RE: GENETIC TESTING AND HEALTH CARE. To say a bit on the issue Sam raises, genetic testing in health insurance, it's a common belief that such advances will essentially make single-payer health care inevitable. That's a bit simplistic. What they'll do is make the current insurance market non-viable, as either patients or insurers will have far too much information. But in some private scheme where we have mandatory insurance laws -- so folks have to purchase insurance -- and community rating with guaranteed issue -- so insurers have to offer insurance -- it won't much matter. Insurers won't be able to cherrypick and consumers won't be able to opt-out, so everyone will just have to make the best of it. Alternately, something closer to the current market could be preserved by using the genetic results to compute a risk-adjusted score (something we do now, but very crudely, through demographic factors like age, race, etc) and insurers could be reimbursed on that basis, which is close to what the voucher proponents want. Lastly, folks get too excited over the genetics stuff. Predictions with any level of accuracy and comprehensiveness are a long ways off, and even then, straight genetics only account for a small proportion of our health ailments, and the interplay between genetics and environment (wherein certain genetic propensities are triggered by certain lifestyles) assures no set of results will really be determinative. Even a fairly clean bill of genetic health will probably do little to dissuade most folks that they'd be better off having insurance of some sort or another. --Ezra Klein
