3, Insightful)

TheLink (130905) | more than 6 years ago | (#22536448)

They also _delay_ payouts (in addition to not paying out for ethically _bogus_ reasons - you did stuff 10 years ago so we're not paying, don't like it? Don't think that's relate? Sue us - have fun attending court while you're dying)

Say a company makes millions of dollars worth of payouts a day, if they delay for 2 months, they make a LOT of money.

Doctors paid by the insurance companies usually have an incentive to work for the insurance company rather than the patient. So more people die that way.

Sometimes it's cheaper if the person dies - sure you pay out eventually, but I think you pay out less. They'll do the math accordingly.

I guess the idea is if some people have to die so that you can afford another yacht/plane/mansion, too bad for them.

My DNA tests show that I am thirsty (-1, Flamebait)

Anonymous Coward | more than 6 years ago | (#22535428)

for a firsty

My experience as a phlebotomist (5, Interesting)

anglico (1232406) | more than 6 years ago | (#22535434)

was that the results are mailed ONLY to the test subject. The paper the patient gave me with the lab address to mail to specifically stated that they will not release the results to anybody else, not even the doctor unless there is a signed document declaring that this is the patients decision. Granted this is only one lab, but Im hoping its the same for all labs.

Results often don't end up with the patient (5, Interesting)

weston (16146) | more than 6 years ago | (#22535852)

I think this is pretty interesting, because 100% of the time, I have to fight to get a solid copy of lab reports on blood work, and half the time the staff at the doctor's office (across several offices) will look at me like I'm some kind of freak because I want copies of my own medical tests and doctor's notes. I can ask that copies of whatever's produced by a test be sent to my home address as well as the ordering doctor's office and they never, ever come. Not once.

The only effective way I've found to actually get records is to tell them I want records faxed to another doctor... at a number I receive at.

If my experience is any indication, most patients don't have *access* to their own medical records, let alone control over them.

Re:Results often don't end up with the patient (1)

Ritchie70 (860516) | more than 6 years ago | (#22536002)

I haven't had a lot of lab work done, but in watching my wife's experience, it's a fight to get it sent anywhere in a timely fashion, including to the doctor who ordered it.

That battle is typically followed a fight to get the doctor's office to admit they received it once the lab does send it.

Re:Results often don't end up with the patient (1)

roman_mir (125474) | more than 6 years ago | (#22536216)

I am a Canadian citizen, that's why I have to go to other countries to get the kind of attention that I want to my health. I like Germany for this, a couple of thousand of Euros give me a lot of power in terms of diagnostics. There is NEVER a question about me getting full access and control about what is happening to me. All tests are in my hands, all choices are for me to make with the advice of really good doctors. That's the way I like it.

Re:Results often don't end up with the patient (4, Interesting)

MMC Monster (602931) | more than 6 years ago | (#22536668)

IAAP (I am a physician), and I can tell you that I *never* hesitate in giving patients their lab results, etc. I will even give them a copy of recent tests, etc. I only make a not of it in the official chart if the patient asks for copies of their entire record (but even then don't delay). Physicians are part of the service industry. If we don't serve, there are plenty of alternatives.

That being said, I've seen other medical offices in which their general policy is to avoid giving official documents to patients, in fear of litigation. My thought on the subject: A happy patient is less likely to sue, even if a mistake is made.

Re:Results often don't end up with the patient (1)

anglico (1232406) | more than 6 years ago | (#22536738)

I've had plenty of patients ask for a copy of their results from the main testing lab we use, as long as they signed a medical record release I'm allowed to give them a copy. The lab we send the blood to will fax the results to a number automatically if I supply a number, and if I put CC:Patient it is SUPPOSED to mail them a copy. I've had problems with bad addresses where I received over 30 pages of form letters saying that "We tried to mail a copy of these lab results to this patient and it was returned as ...." so I know they are doing it. One patient told me that it took two weeks when he had them mailed to his house, so he gave me a fax number the next time.
  As far as California law I believe a patient is allowed to come in and view and copy their medical record at their own cost at any time, it may just be a clinic policy of ours, but I'm pretty sure it's a law.

Um, how is that different from....? (5, Insightful)

NIckGorton (974753) | more than 6 years ago | (#22535436)

People already do this with tests other than genetic ones. I have heard many times: "Don't write this in my record but..." with regard to 'stealth' health care problems. In most states you can order labs without a doctor's prescription through direct to consumer labs, so you can find out all sorts of things that can effect your insurability. Heck, go to a pharmacy and you can check your BP for free.

The solution of course isn't congress passing a bill that makes such discrimination illegal, but rather to pass a bill that establishes universal health insurance (preferably single payer, but lets be honest, the US is far too much a classist society to adopt that... sigh.) Though what's particularly stupid about such a bill is that it would outlaw discrimination from insurers if I noted in your record that you had a blood test that said you were predisposed to diabetes or hypertension, but it would not outlaw the same discrimination that would occur if I noted in your chart that your BP was 160/100 or your fasting blood sugar was 160. If we diagnose your hypertension or diabetes with a $2000 test, you are safe, but if I diagnose it with a $3 lab test or by taking your BP several times, you are hosed.

Brilliant.

We still discrimination illegal for jobs (1)

Joe The Dragon (967727) | more than 6 years ago | (#22535482)

as then they can just keep you from working if you have predisposed to be sick have have to miss work for a long time.

Re:Um, how is that different from....? (1)

Tuoqui (1091447) | more than 6 years ago | (#22536524)

Unfortunately this wont help for tests where there are already established easily detected stuff... What it will help prevent discrimination for is genetic defects and genetic disorders that are difficult or impossible to diagnose without genetic tests like Huntington's Disease (there was a slashdot article about some young woman doing a test in her 20's to tell how much 'time' she had before the disease affected her) and other such things where the only way to tell is a DNA test.

Just like you're screwed with high blood pressure today, you're screwed with it tomorrow. So you have not really gained anything but you are not losing things in the future (IE. the insurance company cant ask you if you knowingly have a genetic disorder)

He who pays for the test owns it (1, Insightful)

Anonymous Coward | more than 6 years ago | (#22535458)

There's an easy solution here:

Whoever pays for the test should legally own the result. So if you pay for it out of pocket, you own the result and it's up to you whether you want to share it with any third party.

If your insurance company pays for it though, then they have a perfect right to see the results.

Layering still more legislation on top of medical record privacy law is just going to add complexity to a system which is already drowning under its own administrative overhead.

Re:He who pays for the test owns it (4, Interesting)

NIckGorton (974753) | more than 6 years ago | (#22535690)

Except that (given the current model of insurance and health care as a commodity rather than a human right) when you purchase and insurance policy they have every right as a business interested in making money to say: "Do you have any pre-existing medical condition or genetic predisposition to any significant medical illness?" If you say no when the answer is truly yes, you are violating your end of the contract. If that can be proved in the future by subpoenaing your private health care records or if you actually do something like the woman in TFA that reveals your genetic status in your health care records, they can cancel your policy, since you lied when entering the contract for health insurance.

And since this is a business contract, your medical privacy is meaningless since the insurer can also (as a condition of selling you the policy) require you to allow access to all medical records and tests. Of course they likely won't do that unless you actually become sick and they have to pay money for your care. If they do, they hire people to scour your medical record for one slip up (like you may not have revealed you had a cold in December 1987 for which you were prescribed robitussin with codeine) as a means to void your policy.

Events like the recent ruling in favor of a woman whose insurance was canceled while she was undergoing treatment for breast cancer (because she had failed to reveal a history of a heart ailment and she mis-estimated her weight) are unusual - but only in that the arbitration judge ruled in her favor. Most of the time, arbitration (which you must agree to when buying any private insurance - they all require it) goes in favor of the side with the best attorneys to back them. No surprise that the insurers love arbitration. However this case was so egregious that even the arbitration judge was shocked - for example by the fact that healthnet maintained there was no real harm to the woman from dropping her (since after a couple of months she was able to get care in a state program) or the fact that company documents revealed that employees of healthnet actually got bonuses based on the number of policies the were able to cancel for patients on whom the company was losing money (i.e. sick ones.) http://www.latimes.com/features/health/la-fi-insure23feb23,1,2680255.story [latimes.com]

Re:He who pays for the test owns it (4, Insightful)

unlametheweak (1102159) | more than 6 years ago | (#22535898)

Except that (given the current model of insurance and health care as a commodity rather than a human right) when you purchase and insurance policy they have every right as a business interested in making money to say: "Do you have any pre-existing medical condition or genetic predisposition to any significant medical illness?" If you say no when the answer is truly yes, you are violating your end of the contract.
- The simple solution would be to outlaw such questions from being raised

- The more intelligent solution is to outlaw discrimination based on pre-existing medical conditions (thus destroying the business model of the insurance industry as it exists now in the US, which wouldn't be a bad thing). The point of the medical industry is to cure people. The point of the medical insurance industry is to make the most money possible. They are contradictory goals for which only legislation can facilitate a more rational change.

And a point from the article:

A bill that would ban genetic discrimination by insurers and employers -- and presumably make people feel safer about taking care of their health -- is stalled in the Senate.
I will tell you that if insurers have this information then they will take steps to discriminate and obfuscate this discrimination as best they can. Like any other multi-billion dollar industry, these people are not fools or philanthropists; they will use creative accountants (think Enron), statisticians (think Ford Pinto), lawyers (just think, no explanation required), lobbyists, MBAs, etc to get what they want and minimize any adverse effects of their image.

Re:He who pays for the test owns it (4, Informative)

NIckGorton (974753) | more than 6 years ago | (#22536130)

The more intelligent solution is to outlaw discrimination based on pre-existing medical conditions (thus destroying the business model of the insurance industry as it exists now in the US, which wouldn't be a bad thing). The point of the medical industry is to cure people. The point of the medical insurance industry is to make the most money possible. They are contradictory goals for which only legislation can facilitate a more rational change.
Except that its the 'for profit' part that is the problem, whether its health insurance or health care delivery. For profit providers of health care also have the same problem (like the famously substandard care that is delivered at nursing homes owned by large for profit corporations.) And similarly, non-profit insurers (cough-Kaiser-cough) in the US are way not as evil as for profit ones. I have had several patients (in the sliding scale clinic where I volunteer 2 days a week) who sought individual policies who had pre-existing conditions - while none was offered any plan by BCBS, Aetna, Health Net, et al, Kaiser covered them all - albeit after I had to send a buttload of tests on some of them and one with an exclusion for one type of care. Kaiser is also one of the few insurers who doesn't as policy drop individual members when they become ill. But then they spend most of the money they take in on care, and none goes to profit. If you have to pay out 25% of your money as profits and administration, you gotta pinch pennies somewhere. Pruning the sick and expensive folks is easy and very successful!

Its not rocket science: You can do health care for people or for profit. Not both simultaneously.

Re:He who pays for the test owns it (4, Interesting)

unlametheweak (1102159) | more than 6 years ago | (#22536302)

Except that its the 'for profit' part that is the problem
That is pretty much implicit as to what I was saying. I think universal health care like we have here in Canada would be the most fair and utilitarian solution. The main disadvantage is that the rich would not be as advantaged, like having faster access to non-emergency or non life-threatening care. The free market people can bitch all they want, but I know (and yep it's anecdotal) from personal experience (through many friends and relatives) that if people need (for example) cancer treatment, or therapy for a stroke; they will get it pronto and it won't be in some cheap third world style clinic. No it's not free; we pay for it through our taxes. But since everybody pays for it and there are no sales people or middlemen making money, it's overall cost is cheaper than it is in the US. It may not have the polish and shine that a CEO wanting health care would want, but it works. And yes universal health care is not directly on-topic so I was avoiding stating it explicitly.

Best regards,

UTW

Re:He who pays for the test owns it (2, Interesting)

KDR_11k (778916) | more than 6 years ago | (#22535868)

Under the condition that the subject of the test must not be coerced or required to take the test, I agree. That would include any form of explicit or implicit requirement, e.g. for employment the employer would not be allowed to require or encourage DNA tests (by preferring candidates who subject themselves to the test).

Opening a can of worms here, but... (2, Insightful)

MWoody (222806) | more than 6 years ago | (#22535498)

*sigh* So now we have to hide information in the fear of the privately owned companies, who operate for profit and nothing else - as well they should; that's how the system works - increasing our rates. How bad are things going to have to get before we let our taxes take over where insurance companies currently operate? Yes yes, it's "taking away our freedoms." Y'know what, though? I'm willing to give up my right to die from a treatable wound or illness.

Re:Opening a can of worms here, but... (1)

ATMAvatar (648864) | more than 6 years ago | (#22535636)

The problem is, they don't merely increase your rates. With the right (or wrong, as the case may be) set of pre-dispositions, an insurance agency will refuse to accept your business, as you are too much of a risk. This is less of an issue with employer group plans, of course, but it can still happen. Life insurance companies are even worse than health insurance companies.

Re:Opening a can of worms here, but... (0)

Score Whore (32328) | more than 6 years ago | (#22535652)

I'm curious. Do you believe in evolution? I know it may sound heartless and uncivilized, but at what point is a person who is fundamentally broken down kicked off the public teat? Societies formed so that the participating parties would be able to do things that are in their best interest but that they could not do for themselves, not so that they could do things that they can do for themselves or are not in their best interest.

To use a real life example, does it make sense that the people in Nebraska should have to carry the insurance burden for the people who choose to live in hurricane alley? That's what Florida thinks should be the case.

Re:Opening a can of worms here, but... (0)

Anonymous Coward | more than 6 years ago | (#22535808)

But there's a difference. A person in Florida can move, a person born with a genetic predisposition to cancer can't change their DNA (yet).

Your post reminds me of the Star Trek TNG episode where they visit the planet that had wiped out genetic impurity, but then found themselves needing the help of the blind guy who wouldn't have existed in their society.

Re:Opening a can of worms here, but... (4, Interesting)

antifoidulus (807088) | more than 6 years ago | (#22535886)

You are taking a VERY individualist view of evolution. Humans are a social animal, we can all gain from contributions from even the weakest(physically) members of society. How many artists, inventors, scientists, mathematicians etc. have had physical abnormalities(maybe even sometimes genetic) but have nonetheless contributed to the advancement of our species?

Killing anyone who has a disability(or just leaving them to fend for themselves) probably does not bode well for the longevity of your culture. There have been groups in history that killed any young that had abnormalities, one of the most famous being the Spartans. You don't see their culture dominating the globe, do you?

Re:Opening a can of worms here, but... (0)

Anonymous Coward | more than 6 years ago | (#22536562)

How many retarded people have "contributed to the advancement of our species"?

Re:Opening a can of worms here, but... (1)

Score Whore (32328) | more than 6 years ago | (#22536672)

Adaption happens at the level of individuals. When groups develop that protect their less adapted members, the group as a whole becomes less well adapted. It has nothing to do with qualitative judgments and is entirely objective.

As to the rest of your comment, I'll just point out that the majority of charitable giving is done by those who think the government should stay out of it and those who give the least think the government should be involved. Anytime I hear someone telling me that the government needs to involved in solving social issues, what I know I'm really hearing is someone who wants the government to be involved in direct wealth redistribution.

Re:Opening a can of worms here, but... (0)

Anonymous Coward | more than 6 years ago | (#22536730)

You seem to be missing the fact physical health is only one part of an individual. I'm rather have a genius with type 1 diabetes in my society than an average person without diabetes.

Re:Opening a can of worms here, but... (4, Insightful)

pclminion (145572) | more than 6 years ago | (#22535928)

To use a real life example, does it make sense that the people in Nebraska should have to carry the insurance burden for the people who choose to live in hurricane alley?

Yes. If they don't like that, maybe they should move to a country where people care less about each other. Plenty to choose from.

Re:Opening a can of worms here, but... (4, Insightful)

Vellmont (569020) | more than 6 years ago | (#22536006)


I know it may sound heartless and uncivilized, but at what point is a person who is fundamentally broken down kicked off the public teat?

It not only sounds heartless and uncivilized, it actually is. Do you really want a society where there's legless people scrawling around on skateboards begging for food because they're "fundamentally broken down"? It wasn't that long ago we did, and I consider it progress that the developed world mostly doesn't have that anymore. Evolution has really nothing to do with it.

To use a real life example, does it make sense that the people in Nebraska should have to carry the insurance burden for the people who choose to live in hurricane alley?

I don't really know. But at least you can choose to not live in "hurricane alley". I'm not sure what the big alternative is here for people who are "fundamentally broken". Death?

Re:Opening a can of worms here, but... (3, Insightful)

Fanro (130986) | more than 6 years ago | (#22536052)

I'm curious. Do you believe in evolution?

Evolution is not a religion. It is not a guide for the proper way to live. It does not provide any of the answers for deciding this problem.

Just because Mother Nature does something one way, does not mean that this is somehow the best, most proper, fairest, smartest, long-term safest way, or that it has any other advantage except for the short-term survival-of-the-fittest well-not-actually-you-but-at-least-your-genes kind.

Mother Nature is a bitch.

You can argue to what degree humans should care and provide for other humans in a society, but do not use evolution as an excuse.

Re:Opening a can of worms here, but... (1)

unlametheweak (1102159) | more than 6 years ago | (#22536066)

Interesting perhaps, Insightful no. The evolution that you speak of involves economics as much as it does biology. Those at the economic apex of wealth get there through accidents of luck (e.g. born into wealth, gambling addict lucked-out on a lottery ticket, etc), gross illegal activity (e.g. bank robbers, mafia hit men), manipulation or dishonesty (sales people, CEOs, union-busters; like the asshats in the auto-industry hiring detectives to find any type of dirt on Ralph Nader when he lobbied for safety regulations for automobiles, or more recently Dick Cheney and Haliburton). Most people at the top don't mind this type of natural selection. Most people in the middle can live with it as long is it does not effect them (hypocrisy is a big theme of mine), and the people at the bottom get screwed as they always do. This type of natural selection only breeds lazy ideas and corruption.

Re:Opening a can of worms here, but... (1)

S.O.B. (136083) | more than 6 years ago | (#22536146)

To use a real life example, does it make sense that the people in Nebraska should have to carry the insurance burden for the people who choose to live in hurricane alley? That's what Florida thinks should be the case.


It's only fair since Florida will carry the insurance burden for all the people in Nebraska that live in Tornado Alley. That's the very definition of insurance. Don't like it, don't buy it. And if your house burns down you can be proud that you didn't have someone else carry your insurance burden. Broke but proud.

Re:Opening a can of worms here, but... (1)

bockelboy (824282) | more than 6 years ago | (#22536274)

A tornado can do what, couple million dollars of damage, tops? A hurricane can do many billions of dollars of damage. In fact, my homeowner's policy in Nebraska is incredibly cheap compared to what a similar one would be in Florida (even taking into account that my current house would cost 2x as much in Florida...)

You get to tell Professor Stephen W. Hawking (1)

crovira (10242) | more than 6 years ago | (#22536480)

that you can get along without him and his perspective on the universe so, in order to not endanger your potential right to buy [stick in some Wal*Mart import] you're going ot kill his lame ass.

Go on. I dare you...

The movie "Gattaca" (3, Informative)

blind biker (1066130) | more than 6 years ago | (#22535530)

More and more aspects of that movie are becoming reality. I am not comfortable with this aspect of our future, guys. This is not good.

Re:The movie "Gattaca" (1)

mrxak (727974) | more than 6 years ago | (#22536194)

I think ultimately, my choice in who to vote for in the general election will be based largely on privacy issues. If there's any supreme court nominees to be had, I want them to have my privacy in mind in the future world of the internet and genetics.

It reminds me of... (2, Insightful)

santiagodr (1137157) | more than 6 years ago | (#22535536)

The movie Gattaca. Not the best movie out there, but definately not a horrible movie. It is about the future when people are discriminated against because of their genes. Looks like we are getting closer to the sci-fi world that we dreamt about 20 years ago...

Making money versus helping people (3, Insightful)

Djatha (848102) | more than 6 years ago | (#22535548)

That is what you get when health insurance companies are allowed to make money: they try to make money and do not care about the health of the people as long as they can not make money. In my opinion the health insurance companies should be rewarded for their service to people and peoples health, not for making money.

Of course, I am living in socialist Europe, so for me there is not really a problem. However, for you guys in the US, it kind a sucks, does it not? Would it hurt to transform your health and insurance system as to promote health for everyone instead health for those who can and are willing to pay? Of course, there will always be people not paying, living as unhealthy as possible (obesitas, alcohol, smoking, driving in cars, etc), but in the end would it not be nice to know that your health is save no matter what happens with you economically?

Re:Making money versus helping people (1, Insightful)

Anonymous Coward | more than 6 years ago | (#22535612)

I agree (as an evil socialist canadian ). The whole concept of "Health Insurance" is stupid. If you get car insurance, there's a chance that you won't get into an accident (especially if you are a good driver). If you get house insurance, there's a chance that your house won't burn down or be broken into. But with health insurance, you are guaranteed to collect 100% of the time. At this point health insurance is no longer an "insurance" business, and is now a "denial" business. It's sad to see.

Re:Making money versus helping people (2)

Score Whore (32328) | more than 6 years ago | (#22535688)

Of course, there will always be people not paying, living as unhealthy as possible (obesitas, alcohol, smoking, driving in cars, etc), but in the end would it not be nice to know that your health is save no matter what happens with you economically?


No. Because no one is subject to random economic events. Yes, people unexpectedly lose their jobs, but anyone who is well prepared won't be subject to significant risk because of that. They will have savings set aside and they understand that they will have the (federally mandated) option to continue their current coverage for up to 18 months if they chose to pay.

Re:Making money versus helping people (1)

Jinjuku (762364) | more than 6 years ago | (#22535828)

All of that not withstanding, we still rank 37th in overall health care. Not good enough for supposedly the #1 country on the globe. Health industries in general should be focused on HEALTH, not on profits. For me, I eat healthy, don't smoke and get exercise. I do my part.

Re:Making money versus helping people (5, Informative)

NIckGorton (974753) | more than 6 years ago | (#22535870)

No. Because no one is subject to random economic events. Yes, people unexpectedly lose their jobs, but anyone who is well prepared won't be subject to significant risk because of that. They will have savings set aside and they understand that they will have the (federally mandated) option to continue their current coverage for up to 18 months if they chose to pay.
So, you are working hard at your job, have no consumer debt, own your home, and have $50,000 in savings (much better than most Americans, but lets go for a best case scenario.) Then you get diagnosed with cancer. So you start undergoing treatment, but because of the toll on your health, you have to quit your job. Your EMTALA mandated coverage is $700 a month for you, but you elect to pay it because otherwise you will be unable to receive your treatment. It will take $12,800 of your savings, but that is your first priority.

You begin living as frugally as you can, but the bills keep mounting. Your insurance has a $2,000 deductible per year, then you have to pay 10% of costs up to a maximum out of pocket of $6,000 per year. So the first several months, you pay out $6,000, but then the first of the year hits and you again have to pay $6,000 in the first few months of the next year. So your $50,000 in savings is now down to about $25,000 just with your out of pocket costs and paying 18 months of EMTALA coverage.

The chemo and radiation you receive gives you profound weakness and nausea/vomiting. Unfortunately the inexpensive antiemetics phenergan, compazine, and reglan all give you a severe dystonic reaction. So the only one you can take is zofran, which your insurer refuses to pay for because its non-formulary. You only use it for the worst days after your rounds of chemo and split pills when you can, but its the only thing that will help. Even ordered online at the cheapest Pharmacy you can find they cost $10 a pill. So you end up spending an extra $300 per month for medicine in addition to the $15 per month copay each for your other half a dozen medicines. So your out of pocket drug costs are $400 per month. That plus your bare minimum living expenses (food, utilities, tax on your house, travel to and from the hospital) are about $2000/month. So by the middle of the year, your savings have dwindled to almost nothing.

So you begin borrowing by taking a loan out on your home, this gets you through the end of the year and into the beginning of the next. Unfortunately, as a result of the treatments, you suffered a mild stroke and now have to walk with a walker. So you begin the laborious process of applying for disability. You are initially denied, and hire a lawyer who works on commission, but he tells you it will probably be a year or more before you get disability (and hence medi-medi coverage as well.)

I'm getting tired of writing this, and depressed because its all too common. Over half of people in the US in 2006 who filed for bankruptcy did so because of health care bills. Over half of those were employed and insured when they became ill. Don't fool yourself into believing that you can render yourself immune from this should you lose your health and hence your usefulness to a capitalist society. We discard 'useless people' like yesterdays newspaper. And the only reason it hasn't happened to you is you are still producing.

Re:Making money versus helping people (0)

Anonymous Coward | more than 6 years ago | (#22536530)

Amen, brother.

Re:Making money versus helping people (0, Troll)

Score Whore (32328) | more than 6 years ago | (#22536596)

So, you are working hard at your job, have no consumer debt, own your home, and have $50,000 in savings (much better than most Americans, but lets go for a best case scenario.) Then you get diagnosed with cancer. So you start undergoing treatment, but because of the toll on your health, you have to quit your job. Your EMTALA mandated coverage is $700 a month for you, but you elect to pay it because otherwise you will be unable to receive your treatment. It will take $12,800 of your savings, but that is your first priority.


EMTALA? No. COBRA. I pay whatever my company pays for the same coverage. We're talking in the area of $200/mo. I'm not even going to try to answer the rest of your story because it has no substantial basis in reality. Is it possible? Perhaps. But you made it up. I've never had a job with the health insurance terms as bad as you've stated.

Spoken like someone who knows of what he speaks. (1)

crovira (10242) | more than 6 years ago | (#22536680)

I am pitting my wife through college for two reasons:

1) To save her sanity. Being unemployed was driving her nuts and being too near a refrigerator was driving her fat.

2) When she finally gets health benefits working for a Catholic School board, its one less worry.

Personally, I hope the USA wakes the hell up and does what Canada did decades ago.

And the argument about socialized medicine being bad for health care is so bogus (as this article points out,) is not funny.

The USA would have achieved even MORE with socialized medicine, (just like they won in Afghanistan and Iraq with a SOCIALIZED ARMY. [I'm not saying that there aren't problems with KEEPING Afghanistan and Iraq, but the battle phases of the operations were remarkably effective.])

Re:Making money versus helping people (0)

Anonymous Coward | more than 6 years ago | (#22536796)

Let's go over the alternative in a country which has your blessed "universal healthcare":

You suffer kidney failure. You can't afford private treatment. You're put on a wait-list because dialysis is expensive and in short supply. You're over 55. You don't make the cut off. Your socialist system has decided that a 55+ year old person is not worth the expenditure. Since you depended on the state to support you, you have no private recourse. You die.

Re:Making money versus helping people (1)

longbot (789962) | more than 6 years ago | (#22536906)

Sadly, this is exactly the case. I saw something very similar happen to my paternal grandparents (who were never in the best of health) as they reached the last few years of their lives, and they were reasonably prepared.

It may be kind of depressing to think about, and people often think that I'm kidding when I say that if I ever get sick, I plan to run up massive debt, and then die. I just think that's the only way to deal with the U.S. "health care" system as it is... just don't get sick, because if you do, you're screwed. Game over.

Re:Making money versus helping people (1)

Hubbell (850646) | more than 6 years ago | (#22536264)

Why should I be forced to pay for someone else's health care? Fuck, lets get right down to it:

Why the fuck should I be forced to pay for my own insurance if I don't want it? Simply turn me away at the doctor's if I can't pay it is how it should be. The federal government has no place in this matter, should be left up to the states.

Re:Making money versus helping people (0)

Anonymous Coward | more than 6 years ago | (#22536602)

Of course, I am living in socialist Europe, so for me there is not really a problem.


I am living in socialist Europe too, in Switzerland, which has a health care system much like what the US Democrats want: every employed person is required to buy a minimum level of health insurance from a private company. Every private company is required to offer a minimum level of health insurance to every person, with only age and sex affecting the premiums.

That minimum level is pretty bad (20% copay after deductible on everything; pharmaceuticals cost more here than in the US). Of course, the insurers offer plans for a little bit more money that provide what most would consider "decent" health care.

And yes, they do practice genetic discrimination on those plans.

Your country may differ, but not for long.

The price of knowing who one really is... (1)

KudyardRipling (1063612) | more than 6 years ago | (#22535588)

There has been a phenomenon of individuals researching their suspected Jewish ancestry who are undergoing genetic testing for this express and exclusive purpose. This process has been used to confront the denials of living family members about their family history. Nowadays, more and more people are questioning America as a viable place to raise a family that could be targeted for their ethnicity by the results of changing demographics (Thank Hart-Celler for that). Such people now have the fear of having this information diverted for such nefarious purposes. Imagine the irony: "Without my knowledge, I have obtained an Israeli passport at the price of private health insurance coverage" or even worse "This pursuit has left me with no claim to an alternate citizenship AND, by reason of this process, I have found myself being denied private health insurance coverage altogether."

Downmodding constitutes antisemitism.

(pluS one Informative) (-1, Flamebait)

Anonymous Coward | more than 6 years ago | (#22535606)

Fact: *tBSD is dying mutated testicle of Were taken over appeared...saying

If insurance companies *could* get at the info.. (3, Insightful)

Junta (36770) | more than 6 years ago | (#22535620)

Would they lower rates due to a clean genetic test compared to the normal now?

How long before insurance companies proactively raise rates, but then offer a discount back to normal if you provide genetic test results?

Is the bill worded such that neither penalties nor bonuses can be given out due to a genetic screen?

How much different really is it from family history, just a more accurate measure?

Insurance is all about modeling the risks for an individual based on available medical data. In *theory*, if genetic screening can increase the accuracy, then people with clean genetic situations should get decreased rates from what they pay now, while those with the dispositions carry the burden of the risk. If all goes according to the hypothetical, neither way is particularly feels 'fair'. On one hand, your rates go up because you got stuck with some genetic predisposition for heart disease that you couldn't control, that may never manifest. On the other hand, someone with a genetic disposition that will never suffer a particular ailment, will have to pay for the risk of that ailment anyway.

Of course, the chances insurance companies would *lower* any rates is slim, just jack up rates with the excuse of apparently increased risk individuals without ever acknowledging the class of reduced risk individuals.

Re:If insurance companies *could* get at the info. (4, Insightful)

Vellmont (569020) | more than 6 years ago | (#22535916)


Insurance is all about modeling the risks for an individual based on available medical data.

No, Insurance PROFITS are all about modeling the risks. Insurance is actually about distributing unknown risk among a large number of people. If I had a time machine and could look into the future and see if I'd ever need insurance, the whole thing would become completely pointless, as I'd know exactly what was going to happen. If the insurance company had access to my "time machine test results", they'd either cancel my health insurance if I was going to get sick, or I'd just sock all that money away in a bank account if I wasn't.

In *theory*, if genetic screening can increase the accuracy, then people with clean genetic situations should get decreased rates from what they pay now, while those with the dispositions carry the burden of the risk.

I think what people are really concerned about here is that certain individuals will just not be able to get health insurance. We don't really worry about that for car insurance, or flood insurance, or whatever, since you can always choose to not drive, or live somewhere else. Without health insurance, the only real alternative if you get gravely ill is death, or bankruptcy and losing your job (then maybe medicaid will take over). I think most people would say those aren't very good alternatives.

Re:If insurance companies *could* get at the info. (1)

Junta (36770) | more than 6 years ago | (#22536452)

No, Insurance PROFITS are all about modeling the risks. Insurance is actually about distributing unknown risk among a large number of people
You're right, taking my view of it to the ultimate extreme (knowing perfectly the future) reduces things to no insurance in the end. Of course, by definition, genetic screening is reducing the amount of distributed unknown risk, so it still would play into your more accurate description If all risks are known, insurance would devolve to meaningless either way. The opposite end, where everyone gets a flat fee won't work in today's market. Any company that offers a flat fee based on the total average of customer induced medical expenses would be too expensive for anyone where other companies exist that scale down the cost.

Let's say hypothetically that these genetic tests are done by people, and insurance companies offered a la carte rates (i.e. could insure for blood cancer specifically, welcome all comers willing to pay for that coverage). In this case, the customers naturally discriminate themselves, as people who have reduced risk of blood cancer would more often waive the coverage, and in aggregate the percentage of people who buy that insurance plan are quite likely to be afflicted. Either way, whether driven by the insurance companies or by the customers, rate hikes would occur. So a la carte premiums for certain prominent genetic conditions might be a way to drive the rates without technically discriminating or even knowing as companies. I wonder if the bill also prevents a la carte plans...

There are naturally given risks (genetic predispositions) which are unfair and in an certain idealistic vision, the ones covered equally at equal cost across the population (i.e. assumes equal risk of prostate cancer and everyone pays without caring about likelihood, screening used merely for early treatment), and there are voluntary lifestyle risks, like smoking, drugs, and physical activity, which could be abusive of a completely flat non-discriminatory system.

It's a whole set of rough questions, and health/life insurance companies from the very nature of dealing with life and death situations from a business perspective inevitably come off as either sinister by effectively choosing death or a poor business by doing the 'right' thing, it seems. Even if forbidden from denying coverage, they can always price the rates such that they aren't significantly cheaper than the treatments, so I see a rough path ahead regardless as tools for accurately knowing the likelihood of genetic conditions emerge.

Re:If insurance companies *could* get at the info. (1)

porpnorber (851345) | more than 6 years ago | (#22536494)

That's a very interesting statement. I would have said that the *theory* of insurance is that it is a mechanism to pool risk, not merely to calculate it. Payments are based on prior probabilities, allowing us to plan our lives, and payouts are made to compensate for surprises. After all, if it doesn't do this, why have insurance at all? You minimise your premiums by cancelling your policy, so on the libertarian analysis the best insurance is no insurance; you just gamble on remaining as lucky as you are today. On average, however, and that's the point, the ideal case would seem to be to have everyone pay the same premiums. It's less paperwork, too. And it's pretty much the economic insight behind universal healthcare.

The thing we should be working on is not screwing over the unfortunate at moments when our doctor happens to be giving us good news, it's developing management techniques that will allow socialist infrastructure to capitalise on its lower costs, so it can outperform capitalism consistently. A simple engineering problem that you would think would excite the slashdot crowd....

Re:If insurance companies *could* get at the info. (1)

noidentity (188756) | more than 6 years ago | (#22536766)

In the end, some people will require more care than others. Insurance is about providing a guarantee of care before it happens, without knowing whether it will happen. Financially it spreads the risk among all members, converting a big unknown into a small known regular payment. Perfect genetic testing would just make this known before it happens, rather than after. We could continue to allow care just as before. The only snag is that since we'd know who would be requiring care, those who wouldn't might not want to have to pay for those that would.

Not discrimination (2, Interesting)

icepick72 (834363) | more than 6 years ago | (#22535638)

From a health insurer's perspective you'd be foolish to cover a disease for an individual if they have the bad gene. This isn't discrimination. It's facts and statistics, common sense from a business perspective. Arguably they could charge higher rates to those individuals (like they do to smokers). Health insurers already "discriminates" against you if you've prior disease. They can continue to do the same and it will be no more wrong than it is now. Discrimination is unjust. Medical facts are not discrimination.

Re:Not discrimination (4, Insightful)

Waffle Iron (339739) | more than 6 years ago | (#22535804)

They can continue to do the same and it will be no more wrong than it is now.

But it is wrong now. The entire US healthcare risk underwriting system is wrong.

By having thousands of individual risk pool managers obsess over saving money by kicking out people who might actually use healthcare services, we ironically end up with a system that costs us almost twice as much overall as any other country, while at the same time not even covering a huge swath of the population.

Meanwhile, needlessly stupid thing like worrying about who gets a hold of medical tests causes stress for millions. Millions more are tied to their corporate jobs like feudal serfs because of fear of losing healthcare benefits.

To stop this insanity, there needs to be one single uniform national risk pool.

Re:Not discrimination (3, Insightful)

cHALiTO (101461) | more than 6 years ago | (#22535834)

Discrimination is unjust. Medical facts are not discrimination.

Medical fact is not discrimination. Making a different decision based on differences in those medical facts IS discrimination. The person saying "we will not give insurance to this person due to this criteria" is discriminating. Wether that kind of discrimination is or not wrong is another matter. I personally think it is.

One thing is to make a person who decides to smoke pay more, as it is a conscious decision of that person, and that person could give up smoking to avoid higher fees, and another is to somehow marginalize you because of a gene, something that you cant change, and that you didnt choose.

Re:Not discrimination (1)

Fanro (130986) | more than 6 years ago | (#22536204)

One thing is to make a person who decides to smoke pay more, as it is a conscious decision of that person, and that person could give up smoking to avoid higher fees

Actually a recent study [plosjournals.org] claims that while the per-year health care cost of smokers is higher, the total lifetime cost is lower than for non-smokers.

Re:Not discrimination (2, Insightful)

holistah (1002858) | more than 6 years ago | (#22535914)

The problem is the genetic tests available don't always give facts. The presense of a gene does not by itself indicate higher risk for most diseases, what it indicates, is a predisposition, so that if dozens of other factors are just so, combined with the gene, then your risk is higher. It is VERY subjective. Additionally, as someone else pointed out, genes are not something you can change. To make it more plain: We know that blacks are statistically more like to get certain diseases, therefore are higher risk, do you think that it would not be discrimination, that it would be just? It is a medical fact in the same right as genetic testing, you simply don't have to test for the black gene because you can see it. The same type of "facts" exist for asians, or women.

Re:Not discrimination (2, Insightful)

zappepcs (820751) | more than 6 years ago | (#22535952)

You have made a perfect argument for why health insurance in a community should not be the equivalent of gambling.

The argument that insurance companies already discriminate against people is exactly why this system needs to change. If a private system is not able to bear the burden of risk associated with provide all people the same coverage, it is a broken system. Sure, you and they will want to complain about how unfair that is and I will continue to tell you that this should not be about fairness. Insurers use the game of having many people pay in, and only pay out to a few. This makes that coverage affordable. The problem is that this same system is 'for profit' and it drives up the cost of the covered medical treatments. The entire thing is about to crumble under it's own weight. I'd give you lots of links here but the current political campaigns have enough fodder for you to read.

If insurance companies CAN get your genetic tests, THEY WILL. It is in their best interest to do so. At that point, they have a vested interest in dropping coverage for you. What we have not yet seen is evidence that they are doing this. They are, there just is no evidence of it yet. The health system of this country is run by insurance companies. Have you looked at how much they spend lobbying the government? http://www.google.com/search?hl=en&output=googleabout&btnG=Search+our+site&q=health%20insurance%20lobby%20money [google.com] Google shows 371,000 hits for this little topic.

Why? Why does a business need to spend that much money lobbying congress? It definitely is not so they can provide better service to the end users. If the health insurance system was not fundamentally broken already, it would not be a major issue in this upcoming election.

The idea that a company can deny you health insurance based on genetic testing is fundamentally a broken idea. (car anology) if you owned a Ford Edsel, would a mechanic ask you about your insurance before working on it? If you owned a Ford Pinto, would you have to pay extra to insure it? - yeah, bad example. but those same insurance companies would not pay out for the car-b-ques in the early days, and it wasn't till Ford admitted the defect that they paid out.

Now, hear we are talking about going to the insurance agent and asking to renew our policies with a full on inspection of our vehicles that includes what type of metal the brake system parts are made of, and a scientific explanation of how likely those parts are to fail under stress. It also includes all kinds of things ... like how likely your vehicle is going fail before the warranty is out.

What all of these things have in common is that they are giving the bookie an unfair advantage in the wager. In the US, the bookies don't have to take your bet if it seems too much risk. Medical science is not making us safer, they are in fact putting us at risk because they are giving the bookies reasons to not want to take our bets. That is a fundamental failure of the system whose goal SHOULD be to reduce health care dangers, increase overall health of the community, and keeps us strong for the defense of the country, our economy, and general well being. Without fulfilling those goals, you might as well just go to the legendary Spartan health care system.

The system is currently broken and CANNOT support it's goals, nor can it live up to its promise to the community.

More and more, big business is failing to do what they are supposed to do. This is just another example of it.

Re:Not discrimination (1)

Fatalis (892735) | more than 6 years ago | (#22536430)

This isn't discrimination. It's facts and statistics, common sense from a business perspective.
you must be using a different definition of discrimination than the rest of us, because ours doesn't include "unless it's bad for business". discrimination is just not treating people equally, and just that. I think responses like yours stem from the fact that it carries some negative connotations, and that there are situations where most of us would agree that it's better to discriminate than not to. I'm not sure the one discussed here is among them, though

Socialized Medicine, Mandatory DNA Testing (1, Troll)

Nova Express (100383) | more than 6 years ago | (#22535640)

Just wait until we get nationalized health care under Hillary or Obama. I'm sure DNA testing will eventually be made mandatory under such a regime. If the person responsible for your health care is the State, then "privacy" in such a realm no longer exits.

Of course, testing is only the first step. Expect to see those with expensive, insurable genetic conditions simply denied care, much as those over 70 are denied health care for many ailments in the UK because it's not "cost effective." [liberty-page.com]

Nationalized health care is, by definition, rationed health care. DNA testing will just be another way to make it more "fair" and "rational.'

Re:Socialized Medicine, Mandatory DNA Testing (1, Insightful)

matt4077 (581118) | more than 6 years ago | (#22535790)

There are many countries with public health insurance, and none of the have any such requirements. There's obviously no use to them if you can't deny coverage anyway. As to your story of healthcare being denied to some people: even if it's true (which it is not in my "socialist" country), it doesn't take away your option to pay for those procedures yourself. That shouldn't happen too often and even if it does, you're in the same position as you ALWAYS are in the US: ridiculously expensive healthcare.

Re:Socialized Medicine, Mandatory DNA Testing (2, Informative)

Shuntros (1059306) | more than 6 years ago | (#22535814)

Don't be ridiculous. Here in the UK, as in Canada and a lot of other developed nations, technological advances such as this are hugely advancing prevention of inherited diseases. My ex, for example, discovered she had a gene which made her prone to a certain type of cancer, so the NHS (national health service) put her on regular screenings for it.

Free health care doesn't have to mean lower standards. All the bull in the USA slating universal healthcare is coming from.... you got it, the medical insurance industry. Joe public believes what his TV tells him and falls for it hook, line & sinker. Sicko was a little biased, I'll give you that, but the points Moore made were 100% valid. I needed some antibiotics on a recent business trip to the USA and for a 5 minute consultation and 20 tablets it cost me $300. 'The greatest nation on earth'? Do me a favour!

Go Clinton, I say. The USA needs a serious kick up the ass in terms of its view of healthcare.

Re:Socialized Medicine, Mandatory DNA Testing (1, Insightful)

radtea (464814) | more than 6 years ago | (#22535876)

But the NHS is not the only way to access health care in Britain, any more than the various provincial medicare programmes are the only way to access health care in Canada. If you are rich in Britain you can get faster care, just as in the US. Even in Canada we have an extremely steeply stepped two-tier system, in which the second tier is known as the United States, where the ultra-rich like Liberal politician Belinda Stronach go to get the treatment they deny others in Canada.

In the US you also have a multi-tier system, and this would continue under any regime that, like Canada, provided a basic level of care, including preventative care, to everyone. The current heavily socialized system in the US, which spends more public money per capita than the Canadian system, is extremely inefficient and ineffective because it is not able to focus on preventative care.

No system of health insurance can provide all the care that everyone needs. Someone is always going to get the short end of the stick, either by long waiting lists in a well-ordered public system or lack of anything but emergency care in the disorganized mess that the US has. Most of us think that some basic level of care provided by the public purse is a justifiable expense in a free and democratic society.

We also know that the expense of a public system pays for itself many times over. I for example am a Canadian entrepreneur whose business career has been made much simpler because my health insurance is decoupled from my employment. Thus, Canada gets a dynamic and successful small company--and small companies are the engines of employment and economic growth--whereas in the US I would have had to stick to my corporate job with attached health care.

And strangely, we don't have mandatory DNA testing here yet, nor is there any impulse to do so under a public system because everyone is covered anyway. Unlike private insurance companies there is no incentive under a single payer system for any of the invasive and stupid games that get played with medical data in the US.

What a crock of conservative bullshit. (1)

zerofoo (262795) | more than 6 years ago | (#22535892)

Do you happen to be a Fox News pundit?

Step back a minute and use your brain. Under what health care system would mandatory genetic testing be more likely to be misused? A system where insurance premiums and profits are maximized by reducing or refusing care; or a system where everyone pays, everyone participates, and everyone benefits?

In the current system, mandatory DNA testing would be used to refuse coverage or care - to maximize profits and weed out costly/sickly individuals.

In a universal system, it benefits the system to give you preventative care - that reduces costs for all. In that situation DNA testing benefits all.

I'm so sick of hearing everyone claim the United States is the greatest country in the world, yet we can't care for our sick or elderly, and we sure as hell can't educate our young (the parent post illustrates the education problem).

What the hell makes us so great? Military hardware?

If we are to be a great nation, we need to find a way to provide health care and education for all. A sick and stupid population is not the way to greatness.

-ted

Re:Socialized Medicine, Mandatory DNA Testing (3, Insightful)

ScrewMaster (602015) | more than 6 years ago | (#22535902)

DNA testing will just be another way to make it more "fair" and "rational.'

That is, profitable.

I see some people from Europe and Canada posting here about how wonderful their respective medical systems are, and how America should move towards a socialized approach for our health care.

Might as well try to institute such a system in Mexico, or any other nation with thoroughly corrupt government and private sectors (like the U.S.) I mean, hell, we've been throwing money at the education system for years (sixty percent of my property tax dollars go to "education") and for all that we're near the bottom of the education heap. Why does anyone believe that throwing vast sums of Federal money at the medical system, thereby subjecting all of us to even more government scrutiny, will have a positive outcome? When will we understand that these people can't be trusted with the power they already have? Yes, I know that countries like Germany have a fine socialized medical system ... but that means nothing here. Our bureacracies are very different: their's works very well and has a much higher degree of trustworthiness than ours ever will.

Besides, people forget that we've already had socialized medicine in the U.S. for decades: it's called Medicare. Do want more of that? Yes, it's only for older people, or those of any age who have specific conditions (such as total renal failure) but it can hardly be pointed to as a successful operation from a cost-benefit perspective. Any national health-care system as proposed by some of our Presidential candidates would, in effect, expand the Medicare tax base to theoretically include everyone. Given the fraud and malfeasance and gross inefficiency of the current Medicare system, I simply don't believe that our government (or our health care providers) can be trusted with even more power than they already have. The way they handled Medicare has conclusively demonstrated that they are incapable of acting honestly and in good faith when it comes to health care.

I'm not saying they'd just make Medicare bigger: they'd probably establish an entirely new bureaucratic organization to handle a national medical system. What I am saying is that any such organization will be just as efficient and trustworthy as the DHS, the TSA or FEMA. It can't help but be anything else, given how our government works today. Furthermore, given the propensity for certain three-letter agencies to ignore their charters and lie to Congress, you can bet that socialized medicine would be a privacy disaster.

We'd probably be better off getting the food lobbies out of Congress and spending some serious money on public education, to teach people how to eat. Hell, if we just got a significant number of people to lay off the fast food it would cut the number of new diabetes and cancer cases. In the long run, if we became a healthier nation overall, we'd have less dependence upon advanced medical services.

Re:Socialized Medicine, Mandatory DNA Testing (0)

Anonymous Coward | more than 6 years ago | (#22535968)

Nationalized health care is, by definition, rationed health care.

True. But on the other hand, how is the US different? Insurance companies, HMOs, PPOs, caps and co-pays all lead to rationed health care.

Further, I would make the capitalist argument for Nationalized health care. When you compare the USA to other major western countries (Canada, France, UK, Germany), other countries pay less in total health care costs and live longer.

Hard to argue with that.

Re:Socialized Medicine, Mandatory DNA Testing (1)

makomk (752139) | more than 6 years ago | (#22536658)

Of course, testing is only the first step. Expect to see those with expensive, insurable genetic conditions simply denied care, much as those over 70 are denied health care for many ailments in the UK because it's not "cost effective."

ITYM expensive, uninsurable genetic conditions - since there's no way in hell anyone will insure them for an affordable price. (Also, the UK thing is, I think, an incredible exaggeration - there are issues with the treatment of the elderly, but they aren't flat out refused health care.)

(Incidentally, that page is basically propaganda for a certain type of idiotic libertarian capitalism. For example, take "1) Destroys patient incentives to find the best possible prices for the best possible services/products available". In practice, the health insurance industry is so complicated that most people can't adequately assess its quality, and it's not like it's in the companies' interest to make the nasty little small print clear. The health insurance is under-regulated in many ways as is - for example, it's far too easy for providers to sell insurance that, in fact, covers basically nothing - and this jackass want to remove what little regulation exists. Also, reading between the lines, it sounds like the author of that page wants to remove registration requirements and allow anyone who wants to to practice medicine to do so, regardless of whether they're qualified to do so or have done all sorts of malpractice in the past. This will lead to people getting hurt or even killed - it's inevitable, since hardly anyone actually has the knowledge to tell whether someone is a real doctor or surgeon.)

Re:Socialized Medicine, Mandatory DNA Testing (1)

Maximilio (969075) | more than 6 years ago | (#22536806)

Actually I think the opposite will happen with nationalized healthcare. Since a nationalized system exists to provide care for constituents, and not profit to shareholders, I believe that taking insurance companies out of the loop will fix this problem. The US is the ONLY major industrialized nation to not have nationalized healthcare. And the quality of our care is abysmal. Your scaremongering about "socialized" medicine is hysterical, unfounded nonsense.

Stark choice... (0)

itsdapead (734413) | more than 6 years ago | (#22535666)

Its quite simple - as genetic tests become more powerful and reliable, either you either introduce mandatory state-funded free healthcare or you have Gattaca.

You can't prohibit insurance companies from minimising their risks and still call it a free market. If you did there's bound to be some offshore haven from which insurers can offer preferential deals to the genetic elite.

Not to worry... (0)

Anonymous Coward | more than 6 years ago | (#22535718)

Health insurance companies already have a term for this: pre-existing condition. If you don't report your genetic deficiencies to them, they'll simply deny you coverage on that basis.

Nothing to worry about, yet. (2, Interesting)

pla (258480) | more than 6 years ago | (#22535770)

Don't sweat the small stuff, people. At the moment, the insurance companies can't accurately enough correlate your DNA to your future expected healthcare costs - Your familial history and general current health indicates that far more accurately.

So don't worry about taking your curiosity underground, the evil bastards simply don't care yet; and when they do, you'll simply get your test date in the mail (or the option to drop your coverage).

Attempt at rational thought (1)

kanweg (771128) | more than 6 years ago | (#22535774)

Knowing who is at risk and who's not doesn't make the health care cost for treatment go up. It is not that suddenly more people get heart attacks if you know who is at risk and who is not.

Instead of making the cost go up, it could make the cost go down (insurers would spend some money on preventive medicine like statins and save a bundle compared to the expense if the disease actually develops). This remains true even if you take the cost of the actual tests in account, because only those tests would be performed for which the cost of testing results in a net surplus.

All that needs to be done is legislation that requires any insurance company to accept anyone, and that the rates for individuals may not differ more than by a factor of 3. More legislation to help drive the cost down: Set a max to the amount of money in case a person dies because of a medical mistake at $100,000 and for invalidity at $500,000. Of course, expect to lose a couple of more quarters for ambulance chasers turned into beggars.

Oh, and there are health insurance organisations without profit motive (like Unive in the Netherlands).

Bert

Re:Attempt at rational thought (1)

NIckGorton (974753) | more than 6 years ago | (#22536030)

All that needs to be done is legislation that requires any insurance company to accept anyone, and that the rates for individuals may not differ more than by a factor of 3. More legislation to help drive the cost down: Set a max to the amount of money in case a person dies because of a medical mistake at $100,000 and for invalidity at $500,000. Of course, expect to lose a couple of more quarters for ambulance chasers turned into beggars.
First, while I am a doctor and hate med-mal attorneys, they are not what is bankrupting the health care system. They add some, but systematic uninsurance and $0.25 on the dollar profit is what's crippling it.

But let me expand on your idea. Say we require insurers to just charge a set community rate, and not be allowed to decline care because of a pre-existing condition. Of course that would drive the cost of insurance up because a lot of young and healthy folks (who pay more in that they get) would opt out knowing that they could buy insurance in the unlikely event that they became ill. So to control for that, you mandate that *everyone* has to buy insurance (just like we mandate that everyone has to buy car insurance.) People unable to pay (like unemployed people, children, the disabled and elderly) get insurance for free. And people who can pay some but not all are subsidized (like the working poor.) We also decide that since the cost is pretty standard, and its required, that we will just take it out of people's paychecks so they don't have to send a check in every month. Its a higher percentage for people who make more, and lower for those who make less.

Of course its more expensive having 42 companies providing the same thing (42 separate infrastructures and every doctor has to pay people to know how to submit 42 kinds of forms for payment) so we decide that its cheaper if we just use one company to do the work, so they are all merged. And we mandate by legislation that this must be a not for profit corporation. We also can mandate that the insurance provide a certain minimum level of care... and since everyone has it, we are ensured that this level is decent because those who are wealthy and in power have to use the same system that those who are poor and disenfranchised do.

And then... we'd have single payer universal health insurance and 95% of American's health care quality would increase. Unions got a few things right: the weekend is good, child labor is bad, and the fact that we all do better when we all do better.

Discrimination will Occur (1)

Phoenix666 (184391) | more than 6 years ago | (#22535796)

without a Constitutional ammendment guaranteeing our right to privacy.

And it's not just on the level of DNA testing. We're already hearing about the dangers that data-mining companies like Acxiom are posing to privacy through their purchase and aggregation of previously unrelated databases.

Universal healthcare in the United States would fix one part of the problem, which is that you could be denied insurance coverage based on factors over which you manifestly have absolutely no control.

However, discrimination from employers would persist.

There's an additional danger: loss of reputation. Imagine the damage you could do to a political rival if you could access their DNA and learn that they are genetically predisposed for cancer.

They could be obviously predisposed (1)

crovira (10242) | more than 6 years ago | (#22536558)

to being stupid but that didn't stop us from electing the current administration. (Which is largely composed of elements of a prior one.)

Blood Secrets (3, Insightful)

Doc Ruby (173196) | more than 6 years ago | (#22535802)

Wait until someone's genome is copied without their permission from when they donate blood, and the privacy backlash leaves blood banks dry, patients dying.

Individuals should get the same explicit copyright protection on our personal data, including our genetic and other health data, as corporations get on recorded products. Personal data must be destroyed once the transaction for which it was initially transmitted is complete, with short timeouts, unless explicitly permitted into some specified other scope. Violations should be criminal violations of our privacy rights.

Probably we need a Constitutional Privacy Amendment to make indisputable the force and clarity of this protection of our rights. The Fourth Amendment already protects our private data, but the government hasn't been enforcing it. Since the 4th is itself redundant to the Constitution's lack of a created power to invade our privacy, it's clear that the fundamental line between private and public that is the basis of our liberty must be reiterated strongly or be ignored.

As our entire world becomes defined by the Info Age, the people better get our government to properly protect our privacy soon, or there will be blood.

Self-Test (1)

Phoenix666 (184391) | more than 6 years ago | (#22535860)

The dangers of discloser of your DNA to potential insurers and employers would seem to create an opportunity for people to self-test.

At the moment for a fee you can send a swab to a lab, and they'll return the results to you. That's reasonably private until Acxiom buys a copy of their database or the Department of Homeland Security decides it wants to know your genetic code for whatever reason.

But if you had an affordable device you could drop a swab into and have it return results, there would be no need for anyone else to ever be the wiser.

In the meantime, the only way I can think of to get the results of such a test without risk of others finding out is if you have access to the necessary lab equipment and ran the tests yourself. I know if I had, I would.

strange... (0)

Anonymous Coward | more than 6 years ago | (#22535992)

Why all the /. love for universal health care? The US has the best health care system in the world, and /.ers want to destroy it in favor of an inefficient government controlled program?

Please stop drinking the Michael Moore kool-aid.

http://gregmankiw.blogspot.com/2008/02/should-rich-get-better-health-care.html [blogspot.com]

Mod parent neocon troll (4, Interesting)

NIckGorton (974753) | more than 6 years ago | (#22536772)

Why all the /. love for universal health care?
Its not just /. It cuts across the entire US population. And its for several reasons.

First, with more and more people who are uninsured or underinsured, the experience of finding oneself with a serious illness and no way to get help without bankrupting yourself and your family is becoming more common. This experience is also entering into the middle class (and even upper middle class) ethos because its not just a poor person's problem anymore.

Second, any idiot with a modicum of intelligence can see that the US health care system is failing the US population. Even those who are insured cannot be guaranteed care when they need it. The US is undergoing an emergency care and on call crisis due to the problems created by uninsurance. If you are a specialist and agree to be on call for a hospital, or you are a hospital who has an ER, or if you are an ER physician on duty in those hospitals, you are bound by the EMTALA law which says you have to provide care for all medical emergencies regardless of ability to pay. This unfunded mandate is pushing emergency care to the breaking point. From 1993 to 2003 in the US, 425 hospital EDs closed their doors; the number of ED visits rose by 26% during the same period (Institute of Medicine, 2006). Moreover try to find that on call neurosurgeon you need to drain your epidural hematoma or the hand specialist to reattach your finger in under 4 hours. Specialists are now refusing to take call because it makes them vulnerable to provide uncompensated care. So while years ago, it was only the poor who suffered, now even the insured are suffering because ERs are overcrowded and specialists are just unavailable. (See what's going on in LA's now as its emergency system implodes if you would like an example.)

Third, (and this is the only thing that has kept me from leaving the US to practice in Canada), I genuinely think the American people are good and want a system that provides people health care just like we provide every child an education and other services like EMS, fire, and police. When bad things happen to others, I think Americans really do want to help. I saw that when I was a chief resident in the ER at Brooklyn's largest trauma center on Sept 11, 2001. We saw it in the actions of individuals and organizations to help NOLA after Katrina when our government stood by with its hand up its ass. Most of us, at heart, are not hateful neocon hawks. However, the hateful neocon hawks have pretty mighty propoganda machines and they were able to fool a lot of people a lot of the time. But eventually we do come around. Witness the phenomena of Evangelical Christians who won't vote Republican because while they don't support abortion rights, or my right to marry my partner, they think that the US's inaction in Darfur, the war in Iraq, the fact that Americans are dying as I type this from preventable diseases, the fact that poor children are abandoned in drug and gun infested warehouses that used to be schools are far worse tragedies than the fact that I have buttsecks with the man I call my husband.

And I would damn rather work in an organization with one of those folks or have one as my neighbor than you. Because she and I would both be Americans who love our country and understand that diversity of beliefs are OK, but that first and foremost we have to ensure that there is social justice, that every child has an education, that every person has health care when they need it, and that our military and our political capital is spent on real problems like resolving the tragedy in Darfur and creating freedom in China rather than creating a profit for Haliburton.

Nick

Institute of Medicine. (2006). Hospital based emergency care: At the breaking point. Washington, DC: National Academies Press.

fp 78oll? (-1, Flamebait)

Anonymous Coward | more than 6 years ago | (#22535996)

EFNet, and apply includes where you balance is struck, OpenBSD. How many to the crowd in too much formality are a pathetic numbers. The loos bootoms butt. Wipe

The insurance are NOT in the business of (3, Insightful)

crovira (10242) | more than 6 years ago | (#22536102)

taking care of you.

They are in the business of evaluating risk and spreading that risk to all of their share holders while charging a premium based on the risk in order to MAKE A PROFIT.

You, as an individual, don't matter. In fact you, as an individual, don't exist.

If you fall into the cost side of the equation, they will try to eliminate you as you are reducing their profits.

You can't run health care for profit.

The United States is the LAST hold out in the civilized world where people think it can be. (Actually, they DON'T but the major shareholders, being anonymous pools of capital, DON'T CARE about the suffering of individuals.)

You aren't even a line item on a spreadsheet somewhere.

The only way to actually run a health care system (as opposed to the health-don't-care system currently in place) is with socialized medicine, just like we have a socialized military (you don't want a bunch of militias running around after all.)

Health is a social responsibility.

Insurance is an actuarial game played for profit. (As long as you don't need it, you don't mind losing a little bit since it is spreading risk around to all the players. The problem comes when you DO need it and the companies DON'T WANNA PAY. [With health care, you might very well DIE!!])

Not a problem when we switch to the new systems (1)

FromTheAir (938543) | more than 6 years ago | (#22536534)

These fears are all based on an outmoded approach to health where chronic disease is permitted and the symptoms are treated. There is a new approach where the cause for disease is eliminated and most of the causes are not genetic. In fact the genetic changes that are signatures of various diseases may actually be adaptive responses to deficiency conditions or the consumption of structurally damaged raw material, or the exposure to toxic elements that interfere with metabolic processes. In other words Genes as a cause of disease may be in 98% of the cases a fallacy

We need to remember that much of science is politically and or profit driven giving rise to pseudo science. Much of it built on the premise that life is an accident resulting from random mutation and no intelligence was involved. Furthermore it holds that nature is flawed in it's system design and needs to be fixed when in fact it is perfectly designed. We simply need to adapt and integrate with it.

When the new approach is implemented medical treatment costs will be very low reducing and perhaps eliminating the need for health insurance that covers disease leaving only physical injury repair to be insured.

Most people do not know this yet: About 50 human genetic diseases due to defective enzymes can be remedied or ameliorated by the administration of high doses of the vitamin component of the corresponding coenzyme, which at least partially restores enzymatic activity. From the Department of Molecular and Cellular Biology, University of California

http://www.ajcn.org/cgi/content/abstract/75/4/616 [ajcn.org]

The reason you don't know this is that it is a very low cost therefore low profit approach that offers no monopoly or control.

Read about the end of disease protocols here. http://intelegen.com/nutrients/index.htm [intelegen.com]

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