I'm among that group of fans who believe that Dr No was the best Bond film of the genre (although the newest reimagination was pretty darned good). But this post isn't about the fictional Spectre villain; (Dr) Tom Coburn is the Oklahoma Senator who's earned that epithet for his frequent use of "holds" to bottle up bills that "violate his core principles."
And which kinds of bills are those? Well, they include "any new federal program that is not paid for, or anything that might duplicate another program, or anything that might be unconstitutional."
And that's why he's put the (temporary) kibosh on the Senate version of legislation prohibiting the use of genetic information in insurance underwriting (H.R.493). Among other things, the bill would "prohibit a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information."
On the face of it, the bill seems innocuous enough: after all, why should folks be penalized for things over which they have no control (i.e. their genes)?
Would that it were that simple.
But the fact is, such prohibitions already exist at the state level, so a federal limitation would be redundant. Even more important, it's a bad idea: underwriters have a number of tools at their disposal, and genetic testing just isn't one of them.
But for the sake of argument, let's say that it was, and that it was used.
So what?
How is that any different than testing for HIV, or tobacco, or cocaine? On a group basis, any one of those factors may (or may not) go into the mix in order to arrive at a reasonable final rate. Thanks to HIPAA, groups can't be declined on the basis of health, and states have put caps on how much a given group may be surcharged.
Speaking as one whose own genetic makeup would fall squarely in the sights of such a tool, I would have no problem with its use. Why not? Because insurance is a mechanism of risk management, and in order to effectively manage a given risk, one must have an accurate assessment of it.
There's another problem with the proposed legislation, as well: it's poorly written.
How's that, you may ask?
Well, as "Dr No" points out, "the current language of the bill is that the definition of genetic test is inconsistent.” One has only to read the bill to see that this is so. While that may seem an excercise in picking nits, it is actually a major flaw: since the definition of what constitutes such a test is fluid, the trial bar would have a field day interpreting what underwriters use as criteria in their assessment of a group. This in turn could (would?) lead to even higher premiums.
And nobody wants that.
And which kinds of bills are those? Well, they include "any new federal program that is not paid for, or anything that might duplicate another program, or anything that might be unconstitutional."
And that's why he's put the (temporary) kibosh on the Senate version of legislation prohibiting the use of genetic information in insurance underwriting (H.R.493). Among other things, the bill would "prohibit a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information."
On the face of it, the bill seems innocuous enough: after all, why should folks be penalized for things over which they have no control (i.e. their genes)?
Would that it were that simple.
But the fact is, such prohibitions already exist at the state level, so a federal limitation would be redundant. Even more important, it's a bad idea: underwriters have a number of tools at their disposal, and genetic testing just isn't one of them.
But for the sake of argument, let's say that it was, and that it was used.
So what?
How is that any different than testing for HIV, or tobacco, or cocaine? On a group basis, any one of those factors may (or may not) go into the mix in order to arrive at a reasonable final rate. Thanks to HIPAA, groups can't be declined on the basis of health, and states have put caps on how much a given group may be surcharged.
Speaking as one whose own genetic makeup would fall squarely in the sights of such a tool, I would have no problem with its use. Why not? Because insurance is a mechanism of risk management, and in order to effectively manage a given risk, one must have an accurate assessment of it.
There's another problem with the proposed legislation, as well: it's poorly written.
How's that, you may ask?
Well, as "Dr No" points out, "the current language of the bill is that the definition of genetic test is inconsistent.” One has only to read the bill to see that this is so. While that may seem an excercise in picking nits, it is actually a major flaw: since the definition of what constitutes such a test is fluid, the trial bar would have a field day interpreting what underwriters use as criteria in their assessment of a group. This in turn could (would?) lead to even higher premiums.
And nobody wants that.
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