Why advances in molecular genetics make universal health care “inevitable”

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It’s behind the FT’s pay wall, but Brandeis economist (and inflation geek) Stephen Cecchetti‘s opinion piece in today’s paper is worth citing:

A single-payer, publicly run health-care system is the inevitable consequence of the nearly continuous scientific revolution in molecular genetics that began a half century ago. … The time is fast approaching when we will have an inexpensive test that is capable of revealing a person’s genetic propensity to contract a broad array of chronic diseases. That means that we will be able accurately to assess the cost of treatment over their lifetime.

The fact that we will all have health scores has profound implications for insurance; or, more accurately, for the failure of market-based insurance. If I have the information revealing that I am likely to be healthy, living a long life with a low cost of medical care, then I am going to forgo insurance for everything except treatments arising from accidents that are completely unforecastable.

Alternatively, if my insurance company can obtain my health score, then, in the same way that lenders use my credit score to calibrate the interest rate they might offer on a loan, they will adjust my health insurance premium based on their precise estimate of the cost of my future medical care.

And he thinks there’s something wrong with that? I see a glorious future of sub-prime health insurance and collateralized health insurance obligations. It’ll be great!

Actually, Cecchetti is making a really interesting point here. Defenders of market-based health care say that if only the business were more transparent and more decisions were put in the hands of consumers, things would work much better. But here’s a case where more information and transparency would probably cause the market for health insurance to completely break down. Anybody got an answer for that?

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