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Health

Cheap genetic tests (but we get to keep the data)

Gene ExpressionBy Razib KhanFebruary 16, 2010 2:24 PM

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Dr. Daniel MacArthur reports on shenanigans in his homeland, Australian insurance company offers discounted genome scans to customers; read the fine print!:

A reader pointed me to this article in the Australian news: it appears that a major Australian insurance company, NIB, is planning to offer half-price genome scans from personal genomics company Navigenics to 5,000 of its customers. The catch is in the fine print: those who take up the offer "may have to give the information to life insurance or superannuation providers", according to the article. In a letter to customers, the chief executive of the company explicitly says that this information could be used to alter the premiums people pay for their life insurance.... ... You can expect to see some reflexive outrage following this announcement; people have a visceral dislike of the notion of insurance companies using genetic information to make decisions about policy. Indeed, this dislike has been enshrined in law in the US via GINA , which prohibits the use of genetic information by health insurance providers and employers (although it's worth noting that the law doesn't apply to life, disability or long-term care insurance policies). Australia has no such law. ... I'm personally pretty ambiguous about the need for bans on the use of genetic information by insurance companies, and tend towards opposing them. However, I do accept that there is a genuine danger that insurance companies will weight genetic information more highly in their premium calculations than is warranted, thus unfairly discriminating against potential customers. Especially in these early days, it is crucial that companies get the science right when they perform these calculations.

In general, I'm with Dr. MacArthur. Blanket bans just open up opportunities to be circumvented, and will end up distorting the market. One of the problems with the American insurance system is that it's totally scaffolded by regulation on a state by state level. I do believe in a general way that our psychology is biased so that we'll oppose strong forms of genetic discrimination because it seems arbitrary and capricious. But instead of passing laws which we perceive as cost-free expressions of outrage, it would be more efficacious if we bit the bullet and raised taxes to fund more research and enable affordable health care for everyone (or reallocated resources from the budget). Banning genetic discrimination is like banning discrimination against preexisting conditions, humans seem to find the bans appealing on intuitive grounds, but they undermine the logic of the insurance system. Passing a fiat law does not get at the structural root of the problem. P.S. Also, it's kind of funny that people get worked up about genetic tests, as family information is out there and so means that insurance companies can infer a lot already.

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