Insurance and Genes

Here’s a long Brad DeLong post spelling out some features of the American health insurance system that makes it difficult for us to fully realize the promise of advancing understanding of genetics. I think the issue can actually be put quite plainly. Virtually everyone suffers from some medical problems over the course of a lifetime, and genetic information can often—and increasingly—shed light on preventative strategies that will help you minimize the extent of the problems you face. Thus even people with below-average lifetime health care costs would benefit from obtaining a better understanding of their genetic situation.

But insurance companies would also like to get their hands on this information, primarily for the purpose of using price discrimination or other methods to ensure that the pool of people they cover has below-average healthcare costs.

The United States of America is likely to attempt to resolve this problem through a variety of semi-effective regulatory tools—proclamations that insurers, employers, and other firms are “banned” from using genetic information in this way. Insofar as that helps us avoid a Gattaca scenario, that’s all to the good. But such methods ignore the fact that genetic screening isn’t just a threat, it’s also an incredibly promising means of improving public health and overall living standards by bringing people tailored and effective preventive health advice. As DeLong says what we need is “single-payer publicly-funded national health insurance and as much individual fine-grained information about genetic makeup and risk as we can get.” But the odds of it happening any time soon don’t look good.