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Of course, employer based health insurance under present arrangements is defective because employees who change jobs may have trouble finding employment if they tested positive for a genetic defect. The solution to this problem is to encourage a move toward a system that allows health coverage portability, so that coverage moves with employees when they change jobs.

I wonder how exactly this would work. At first glance, it seems that such a system would destroy the best aspects of the current employer-based system. Since nowadays most workers change jobs frequently, if someone knows they are healthy, they will have an incentive to switch to a lower-cost health plan when they change jobs, creating exactly the kinds of problems you describe above in an individual health market. (Perhaps the problem is somewhat less because the incentives for health insurance are mixed with the other incentives of a job choice?)

I believe there is no solution to the health care issue. It is not Americans' economic illiteracy that is to blame, but the perception that everyone should have access to high quality health care at roughly the same cost. A perfectly efficient market would be to have no insurance at all- and as predictive tests advance, we are moving closer to this system. (In the limit, the cost of the insurance is exactly the (deterministic) cost of the procedures that will be required.) I don't think that any private system satisfying general ideas of social justice can also be efficient.

I wonder, what would be the effect if the government mandated that everyone purchase health insurance covering them to some level? It seems that costs for that level of insurance would drop, since self-selection effects would disappear.

Richard Mason

Becker: A better way is to penalize individuals who withhold information from insurance companies about the outcomes of genetic tests.

Either a public service or a private company could provide anonymous genetic testing. Perhaps one could mail a Q-tip with a buccal swab to a lab, possibly in a different country, and receive the results at an anonymous email account. Eventually there may be kits to perform the test in the privacy of the home.

So I think that provisions of the form, "Have you ever had your DNA tested? We will punish you if you lie," are unenforceable. People have a lifetime of unlimited access to their own DNA. We have to assume they will have it surreptitiously tested if the information advantage they gain has significant consequences.


Richard! Great! One way I can get the paper off my front porch is that of going out the back door and running around three sides of the house, grabbing the paper and then running back around. But there are easier ways!

In short why in hll are we the people putting up with such dictatorial hrsht from those NOT elected? Why are WE not at the table as, at least, EQUAL participants in writing a health care contract which THEY can then bid to insure?

Even more pertinent? UNLESS we ARE willing to point to someone and say: "He does not deserve and will NOT get medical care" Why are we continuing to spend half of our healthcare dollar on the sorting process? and driving those "not covered" to show up half dead at our overworked ER's for the most expensive care on earth?

Bye for now...... this time I'm going out the back door and run around three sides of my whole block to pick up my paper? Jack

Joe C

Insurance needs to be reformed in the USA.


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