Congress, protecting you from the world they built:
Lawmakers have agreed to make it illegal for employers and insurance companies to deny applicants jobs and health care coverage because DNA tests show they are genetically disposed to a disease.
It also makes clear that, while individuals are protected from discrimination based on genetic predisposition, insurance companies still have the right to base coverage and pricing on the actual presence of a disease.
Here’s an idea: eliminate the favorable incentive that irrationally ties health insurance in America to employment. If employers are no longer in the insurance business, they’ll have no opportunity to discriminate on the basis of future health care expense. Instead, Congress leaves the underlying problem that permits possible discrimination and codifies “discrimination is bad, mmmkay.” Never mind that politicians discriminate against the unemployed, under-employed, and self-employed.
Naturally Congress misses the point that discrimination is not inherently evil. It is often used for reasons we don’t like, so we’ve attached an exclusively pejorative interpretation to it. But I discriminate against meat when I choose vegetables instead. I discriminate against Ford when I drive a MINI. The Phillies discriminated against a local player when they traded him for a player they value more.
Politicians discriminate against one expenditure when they vote for another. Sometimes, discrimination is just about making choices in a world with limitations.
I’m playing semantics right now. Conceded. But semantics matter, as this shows:
[Senator Olympia] Snowe noted that nearly 32 percent of women offered a genetic test for breast cancer risk by the National Institutes of Health declined because of concerns about health insurance discrimination.
I’m not advocating mandatory screening against a person’s wishes. But I’m also against prohibiting insurance companies from pricing risk more precisely by requiring genetic information through the voluntary application process. (Is that the inevitable future from this legislation?) Yet, just as an insurance provider may require the test, no applicant is forced to accept that condition. Competition breeds options where it is permitted. To a significant extent, it is not permitted while insurance is tied to employment, so we get further legislation.
Although it’s not explicit, I think the sponsors of this legislation are more content with the collective outcome of this. Insurance providers are good at knowing their business. They understand risk and how to price it based on statistics. Congress seems to be saying that pricing it better – to the individual, based on the individual – is discriminatory. Perhaps. But the risk will be priced. The only question for discussion is who pays. Is it shared across the insurance pool or paid by each according to his risk?
Legislation like this, as opposed to the more logical solution that removes the faulty incentive, clarifies the political mandate: genetic luck, just like financial “luck”, increases one’s responsibility to the unlucky.