Genetic Non-Discrimination Act

I like to think I pay closer attention to the news than your average American, but I had no idea this law was ever written. Apparently, no Gattaca-type scenarios are going to emerge:

The most important new antidiscrimination law in two decades — the Genetic Information Nondiscrimination Act — will take effect in the nation’s workplaces next weekend, prohibiting employers from requesting genetic testing or considering someone’s genetic background in hiring, firing or promotions.

But also:

The biggest change resulting from the law is that it will — except in a few circumstances — prohibit employers and health insurers from asking employees to give their family medical histories. The law also bans group health plans from the common practice of rewarding workers, often with lower premiums or one-time payments, if they give their family medical histories when completing health risk questionnaires.

“Genetic information is very broad,” said J. D. Piro, a principal in the Health Care Law Group at Hewitt Associates. “It doesn’t simply include my own genetic information, such as do I have a risk for cancer. It also includes my family medical history — do I have any relatives who have had cancer or leukemia.”

The political impulse to apply non-discrimination principles to health insurers reflects, I think, the fundamental fact that America really doesn’t want to see private health insurance play the kind of major role in our system that it plays. Discriminating against people based on their risk profile is what insurance companies. That’s the essence of the business. But the regulatory impulse with regard to the special case of health insurance is to try to curtail discrimination based on gender, discrimination based on age, discrimination based on genetic profile, etc. I sympathize with the impulse, but if you’re not going to have companies doing risk-based discrimination then the way to get that is to try to cut the insurance companies out of the whole sector.

We’d be happier, I think, if we just had the government cover catastrophic costs and preventive costs and then individuals would pay out of pocket for other stuff. Political debate could then center around how expansively to define “catastrophic” and “preventive” with the left pushing for expansive definitions (and higher taxes) and the right pushing for restrictive definitions (and lower taxes). We’d have a division between the realm of social responsibility and the realm of individual responsibility, people would contest where the line should be drawn, and private insurance wouldn’t be important to health care.