In 2008, Congress overwhelmingly passed, and President George W. Bush signed, the Genetic Information Nondiscrimination Act. Ron Paul was the lone dissenter. The legislation bars insurers from denying coverage or raising premiums on individuals who show a genetic predisposition toward particular diseases. And in doing, it armed a time bomb beneath the health-care industry.
As we sequence more genomes, mine more data, and conduct more studies, we’ll find a lot more connections [between genes and diseases]. Eventually, genomic testing will be a powerful predictor of future illness. And it raises the potential that young people will get themselves tested and then purchase insurance based off the result. So those with a clean genomic result might go for a cheap catastrophic plan, while those with a high risk of developing pricey illnesses will opt for more comprehensive insurance.
The result would be, in insurance terms, an “adverse-selection death spiral,” as the healthy opt out of expensive insurance, the sick opt into it, and premiums spin out of control.
I would argue further that adverse selection already occurs to some degree with healthy adults often going without insurance or avoiding health maintenance until they qualify for Medicare, which is one reason why Medicare usage is disproportionately high in an individual's first year of use. Why pay for coverage or a service when that service will be covered by Medicare in a short period of time?
In one of the quirks of the US system, workers slave away and submit payroll taxes to cover [often wealthy] seniors while they themselves are without insurance. Odd that. I think Americans just don't understand how screwed up this concept is... and we limp towards single-payer. While I appreciate Klein's argument, private health insurance is already destroyed.