Tuesday, April 24, 2012

The End Of Health Insurance

I was watching a recent PBS Nova episode about analyzing the human genome, and how the future is one where any illnesses related to genetics will be predictable to a high degree of confidence. While I understand that it is a bit esoteric for a national discussion that includes people dumb enough to holler things like this, the inevitable future of insurance needs to be broached. In the future, insurance will be dead because of genetic analysis.

I'm not a tin-foil-hat sort of fight the future wingnut. I can't wait for the future. It's gonna' be great. But that doesn't mean that many things that the future holds do not carry concerns along with them. Genetic understanding, perhaps more so than any other endeavor, is a hornet's nest of thorny issues. And that's absolutely great. All of the ethical issues that must be addressed are actually a blessing in disguise, not an imposition on progress. They force people to realize a mechanistic nature to our reality.

We are mechanistic, and we are learning more about the gears with every passing day. Many of the systems in our modern world are based on not knowing. For example, I buy car insurance because I don't know if I will get into an accident. Likewise, health insurance is based on not knowing. But as we discover more, we are starting to know. We are starting to understand.

For example, a person has a genetic make-up that guarantees that they will contract an ultimately deadly illness. This person is a guaranteed loss for any insurance company. If this is known, no company would ever accept this client. How can we fix this? We could force insurance companies to cover these patients, but could we force them to charge certain prices? The government would be forcing a company to accept a loss.

Would we see the emergence of cheap insurance providers who specifically provide only to those with clean DNA, thus leaving other insurance companies to provide incredibly expensive care to those without? Both DNA and economics would conspire to create a genetic underclass who cannot afford health care.

This future is inevitable. Some day, we will know with incredibly high confidence the healthful future of anyone who has their DNA sequenced. And if we still have insurance companies, why should they not be allowed access to data that is substantive to a prospective client's health? Understanding the human machine and insurance based on chance do not mix.

So what do we do? We either restrict health insurance companies to the point where they become quasi-governmental entities or a fool's business, or we stop pretending like the conservative wackos in this country know at all what they're talking about, and join the rest of the Western world in government-provided health care.

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