Six New Degrees of Separation, and some terminology qualms…
No, I’m not talking about the “phenomenon” of figuring out how you are somehow linked to Stephen Spielberg, the Dalai Llama, and the guy who invented Pez. I’m talking instead about the American College of Physician’s recent policy monograph detailing the need for “separation”, or federal protection, against genetic discrimination between insurers and clients. Below are their six positions, posed succinctly, and a few comments of my own upon them. Please forgive me for playing Devil’s Advocate rampantly, I’m only hoping to explore all sides to come to more certain conclusions.
Position 1: Insurance providers should be prohibited from using an individual’s genetic information to deny or limit health coverage or establish eligibility, enrollment, or premium contribution requirements.
Position 2: Insurance providers should be prohibited from establishing differential premiums based on an individual’s genetic information or request for genetic screening.
Comment: This may seem obvious, but as with all obvious facts, a critical eye never hurts. Why should someone with a predisposition to Alzheimer’s be denied, marginalized or “ripped off” simply because their DNA indicates a higher probability of needing insurance down the road? Well, for one, we live in the United States of America, where any business can pretty much do whatever they want. Is it impossible to think that within the competition between insurers any inadequacy of coverage will be ironed out? Insurers will surely stand to make more money by having far more people paying less than far fewer people paying much more. Further, could you really blame the insurance companies for asking for a higher premium from someone who’s far above the average expectancy to develop leukemia? When we developed X-Rays, we didn’t say, “Hey, X-Ray companies, don’t look in our baggage when we go on planes, that stuff’s personal!” Of course not, and just as someone might be carrying a bomb out of the view of the naked eye on a plane, so might someone be carrying genes that would be destructive not only to the insurer’s bank accounts, but to other people as well. So, consider an alternative middle-ground a bit more in line with laissez-fare and sympathetic with the villainous insurance companies: the insurance companies provide assistance in preventative treatment for its clients with predispositions to ailments, and in turn the customer pays a slightly higher but more beneficial premium. In summary to this longwinded comment, I am choosing to weigh liberty higher than public welfare in this scenario, and while certain goods and values are certainly going to be lessened in this approach, I think it’s important to look at potential benefits and compromising scenarios which may be more in line with the Constitutionalist philosophy which our country claims to strive for.
Position 3: Employers should be prohibited from using an individual’s genetic information in employment decisions, such as hiring, promoting, or terminating an employee or establishing the terms, conditions, and benefits or employment.
Comment: I think that the main problem with most people’s view on this position is just that–the restricted point of view. This statement seems to apply solely to an employer restricting a potential employee based on his or her genetic deficiencies. However, perhaps an evaluation of a person’s genetic criteria will lead the employee and employer to a greater understanding of his or her strengths and/or weaknesses. So, that is not to say that someone should be assigned a job or role based on his or her DNA, but rather the employee and employer can work together, using the DNA information in tandem with other criteria to create the best possible workplace. In short, I don’t think that incorporating a genetic evaluation in a background check is necessarily an all-bad idea.
Position 4: Insurers and employers should be prohibited from requiring individuals and families to undergo genetic testing
Comment: I pretty much agree with this statement, but how can this be called different than a drug test? If an employer wants to test me for evidence of opiates or THC in my blood, I have to comply or I can’t be offered the job. Further, examining this position in the view that a required genetic test would reveal private information about someone that could be embarassing or hurtful is the wrong view. Just like a drug test, a genetic test might test someone for the likelihood of schizophrenia, mood disorders, or any number of items on a long list of potentially compromising attributes.
Position 5: Insurers and employers should be prohibited from collecting and/or disclosing an individual or family’s genetic information. Written and informed consent should be required for each disclosure of genetic information and should include to whom the disclosure is made.
Comment: Absolutely. There is no logical reason for a company to peddle DNA info like calling lists for telemarketers.
Position 6: Congress should establish comprehensive and uniform federal protection against genetic discrimination that closes the gaps in protection due to varying state laws. Federal protection should also cover ERISA health plans.
Comment: Agree, but disagree. I agree wholeheartedly that the variance in state laws should be remedied, as a unified stance on genetic discrimination across the nation will be the best scenario for both employers and employees. However, I still have a problem with the term “genetic discrimination.” It seems to me that people associate this term with other atrocities such as racism, sexism, and onto fascism, etc. However, I feel that genetic discrimination should be analyzed carefully, and the differences between it and, for instance, racism should be made clear. Racism is holding a prejudice toward someone because of their physical race (or, by some definitions, skin color). Clearly, this prejudice is nowhere near as logically founded as a prejudice toward someone who is incredibly likely to die of a heart complication before the age of 50. Further, the term “prejudice” takes on two different meanings; with racism, the person is prejudiced as an individual, as a character, but in genetic discrimination it is merely a precaution that any capitalist or rational employer would want to take. It may seem insensitive to think that letting many people incapable of choosing their faulty genes slip through the cracks is okay. In fact, it is insensitive. However, what’s worse and furthermore far more irrational is to think that the solution to preventing “genetic discrimination–the atrocity” is to ensure that genetic information remains secret at all costs. True, there are many downsides to releasing genetic information to insurers and employers, but if society can act with a bit of control, reason, and creativity, current views of inappropriate, insensitive skepticism might lead to a better future.