The Risk Factor

From Spectrum senior associate editor Steven Cherry at Tech Talk:

Would electronic medical records save the United States $77 billion?

Hillary Clinton, Senator from New York and one of the leading candidates for the 2008 presidency, said so on Thursday night.

You can hear it for yourself. It’s about five and half minutes into this YouTube video.

If you don't want to listen, here’s the key soundbite:

According to the Rand Corporation, hardly a bastion of liberal thinking, they have said that we would save $77 billion dollars a year. That money could be put into prevention. It could be put into chronic care management. It can be put into making sure that our health care system has enough access so that if you are in a rural community somewhere in California or somewhere in Tennessee or somewhere in Georgia, you’ll have access to health care. If you’re in an inner city area, and you see your hospital, like the Drew Medical Center, closed on you, then you’re going to have a place once again where you can get health care in the immediate area.

I have been blogging recently about the expansion of government DNA databases and their potential uses. In a related story, last Thursday the US Senate unanimously voted for a bill that bars insurers and employers from discriminating based on a person's genetic makeup. It is expected that the US House of Representatives will pass the bill this week, and for President Bush to sign it soon thereafter.

The new law would keep insurance companies from denying health coverage or charging higher insurance premiums based on someone's DNA. It would also prevent employers from gathering DNA information or using DNA information to make job-related decisions, for instance in hiring or firing employees.

In a Wall Street Journal article on the legislation, it said that, "A survey by Johns Hopkins University's Genetics and Public Policy Center last year found 92% of the adults surveyed were concerned that genetic information could be used against them. Just 24% said they trusted health insurers with such information, and only 16% trusted their employers."

While not a perfect bill, it should help those who have genetically-related health problems and who worry, like the folks in my IEEE Spectrum story a few years back on electronic health records, that they or their children will be discriminated against.

BTW, a story in the Washington Post appeared earlier last week spoke of how the state and federal criminal justice systems are using DNA databases to solve crimes even if a suspect is not in the database. All the police need to do is to get a "close enough" match an existing DNA profile, which might lead to the identification of a relative of a person in the database.

More on how the US government is using DNA to attack crime can be found at the President's DNA Initiative website as well as in a weekend story by the LA Times on how California is aggressively using DNA as a crime-fighting technique.

The US House approved by a vote of 414-to-1 the Genetic Information Nondiscrimination Act prohibiting discrimination by health insurers and employers based on a person's DNA. President Bush said he would sign it.

According to the New York Times, "the legislation prohibits health insurance companies from using genetic information to deny benefits or raise premiums for individual policies. (It is already illegal to exclude individuals from a group plan because of their genetic profile.) Employers who use genetic information to make decisions about hiring, firing or compensation could be fined as much as $300,000 for each violation."

The Times story also has some words of warning, as well: "The health insurance measure would not go into effect until a year after it becomes law, and the employment measure would take effect only after 18 months. Even then, there may be reason to be cautious. The bill may be hard to enforce, some experts say, and it does not address discrimination by long-term care insurers or life insurers."

It also notes another interesting implication, however: "For health insurers, the bill may avert the need to compete in a complex game of calibrating policies to an ever-changing set of genetic risk probabilities. But as genetic tests provide ever more information at lower costs, the entire notion of insuring against unknown risk that has long defined the industry may be upended."

It will be interesting to see how electronic health records, DNA information recorded within them, and the data mining of millions of health records come into play over the next two decades in regards to the future of medical insurance.