Tuesday, April 29, 2008

Civil Rights for the New Century

The US Senate has unanimously passed a bill that would bar discrimination on the basis of genetic test results. It still needs to pass the House and Dubya before it's a law, but I can't imagine either of them could find any reason to take issue with it.

This is a good idea, and a surprising example of foresight from the US legislature. Now that it is feasible for people to have their entire genome sequenced, there are all sorts of things to worry about for those that choose to have it done. Will employers refuse to hire you if it looks like you may develop a neurodegenerative within the next decade? Will you be charged a higher premium on health insurance, or denied it altogether, if you carry a gene for a late-onset disease? This law will help to prevent those kinds of things from happening.

On the same token, it does open the door to some dishonesty from patients. If you know that you're going to get sick and need some very expensive treatment sometime soon based on genetic evidence, then you'll go out of your way to make sure you get health insurance that covers the exact treatments you'll need. Right now, it's kind of a gamble - what do you want to protect yourself against? Do you spring for coverage of the rare disease that you may or may not have? With genetic evidence in your hands, you'll have much better information than the insurance companies, and they could stand to lose a lot of money. Yes, I realize that they exist to pay out money for medical procedures, but when the customers know exactly what they're going to need and about when they'll need it, that could throw a serious monkey wrench into the economy.

This bill is definitely a step in the right direction, but as science creates new frontiers, we are going to need to do a whole lot more thinking about the social and economic implications of those frontiers and do some tricky legislating to make sure everything still works. I haven't a clue what the best way is to handle the potential exploitation of insurance companies by their own customers. I suppose that may be an argument in favor of socialized medicine in the future. It will be interesting to see where this goes.

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