There are laws against age, race, and other discrimination in employment. But it still happens, and in some industries in widespread.
Greed finds a way. Your point is moot.
While adverse selection is undeniably a tricky problem, the underlying raison d'etre is pooled risk, to help individuals and families mitigate catastrophic losses. Maybe you're all right with the prospect of future analyses condemning to uninsurability folks with rare combinations of alleles that turn out to be strongly deleterious. To me, this seems like breaking the regulated semi-statis between insurers and insureds, and like breaking the social contract more generally.
The whole system is going to have to adapt to more information on individuals being available.
This might or might not be an issue now (regardless of the place of residence), but laws can always be changed. And societies can always develop to be more totalitarist, even up to extremes, and it is not like the collected data just vanishes when things start to slide. (Case in point: IBM's Hollerith machines and population records)
I was very curious about 23andme and really wanted to try it. After some due diligence I concluded it is not worth it because of privacy and other implications going forward. It is not what they do today, since they don't hide the obvious sharing and datamining, so if one joins them it is through informed consent. My concern was rather what kind of systems and policies they enable eventually in the future, after the information gets sold/shared enough times to anyone who can pay enough. At this point there is no control anymore in how (and by whom) the data gets used.
Cue adverse selection. They might not be allowed to collect genetic data, but nothing stops patients from doing their own sequencing, and shop for healthcare plans depending on their predispositions, thus drastically affecting healthcare profitability.
This is not a pervasive problem yet because the tests are pretty crappy and very few people bother, but on the long run, I bet your "level playing field" hypothesis will be debated.
How about displaying recruitment ads to people with lactose tolerance gene, effectively excluding most of worlds non-white population?
> It shall be an unlawful employment practice for an employer-- (1) to fail or refuse to hire, or to discharge, any employee, or otherwise to discriminate against any employee with respect to the compensation, terms, conditions, or privileges of employment of the employee, because of genetic information with respect to the employee;
No job advertising protection there
NJ (LAD):
> It shall be an unlawful employment practice, or, as the case may be, an unlawful discrimination: a.For an employer, because of [..], genetic information, [..] to refuse to hire or employ or to bar or to discharge or require to retire, unless justified by lawful considerations other than age, from employment such individual or to discriminate against such individual in compensation or in terms, conditions or privileges of employment;
Nope, nothing there either about recruitment ads..
I think the pros far outweigh the cons.
Sure, 23andme and GSK and others will get richer off this but so what—they are doing something good.
I think few people would argue against the benefits of genetic testing, but just because it's a great thing doesn't mean that being complacent around adjacent shady business transactions is the right approach.
You can be for it, but also for privacy, protection against insurance discrimination, etc. at the same time.
I’m dead in the long run regardless, and would rather find every way I can be impactful with the time I have left, even in these small ways.
10 million tests vs 10 million person database means 1 in 10 trillion false positives happen 10 times.
Generally at a 7cM overlap you have 50:50 chance whether you're related to that person or not. Anything over say 150cM you're virtually certain to be related (ignoring endogamous populations). At 3,400cM (full-match) it's not even worth considering randomness.
Paternity tests involve random ~50% of your dna. Sperm samples are generally contaminated and thus less clear cut. But, people’s relatives have been used in the past for these tests dropping the bar even further.
However, being related genetically is not enough. Some people have twin siblings they don’t know about pointing out being related is not nessisarily mean you know anything about the other person allowing for false positives even at 3,400cM.
Unlikely sure, but harm comes in many forms. Saying I can’t think of anything is a long way from saying it’s safe.
If you've got a identical twin then you're right that their child will be genetically indistinguishable from your child. But that's down to the nature of genetics rather than anything to do with the reliability of testing or database size.
If a test failed because _ then it failed independent of why it failed. If your long lost twin causes you to be involved with a paternity suit or homicide investigation then that's both a false positive and a significant problem.
Suppose a male with red hair, green eyes, and AB+ blood actually has those traits they are just not enough to unlikely identify someone. Adding more genetic traits on it's own is not enough for example you have identical twin or even triplet separated at birth. The core issue is DNA marks are not independent though people often assume they are.
Sure, at some point in the future it might get fixed or always fail, but until then you need to deal with today not some mythical perfect future.
For more hypothetical societal risks, I’ll cite the movie Gattica where DNA credentialism has created an underclass of people who can’t afford genetic manipulation at birth of their children. If your DNA is found wanting in that society it could be used against you in job applications, rental applications, etc.
Currently (IANAL) but I don’t think this would be legal, but once your information is out there, it’s rather hard to bottle back up.
Currently, it's explicitly illegal under US federal law, but there is also a full-frontal assault going on against consumer protections in the health insurance market in the federal government, so absent a significant change in government direction, I wouldn't bet on it staying that way.
Insurance only works as a system for society if the risk is spread among many parties, but if the insurance companies know the risk ahead of time it ceases to subsidize the unfortunate, who are left out in the cold (taxpayer funded programs and hospital ERS)
I’d make an exception for science if and only if it’s full deanonymized and controlled by a nonprofit third party entity.
People who have serious disabilities should be supported by taxpayer funded programs, in my opinion.
Also I hope you never have my DNA. I can’t think of a reason why you should, and for one possible exercise on why you shouldn’t, please watch Gattaca.
As for your DNA: Do you take the precautions of the protagonist in Gattaca? How do you avoid leaving DNA samples in public places? How long before drones/bots/Roombas are hoovering this up at the behest of some VC?
Re DNA precautions: We just need to make hovering up DNA illegal, or selling insurance, or selling anything based on the genetic information gathered from people; make it all illegal, so I don’t have to worry about it in the same way I don’t have to worry about insurance companies breaking into my house to spy on me.
What happens when someone gets their genetic information released in a country with public healthcare, and then moves to a country with private healthcare?
Why is that bad?
US insurance companies use treatment guidelines issued by organizations like NCCN (oncology). If they stray too far, they get dinged for not meeting "medical necessity" requirements.
If anything, you're more likely to get an experimental cancer drug in the US than Europe since US insurance companies don't like bad press.
Edit: As people bring up the insurance risk, yes I did consider that and mention it in my post. I am personally not concerned about it and think the advantages outweigh the risk. Besides, I think insurances companies are going to have all the data soon anyway. If every time I get a blood test, they have a chance to capture my DNA, how can I stop them?