The G.I.N.A. could be a bad thing for healthcare.

The DNA Network batted this issue around several months ago, but it’s coming back in the form of a Letter to Nature.

His argument is that there’s no guarantee that making insurance companies remain ignorant of a patient’s genetic risks will prevent discrimination against those who have the unlucky combination of poor economic status and genetic risk factors.

I think he’s right. For one thing, the government would have to force people to not voluntarily disclose their info to the insurers, perhaps in exchange for a premium reduction, and that would be a little heavy-handed, wouldn’t it? Currently, the system helps those with higher risks obtain insurance by essentially letting the people who pay in without making claims subsidize the rates for those who make more claims than they pay in. Why couldn’t it work the same way if the insurers were able to take genetic risks into consideration? It might even lower the total cost of insuring everyone, allowing the insurers to cover more people for the same costs, or the same amount of people for much less cost with the high risk people picked up by programs similar to those which cover the homes of those in flood-prone areas. (As a New Orleanian, I’m not one to sign the praises of FEMA, believe me, so I’m not holding the NFIP up as an example, I just think the actuarial considerations are similar). Maybe we could even make enrollment of a certain amount of high-risk people a condition of being allowed to set rates based on genetic profiling?

This is all jumping the gun a little, because actual rock-solid, high-confidence correlations between a genetic feature and a disease are still rather rare, but one thing’s for sure: The better you see what’s ahead, the better you can plan for it (whether a insurance company or an individual), and having a good plan leads to better outcomes for everyone. Everyone’s worried about enabling social injustice, but it can’t really be said that our current insurance system in which many are so under-served is really all that great to begin with, so let that temper your thoughts, as well.

Genetic-Future via Genome Technology