From: Adam Back <aba@dcs.ex.ac.uk>
Date: Thu, 6 Nov 1997 16:19:00 +0800
To: kelsey@plnet.net
Subject: Re: Protocols for Insurance to Maintain Privacy
In-Reply-To: <199711052249.QAA06301@email.plnet.net>
Message-ID: <199711060003.AAA12962@server.test.net>
MIME-Version: 1.0
Content-Type: text/plain




John Kelsey <kelsey@plnet.net> writes:
> Suppose there is some genetic disease that kills its victims on
> their 31st birthday, unless they get a $1,000,000 treatment first.
> Before I have taken the test for this disease, I have to accept a
> certain risk--if I find out I have the disease, I have to raise a
> million dollars in the next few months.  After I have taken the test
> and gotten back the results, there's no more risk involved (assuming
> the test is perfect)--I either have the disease or I don't.  

The insurer can't determine whether you've taken the test.  The
insurer may insist on the test anyway or offer you unfavourable odds,
basically assuming you have privately tested and found positive
otherwise you wouldn't be refusing to have the test.  (A variation of
the `he must have something to hide' theme).  Unless you can afford
the premium for withholding this test, you're stuck.

> Before the test, though, insurance might be useful--I could
> essentially place a bet with someone that I had the disease--I pay
> $1, and get a million dollars back if my test comes back
> positive--just enough to pay for my treatment.

The insurance company would have no financial incentive to take on
such risks -- I reckon they'd sooner let the wanna-be customer die.
Nasty, but it's reality.

> >The alternative is not pretty: banning private testing
> >(how?) and forcing insurance companies to cover all
> >applicants for all conditions at a fixed rate.
> 
> I know.  Let me make it clear that I am not at all
> interested in banning private testing, coercing insurance
> companies or anyone else into agreements they don't want to
> make, etc.  I am saying it would be nice if I could buy
> insurance against the results of the tests before I took
> them.  The problem is, I can't see a really workable way to
> do this, because there's no way to keep people from taking
> the test beforehand.

I reckon your only option would be charity.  If these $1,000,000
treatment 1:1,000,000 odds genetically testable diseases are rare
(1:1mil is rare), perhaps a charity would be able to cover the costs.

The increased choice in insurance would ensure cheaper medical care
for all.  A deregulated medical profession with third party rating
services rather than top down government services should reduce prices
dramatically also.  Same for medical drugs, third party ratings.  Buy
your ratings service.

And being a hard line anarcho capitalist, I draw the conclusion that
if you can't afford to keep yourself alive, that is your problem.
(Heartless ain't it:-) Aside from comments about evolution in action
(perhaps I personally don't want to fund propogating these genetic
defects, and that is my choice), my suggestion is that such cases
would have to be met by charity.

A charity could also refuse to help people who hadn't donated, if
it chose.

I bet it would work too, and a lot more efficiently than the
government regulated setup now.

Heck I might even donate to it, with the savings I'd make from
the breakup of the medical cartel.

(UK is as socialist as it comes with medicine, and your taxes reflect
this.)

Adam
-- 
Now officially an EAR violation...
Have *you* exported RSA today? --> http://www.dcs.ex.ac.uk/~aba/rsa/

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