Policy

More DNA Day Fun: To Test, Or Not to Test?

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In honor of DNA day

Congress reached an agreement clearing the way for a bill to prohibit discrimination by employers and health insurers on the basis of genetic tests…

[The bill] would make it illegal for health insurers to raise premiums or deny coverage based on genetic information, and would prohibit employers from using such information for decisions on hiring, firing, promotions or job assignments.

Everybody's favorite fillibusterin' Republican Tom Coburn of Oklahoma has been delaying the bill, but it looks like it's about to shake loose. Coburn says he was worried about a new lawsuit boom as people with genetic conditions sued employers, insurers, or any body who looked at them cross-eyed. Some additional legal protections for employers have been added to the bill in the form of a "firewall" between insurer and employer sections of the bill, so it will mostly affect people looking to get individual health insurance plans.

We're bound to see more debate in this area as the science improves and the price of genetic testing comes down–this particular legislation took 13 years to make it through Congress. On one hand, people are afraid to do (potentially lifesaving) genetic tests right now because they're worried about future insurabiity–surely a suboptimal state of affairs. On the other hand, employers will discriminate on certain conditions, no matter what the law says, and in many cases, they ought to be able to. Why should we demand, for example, that a company invest in training an employee that it knows will likely to be out of commission due to illness in the near future? 

And then there's this slippery slope:

[The bill] does not prohibit discrimination once someone already has a disease, and some experts said such protection would have to be the next step.

"You don't want to be denied health insurance when you are at risk for breast cancer," said Sonia M. Suter, an associate professor at George Washington University Law School. "But it seems to me you really don't want to be denied health insurance when you have breast cancer."

Our insurance system is pretty broken at this point, but layering on legislation requiring insurers and employers to ignore the information made available by quickly evolving science and medicine doesn't seem likely to help much.