What follows is inspired by this little post by Matt Yglesias. Believe it or not, this is something about which I have given much passing thought. In a general sense, I have wondered about the ways in which certain diseases strike certain individuals. In my family, three of my grandparents made it in to their 80's, and my paternal grandmother lived to be 95 (my maternal grandmother only lived to be 64; had she lived even 20 years later, she might have made it through the breast cancer that killed her). I have seen young people with leukemia, testicular cancer, lymphoma, MS, and other debilitating illnesses. My father-in-law, who died in 2001 at the age of 58, had a personal and family history of cardiovascular disease (he died from a pulmonary embolism).
At the same time, I see people who live long, healthy lives, or perhaps long and not-so-healthy, but certainly long lives. I look at my parents, now officially in their mid-80's, and only recently slowing down (three years ago, they made the drive from upstate New York for a week's visit out here on the prairie). I know people twenty years my parents' juniors who would be hard pressed to make a journey half as long.
There just seems to be a place for DNA in this odd distribution of ailments and diseases. Some folks just seem to have superior genetic material, and either fight off microbial disease or manage to stave off the worst excesses of genetic breakdown that result in cancer. There is nothing fair about this; nor is there anything particularly wrong with it, either. It's just the way the biological cookie crumbles sometimes, as harsh as that sounds.
Yet, as Yglesias points out, the kinds of genetic testing which will in all likelihood be developed over the next few decades will only put the whole issue in sharper focus, as insurers push harder and harder to avoid risky investments. So, you are a young man whose paternal line has a history of cardiovascular disease, you are edging towards obesity and diabetes? Or, you are a young woman who has a history of breast cancer in your family? I would guess that insurance companies would take one look at your genes and say, "So sorry."
On the one hand, this makes perfect sense. Folks who are already infected with HIV can be denied coverage; folks with other chronic diseases who do not have insurance can be denied. Why not extend that principle to those with faulty genetic material, making them more prone to illnesses requiring all sorts of payouts from insurance carriers?
Except, of course, we have a problem here, do we not? When this is boiled down to its most basic level, I just want to know how this is substantively different from discriminating against people because of the color of their skin color. Indeed, one could even argue that such discrimination is also sound, from the point-of-view of a health insurance provider - sickle cell, Taysachs Disease, high blood pressure anyone?
I think this is not an argument for regulating these kinds of things out-of-bounds for insurance companies. Rather, I think it is an argument for scrapping private insurers all together and going to national health care. We are not responsible for the genetic material that makes us who we are, including those faulty genes that may make us more susceptible to this illness or that one. I see no reason why good economic sense should condemn millions of Americans to bad or no health care through no fault of their own.
Virtual Tin Cup
