Afraid of their insurance getting jacked up or of employer discrimation, people who think they might be genetically predisposed to certain diseases are testing themselves with home DNA kits, hiding the results from their doctors, and harboring a potentially deadly secret. [NYT]

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  1. mikelotus says:

    this was in the NYT a couple of days ago. i shouldn’t have to pay for someone’s bad DNA. but then again, the DNA in the Bush clan is clearly deteriorating over each generation and i am paying and paying for the bad DNA in that case. and worse yet, that bad DNA has to do with brain function.

  2. Lin-Z [linguist on duty] says:

    this can only end in success.

  3. Wait… I’ve seen this movie… Gattica, was it?

  4. azntg says:

    @Lin-Z: As weird and as cryptic as that sounds, I have to agree.

  5. Galls says:

    @mikelotus: Social Darwinism for the win!

    Blond Hair, Blue Eyes am I right?

    If only we could get a little more proactive in this genius logic.

    Sieg Heil!

  6. RIP MRHANDS says:

    @Galls: lol what does hair color and eye color have to do with genetic predisposition to certain diseases?

  7. Galls says:

    @RIP MRHANDS: It is a reference to the deep belief of the Nazi’s in Social Darwinism, which is essentially, to an extreme, what Mikelotus was suggesting. Let the people who had no choice or part in creating their own problems deal with their own problems.

    Which if you further dissect is also an argument against the existence of society. As he was essentially denouncing shared burden, promoting hyper-individualism.

  8. RIP MRHANDS says:

    @Galls: On the contrary, if you study the main thesis of national socialism you will find it is exactly that – a form of socialism (as opposed to individualism as you state). The whole idea of the national socialist state was founded around the concept of ‘blood and soil’ – that is, the integral combination of a people as a social unit and their land that they shared their common existence with.

    I think you will find very little in common between the genetic determinism that insurance companies want to exploit purely for profit and the motivations of the Third Reich for building their ideal nation-state.

  9. lemur says:

    @RIP MRHANDS: The Nazis eliminated undesirable individuals from their society by killing them. The insurance companies want to eliminate undesirable customers by letting them die when their genetic defects come into full bloom. The difference is that the insurance companies are less blunt than the Nazis. A difference in degree, not in kind.

  10. bohemian says:

    @Galls: Oh you mean the current US health care policy?

  11. Scuba Steve says:

    I would treat it like a high stakes example of the prisoner’s dilemma.

    Society can chose to either take care of these people or let them die.

    These people can die quietly or make it as harsh for society as possible. What do they have to lose? Their lives? They’re already going to die.

  12. crapple says:

    I read a headline on this a few days back and the article didn’t interest me – I thought it was targeted at those whore’s that go onto Maury Povich for 5 separate episodes of “He’s My REAL Baby-Daddy” with a different guy every time…and still come up empty handed.

  13. You see, this is why I just don’t have health insurance.

  14. johnva says:

    @Galls: I’m in complete agreement with you. People should not get different levels of healthcare (or pay far higher amounts for it, which has a similar effect) just because of the genes they were born with.

    Genetic discrimination is really no different from discrimination on the basis of race. If they found that statistically black people cost the health insurers more money, should it be okay for the insurers to charge blacks higher premiums? After all, it’s “fair”. The only difference between that situation and the broader “genetic discrimination” is that skin color is a VISIBLE genetic characteristic.

    Everyone has some things that aren’t perfect in the DNA. As a society we need to make the choice that these things that people can’t control do not become the basis for differential levels of care and status. Unfortunately I can’t see how this can be done without getting rid of the for-profit health insurance industry (or at the very least heavily regulating it).

  15. Dervish says:

    @johnva: I agree completely. People are born with these predispositions – it’s not as if they’re choosing to partake in unhealthy behavior like smoking or drinking or overeating (not that I’m trying to start another debate about all that).

    It especially stinks, because who gets to say what level of correlation between a particular mutation and an actual expressed disease is the threshold for denying coverage? Just because you have a predisposition doesn’t mean you’ll contract the disease. I know some correlations, such as the BRCA1 gene and apparently the deficiency in the article, are very strong. But what about others? What if someone discovers a mutation that only leads to liver cancer, say, an average of 10% of the time? Is that enough to deny coverage?

  16. johnva says:

    @Dervish: Lots of times, also, the exact genetic factors that affect a disease are not really known. We’ve mapped a lot of the human genome, but we don’t really understand all the different mutations people can have in various genes and how that affects specific expressed proteins, much less how that goes on to produce specific diseases. So they might be able to determine that a disease is genetic in nature, but not why some people get it more severely than others, etc. DNA and human genetics is not a tidy thing. Everyone is different, and our differences make us human and unique. Insurance treats people as a number.

    The broader question for the United States in particular is that we put so much emphasis on “individual responsibility” here. You can see this in the first response in this thread where someone is saying they “shouldn’t have to pay for someone’s bad DNA”. This individualistic argument is the one you see again and again against things like socialized healthcare. We shouldn’t make genetics the basis for who gets to succeed and who doesn’t, and the only way to do this is make some risks shared by everyone together. Everyone has something to offer to society, even if their DNA is not “perfect” by society’s standards (and who is to say that those standards are even worthwhile?). The alternative is something like the GATTACA scenario where only the “best” people genetically get good healthcare and jobs, etc. This is quasi-eugenic determinism all in the name of corporate profit. I firmly reject that because I don’t think our fate is or should be set by our DNA from the moment we are conceived. We’ve got to nip this in the bud before it gets too entrenched.

  17. Dervish says:

    @johnva: Exactly. In the media, it’s always expressed as “one mutation = disease,” but we are absolutely the sum of our parts – if I’m remembering genetics correctly (it was a few years ago), relationhips like the BRCA1 gene and breast cancer are very much the rule. And what about environmental factors triggering the results of those mutations? It’s very possible that someone could have the much-touted “ticking time bomb” lying somewhere in their genes but depending on how and where they live, it’ll never go off.

  18. Angryrider says:

    Hey no one should be mad about this. It’s health insurance, not assurance.

  19. johnva says:

    @Dervish: Yeah, I think some of it is pure ignorance on the part of the public and the media. I think many people imagine that only some unlucky people have mutations in their genes, and that they are lucky enough not to. The reality is that EVERYONE has “mutations” which are really just individual differences. It’s just a question of whether science can identify and quantify the connection to health outcomes at the present time.

    I’m all for the GINA bill that the article mentions, but I don’t think it goes nearly far enough. It’s a start to say that genetics alone should not be the basis for discrimination. But it needs to go further and actually say that health conditions that are the RESULT of genetic conditions cannot be the basis for discrimination, either. Even if GINA passes, the only people that will be protected will be people with genetic mutations that have not actually manifested as disease yet. I can certainly understand why insurers would oppose THAT, since so many health conditions have a genetic component. That’s why I think that for-profit insurance needs to be scrapped as the way we provide healthcare. If we want to retain private insurers at all, we should have a large socialized risk pool and relegate these companies to administration tasks only. At that point though it would be more efficient to just nationalize their industry.

  20. johnva says:

    @Angryrider: I don’t blame the insurers, really. They’re just trying to make a profit, and certainly it makes sense for them to try to exclude customers who have genetic problems that could lead to costly disease. Instead, I blame the society that makes receiving decent healthcare dependent on for-profit insurance companies. It’s our society (and by extension, our government’s) fault that our healthcare system is so screwed up because we created the regulations and environment that makes the insurance companies the gatekeepers.

  21. nardo218 says:

    @ceejeemcbeegee: Exacly what I was thinking. “And even doctors who recommend DNA testing to their patients warn them that they could face genetic discrimination from employers or insurers.” The future is now, and it’s not a happy place!

  22. nrwfos says:

    @johnva:

    Everyone is going to die of something (barring accidents and murder) and it is likely that it can be found in their genes eventually. Soon we may find the insurance companies equating genetics with “pre-existing conditions”. Then what? It is a financial dance with numerous partners…or maybe it really is a giant game of Musical chairs wherein we HOPE that when we get sick or die of something, we (or our families) are left having a chair (insurance company who pays) to sit in.
    Everyone has something in their genetic make-up that will eventually kill them if they live long enough. Sometimes the “mutation” is only that the cells can no longer copy themselves correctly due to aging. We probably only have 7-10 cycles of gene replication before that happens. Most of us have less before a disease shows up.