Genetic nondiscrimination in health care, Part II
Summary: This is the second of a 2-part series discussing the Genetic Information Nondiscrimination Act; in it, I discuss my perspective on the U.S. health care system.
Yesterday, I wrote about the Genetic Information Nondiscrimination Act, which aims to protect people from being discriminated against because of their DNA. I suggested that, the health care system being what it is, it makes perfect sense to me for genetic information to be factored into premiums. The problem is that the health care system is what it is.
Let’s talk about insurance for a minute. The concept of insurance is simple: a group of people have some statistical likelihood of experiencing a negative event. The negative event has a financial cost associated with it. Because we don’t know who will be affected by the event, we all agree to chip in a little so that none of us will have to bear the complete cost alone.
Profit motive
The U.S. health care system takes that concept and puts a profit spin on it: they’re the house and we’re the gamblers. It is in their best interest to encourage gamblers who are likely to lose a lot of money (healthy people) and discourage gamblers who are likely to win a lot of money (unhealthy people).
Because it’s a free market system, they can adjust the rules to maximize their returns. They can actually kick the people they don’t want out of the casino altogether.
Care motive
The problem, of course, is that the purpose of health care is not money. It’s an integral part of our human existence. We may choose to fight other tribes or factions or countries, but within our community we take care of each other.
Why do we take care of each other? Partly because it’s just the way we are. Perhaps it’s an ‘evolutionary insurance’ imperative: the more we take care of each other, the more likely we are to survive as a species. Mostly, though, I think it’s because none of us knows when it’s going to be our turn.
Obviously, these two motives are in direct conflict: to be more profitable, you need to remove people who are likely to be unhealthy; to effectively care for the community, you need to take care of those same people.
Some may argue that the profit system would be set up to reward those people who take preventative measures. But I am confident that the risk of being denied insurance altogether would far outweigh the potential premium reductions available for most people.
Under the current system, people benefit more by ignoring their health than by taking care of it.
Under the current system, suppliers benefit more by not taking care of people than by taking care of them.
The issue is not whether insurance providers should be allowed to discriminate on the basis of genetic information. The issue is that insurance providers should not be allowed to discriminate at all. That’s the whole point of health care: to improve the health of our society. How can we do that by ignoring the people who need care?
