There is a new law on the way that will prevent insurance companies from using genetic information against people. (LA Times Story Here) President Bush has said that he will sign it, so it should be law soon. But this will create an interesting scenario. If a percentage of the population finds our that they are high-risk for a disease and another percentage of the populations finds out they are low-risk, those populations will naturally choose insurance plans based on those predispositions. So, people likely to get cancer will add cancer riders, while those unlikely to get cancer will avoid those riders. We still don’t know enough to be conclusive on those sorts of things, but scientists are getting better at it all the time.
At its core, insurance is a bet on an unknown event. Insurance companies make money when they correctly calculate the odds of an event happening and base premiums on those odds. Insurance companies lose money when they incorrectly calculate those odds. And usually, invididual people have little idea about the odds. If we are about to enter a realm where individuals may know more than the insurance company, it may throw insurance way out of whack. If only people who will get cancer have cancer riders, those riders will become incredibly expensive just so the insurance companies can stay afloat. The net impact of that scenario is financial discrimination of exactly the sort this law hopes to avoid.
The only way this works out is if people cannot opt out of insurance policies (or choose not to get full coverage), so that the pool stays large and the majority of people in the pool do not suffer the events for which they are covered. In many ways, this may be a foreshadowing of the need for single payer (governmental) health insurance. If everyone in the country had the same policy, people learning about their genetic predispositions to various diseases could be irrelevant to their insurance premiums and coverage and this law works as intended. If you expect insurance to remain in the realm of the free market, then this law may cause the exact sort of problem it seeks to avoid. If only people predisposed to terrible diseases buy insurance against terrible diseases, the whole system breaks down.
My guess is that there are a million hypotheticals that can and will test this law over the next two decades. I’m willing to bet that technology will present some completely unexpected challenge to this law that will throw our courts into confusion. I also suspect that this story and this law will follow the model that the biggest news of the day is never the top story of the day. In the very near future, this law, for better or worse, may be one of the most important laws in the country. Technology is moving that fast and genetics is developing in thousands of directions .





