The Senate has passed legislation ostensibly banning discrimination on the basis of genetic testing results. I suppose that the devil will lie in wait in the details, as always, but I must confess to some degree of bafflement at Richard Spencer's reaction:
The fact is, genes affect susceptibility to disease, and genetic testing can help pinpoint just how and to what degree and thus help insurance companies design specific regimes for specific clients. Washington’s banning of testing simply means that we’ll all be paying higher premiums in order to account for the added risk companies bear due to their taking on certain patients who could easily have been put on different plans.
Reihan Salam had an interesting discussion of the slowly-emerging crisis of genetic testing and the business models of contemporary health-insurance outfits some months ago, though I cannot recall where, precisely; but since risk-sharing is the fundamental premise of insurance, well people paying somewhat more to subsidize the costs of caring for the unwell, as a hedge against uncertainty in their own lives, is just part of the package. We're no longer debating the whether, but rather the how; and the increasing precision of genetic testing augurs a future in which this no longer obtains, in which the genetically blessed pay for risk-management they will not need, while many cannot afford insurance because they are not so blessed, genetically-speaking. Many people will not be placed on different plans, so much as priced out of the market, period. The market rations services by means of the price mechanism, and many of the sick, and those with chronic conditions, will be excluded.
As I've suggested, this will defeat the rationale of insurance in principle, and increasingly in practice; let's say that this shift will constitute an ideal which increasing precision will enable us to approach. Now, as I've also suggested in numerous discussions, we're not about to go all Dickensian, abolishing all forms of social provision and solidarity (at least, I won't bet on it), and if the 'private' insurance industry prices large percentages of the population out of its services (and there is no way that genetic testing will not do this), pressures for political provision will mount, as they are presently, even in the absence of widespread anxiety over genetic testing. This legislation may be horridly crafted, for all I know; I might even wager on that. However, something like it may be a bulwark against the eventual imposition of socialized medicine, in this case an explicit dual system, such as exists in Britain: private physicians for the well-to-do and well, public clinics for the poor and ill.
Genetics cannot be banned; neither will the advance of the science be halted. However, neither can every human good, and every aspect of human fate, be subjected to the unmediated discipline of market mechanisms, as Karl Polanyi would say. The attempt to do so would not only cause enormous suffering, but would actually increase pressures for overtly socialistic measures, which will... cause suffering. Some goods are at least partly public, in other words, and this reality cannot be expunged. It is only the sick who need a physician, and not the healthy.