Test Anxiety

The NY Times has an intriguing article today about the conflict people have between getting DNA screening to help determine what illnesses they may have a predisposition for and the fear of letting that information get out to their insurance companies.

The sheer fact this is even a concern is a sever condemnation of the way health insurance works in this country.

At issue is the fact people are worried getting a DNA screening through traditional medical channels would make that information part of their public health record, information which insurance companies might then use to deny access to health insurance (or companies might use to turn away job applicants, a different, but related, matter).

As the article makes clear, there are few, if any, examples of this actually occurring. However, given the propensities of the health insurance industry, no one can reasonably deny this is a legitimate concern. For a recent example, I refer the reader to this LA Times story discussing how Health Net canceled a woman's insurance while she was in the middle of costly chemotherapy treatment ... and how policy cancellation was a key component of the company's bonus plan.

Should information from DNA screenings become public, one can hardly blame the insurance companies for using the information to weed out applicants with increased risk of costly conditions. After all, we are a capitalistic society, and that's the way capitalism works - maximum your income and minimize your expenses. In the end, the bottom line for the insurance companies is the health their bottom line, not the health of their policy holders.

Somehow, conservatives see this as being a good thing in the long run ... and if some people, through no fault of their own, but rather as a result of genetic pre-disposition or, worse, simply being poor and unable to afford health insurance end up not being covered ... well, that's ok with them apparently.

A national health-care plan would have a far different set of incentives than a private health insurance company. It would have an incentive in promoting healthy life-styles and preventive medicine. It would not be driven by the notion of making a profit, even at the expense of the patient. It would (at least in theory) not be as tethered to making money for stock-holders and executives, but could instead pump that money back into the system.

Even with a national health care plan, there would be niches for private insurers to fill, to provide faster access to surgery for needed, but not life-threatening, conditions for example, or a higher level of service. Of course, to encourage people to spend more of their hard-earned money on top of what they would pay in taxes for the national plan, these companies would, just maybe, have to actually show they care about their customers.

It's ludicrous that people are, in many instances, refusing to get testing to find possible issues which could be addressed early because they know that information can, and likely will, be used against them. What they don't know might kill them, but what they do know could end up ruining them financially. It's not a decision anyone should have to make.