Gene test and insurance

Diana Abramo writes to the NY Times editor:

Re "Gene Increases Diabetes Risk, Scientists Find" (front page, Jan. 16):

The discovery of a variant gene that predisposes more than a third of the American population to Type 2 diabetes could, its discoverers hope, eventually allow testing for that gene. But this would mean worse health outcomes, not better, because we have a profit-driven health care system.

As your series on diabetes this month stated, insurers often discourage diabetics from enrollment. Tests demonstrating a predisposition to diabetes could result in refusal of coverage, exorbitant rates or exclusions for diabetes and all related complications.

Without a single-payer system with a goal of providing health care rather than profit, exciting advances in genetics will not result in better health care, but in health care denied.

Scientific breakthroughs unmatched by breakthroughs in insurance systems will be of no avail.

This makes no sense. Insurance companies will not cancel a third of their customers just because of a gene test.

If a gene test raises rates for a third of the population, then it should lower rates for the other two thirds. On average, consumers should benefit because insurance companies should not have to be paid as much to assume risk.

There might be some public policy reasons for barring insurance companies from using certain genetic tests, but anything that allows better prediction of disease should make the whole system more efficient.