[concordDance]

> Medical insurance - oh you have cancer/hear attack/etc gene. You premiums skyrocket.

This is how insurance is supposed to work. It should reflect your actual risk levels.

Now, if what you actually want is socialised healthcare then implement that, trying to backdoor it via insurance gives you the worst of both worlds.

> Job opportunities - oh so sorry you have bipolar gene...

Then the company that looks at actual behavior rather than genes hires people slightly under market and makes bank. Then other companies start copying them.

[ekianjo]

> This is how insurance is supposed to work. It should reflect your actual risk levels.

Of course not. This is how perverse insurance works. Proper insurance systems work by pooling risks into large groups so that the few who are unlucky to have problems at a given point in time are covered.

The whole custom risk factor at the individual level is pure exploitation and a travesty of what insurance systems used to stand for.

[lostlogin]

> Of course not. This is how perverse insurance works. Proper insurance systems work by pooling risks into large groups so that the few who are unlucky to have problems at a given point in time are covered.

Have you just described socialised healthcare?

[ekianjo]

> Have you just described socialised healthcare?

No just regular insurance before insurance companies figured out they could make more profits by making individual customization, which should be completely forbidden by regulations in the first place.

[piperswe]

Socialized healthcare is insurance, so I guess?

[_heimdall]

I'm not sure that I follow. Whats wrong with insurance companies factoring in DNA markers to put people at risk of cancer or heart attack in a higher risk pool?

That's not a custom risk factor at the individual level. Its just using data they believe indicates risk to decide what larger pool the person gets put into.

[polygamous_bat]

You don’t even need DNA data do to that, just use race statistics to increase or decrease your premium! Or do you think that would be illegal?

[_heimdall]

I don't know insurance law well enough to say if that's legally discrimination.

Now if you're asking me personally, I dislike the insurance industry in general. Insurance shouldn't be required, legally or otherwise. At that point insurance companies can use whatever data they want to price policies, as long as the terms are clear customers would actually have a choice whether they want insurance or not.

[jjgreen]

Combine that with race extracted from x-rays and AI ... https://www.nibib.nih.gov/news-events/newsroom/study-finds-a...

[concordDance]

Companies use many forms of data to change premiums, many you don't have much control over (e.g. what area of the country you live in). Why is that wrong?

[polygamous_bat]

Because you can possibly change your address but not your race?

[concordDance]

You can change it in theory but if that's where your family, job, kids school, etc are? Then realistically you don't have a choice.

[dorfsmay]

So car insurances shouldn't account for past driving experience?

Are you talking private insurance or socialised risk mitigation?

The goal of private companies is to make profits. There is space and use cases for both models. Of course large private companies put efforts into making people believe that's not the case.

[lacrimacida]

Don’t compare car insurance with health insurance. Past driving incidents are perfectly okay to take into consideration for car insurance, some people need incentives to drive safely. But genetics is nothing people can change, it’s fixed.

[Chris2048]

This all assumes two perfectly definable categories of characteristic - fixed, unchangeable category, and incentiv-isable behaviour / changable category.

It's not always that clear e.g. genetic disposition to alcoholism is linked to actual alcoholism and related behaviours.

[dorfsmay]

I agree, and that's my point. Should we have private insurances for genetic based risks?

Is there a point of private health insurance?

[bugglebeetle]

No.

[ekianjo]

> So car insurances shouldn't account for past driving experience?

Nope, they should not. That's exactly the kind of things that ends up bringing prices up for everyone in the end.

[polygamous_bat]

> So car insurances shouldn't account for past driving experience?

Do you understand why discriminating job applicants based on race/sex is illegal but not based on GPA?

One is something you were born with. Another is something that you did.

[lotsofpulp]

All the evidence I have seen points to “what you were born with”, including the parent(s), family, neighborhood, etc to be very heavily correlated with GPA.

[genewitch]

Right, but for some reason it lets claim the moral high-ground. Right now individual taxes account for more revenue than all companies combined, perhaps barring payroll taxes.

Socialize medicine, please. A million dollars for a cancer treatment is insanity, when nearly 50% of the US population will get cancer at some point in their lives.

[dorfsmay]

Should we private insurance on "something you're born with" based risks?

[evandijk70]

In the Netherlands insurance is provided by for-profit insurance companies. However, there are very strict rules - they are not allowed to refuse any applicant based on any medical reasons (including preexisting conditions), there is a list of treatments they have to cover, there are rules for the minimum/maximum deductible, etc.

I would not say that this is the 'worst of both worlds'. I actually think it has the best of both worlds, - namely coverage for everyone that needs it (benefit of social healthcare) and competition between insurance companies on price, convencience/reliability of apps, service, etc.

[Jefff8]

No, that isn't exactly how insurance works, and it would be almost pointless for individuals if it did work that way.

Instead, it works by bucketing risk. In the simplest form, everyone is in one bucket, ignoring individual risk. That means that all other things being equal (e.g. size and value of your house), despite you have low risk of your house flooding, you would be paying exactly the same premium as the person who who has very high risk because their house is built on a flood plain.

Of course people paying more for their risk than it warrants may see that as unfair - so insurers use more buckets - e.g. bucketing high, medium and low risks.

But there's a delicate balance here - for instance, insurers may just decide not to insure the high-risk category. Or even if they do, the premiums may be unaffordable or the insurance benefits substantially restricted. And the natural extension of categorizing like this is to put an individual in a category by themselves - and then to limit payout. Essentially making the insurance not any better than a savings account, and probably worse if you don't claim at the beginning of the policy, before there's a large pot in the savings account.

From the point of view of perfect capitalists, the insurers would like to insure people with negligible risk, for high premiums, for low benefits - to make the most profit. From a social-good point of view, we would like insurers to cover risk that people cannot control (e.g. genetic risk) for reasonable premiums and good benefits. Categorizing lives somewhere between these two - a kind of necessary un/fairness.

[concordDance]

> From a social-good point of view, we would like insurers to cover risk that people cannot control (e.g. genetic risk) for reasonable premiums and good benefits.

You're using the wrong tool for the job there, if you want people to be supported regardless of their actual risk levels then you should get socialised medicine rather than artificially restricting what factors insurance companies can take into account (and there will be plenty of information leakage from due to other factors they are allowed to consider correlating with the banned ones).

[funcDropShadow]

> This is how insurance is supposed to work. It should reflect your actual risk levels.

This assumes the relation correlation between genes and adverse health outcomes are actually known. By definition that ignores personal behavior and epigenetics.

If an insurance becomes to specific to the individuals it stops spreading the risk.

[Chris2048]

> Medical insurance - oh you have cancer/hear attack/etc gene. You premiums skyrocket.

Is it assumed that premiums will rise? If you get a package of, say, pension plan your lower life expectancy might lower the premium?

I think this is why certain motorbike cover is actually lower..