“So what do others think? Where can you draw the line? Should insurers be able to take increased health risk into account?”

I don’t see how one can draw a line since genetic susceptibility is often a result of environmental exposure where one may become cannon fodder for a rogue industry and the DNA damage can be passed onto the progeny.

For instance recent scientific findings are consistent with animal studies that have shown low-level, chronic exposure to radiation, such as from the fallout of bomb tests, can cause some genetic mutations that are passed to the next generation.

Such mutations can be traced to radiation exposure affecting sperm at a critical phase of its development.

Other researchers learned after sampling and genetically profiling many gull families is that colonies close to integrated steel mills transmit DNA mutations to their offspring more frequently than those at rural sites.

In addition, the closer the colony to steel mills, the higher the mutation rate. Here’s an easy to read evaluation:

http://www.science.mcmaster.ca/biology/faculty/quinn/Detecting%20Induced%20Heritable%20Mutations%20in%20situ3.htm

And recently I read that victims of the drug thalidomide have now given birth to progeny with similar afflictions. Why should they be penalised?

There is currently scientific controversy over the mutagenic chemicals present in diesel exhaust that are inhaled where the body metabolizes them into activated substances that damage DNA by reacting with it to form adducts. If this damage is not repaired by the cell before the DNA is replicated during cell division, mutations may be introduced that persist through future generations of cells. How do these mutations impact on the DNA of progeny?

May I suggest that all pollutant industries that fail to rein in their carcinogenic, mutagenic and teratogenic emissions, pay an insurance levy anyway, to cover the potential costs of life insurance for the afflicted, no matter the point source of exposure?

I contracted a persistent fungus on my <snip>'s some 12 years ago and my GP and I considered a pill for same as opposed to just a topical treatment.

Previously, we had noted that there was a history of "Haemochromatosis" in the family and had therefore to consider that the "toxicity" of the drug may not be able to be coped with by my liver.

Accordingly, we requested a test from a geneticist who responded with something like:

"You are 80% unlikely to have the condition."

Even so, based on family history alone and after re-consideration of the matter, my gp declined to prescribe and left me with canestan cream (approx $AU0.80 per 10g in Indonesia)

Interestingly to me, what hasn't been differentiated in this thread so far is that whilst only the likelihood of susceptability can be predicted at this stage in the instance of certain pathology, other known hereditary conditions can be determined with almost 100% certainty.

And I believe that includes conditions that manifest at a particular stage in life, say at or around puberty. So I suspect that some will make strong argument that in certain cases certain conditions which have yet to fully manifest would still constitute a pre-existing condition? Yes/No/Maybe?

Tangentally, I know one Dr, a professor of cancer no less, who strongly advocates for (from memory) 1st trimester down syndrome tests with a view to terminating such pregnancies.

..

Thereafter, this matter raises questions of the sort of society one wishes to have. Idealistically speaking I would like to see our "democracy" evolve a system where the safety net incorporates food, water, health, housing, legal and appropriate insurance.

Is it mathematically viable though, and note that obviously some will have to be paid less? What is the wealth of the nation? How many people are there? And can't we come up with productive work for "all" given we have so few people?

It really does concern me that Australia does price itself out of many gainful pursuits resulting in an overall detriment to our development.

A very unsettling topic. I imagine that insurance would be the first step in any 'Gattaca-like' developments (for those of you who have seen the film).

On the one hand, it's something that concerns me greatly however at the end of the day I'm reassured by the fact that if the insurance companies go too far then like any industry they risk a consumer backlash and the companies with less discriminatory policies will leap into the fray.

However, it would still result in a class of people opting for the cheaper health insurance that they're entitled to.

It all comes down to how large a demographic this 'healthy' sector is. Are they a juicy enough carrot to sustain a large insurance multinational?

Or, will spiralling rates of obesity, heart disease, sedentary lifestyles and cancer mean that the unhealthy demographics ensure they are priced into the market via sheer numbers?

TRTL

Glad to see you back online.

I had a thought (tada!) while reading your post - the emphasis by many politicians for us to breed, which has big business as its catalyst.

A big enough demographic to cover the risks for insurers? Fits with 'growth-at-all-costs' economics.

Another advantage with a large enough population, insurers can afford to discriminate against the high risk categories. None of which fits with sustainable economics, but we are as far from that path as we have been for the past 30 years.

Glad to be back.

Fractelle, you say that these large demographics will allow them to discriminate against high-risk categories. Isn't that already the case? If somebody with a known health condition steps forward, wouldn't they be paying a higher premium?

The strides forward in genetic testing, I would think, wouldn't necessarily alter the percentages of the population that are discriminated against. I guess my point is that there is a very large chunk of the population which is unhealthy. That percentage wouldn't necessarily change with more testing, just become more defined, and the riskiest and healthiest people would be small groups on either end of that large, not-too-healthy-but-not-dying mass in the middle.

TRTL

<< If somebody with a known health condition steps forward, wouldn't they be paying a higher premium? >>

Absolutely.

Already there are discriminations, and, as you say, with the advancement in understanding genetics, something I am sure the insurers follow closely, this bias will indeed be refined further.

One thing we will not hear a lot about from insurers is that genetic susceptibility is not a guarantee that an illness will occur - environment plays a significant part. Now a healthy environment is one where people eat healthy non-chemical food, grow in low density housing free of pollutants, have easy access to parks and other forms of exercise. Like that is going to happen any time soon.

Insurers will take the more cynical approach that we are unlikely to create an ideal world, therefore we need enough people to maintain the status quo. Such is capitalism.