To the surprise of those who expect him to oppose reflexively any government restraints on business, President Bush announced that he would support legislative restrictions against using genetic tests to deny people insurance coverage or employment.
In his June 24 radio address to the nation, Bush said “genetic discrimination” is unjustified because “among other reasons … it involves little more than medical speculation.”
Bush’s position is both correct and a bit too easy. Congress should, indeed, enact a prohibition on using genetic test results in employment and insurance. But down the road a blanket prohibition may well prove counterproductive, unenforceable or both.
Bush overstated things when he said gene test results involve “little more than medical speculation.” Existing tests can produce results that range from mere possibility to high probability that an individual will contract a particular disease. Over time, both the numbers of tests and their predictive capabilities are sure to grow.
Most of our current limitations on employers’ and insurers’ rights to discriminate are based on the conviction that an individual should not be disadvantaged for possession of an attribute over which he or she has no control.
Given the state of things at this moment, the situation seems to cry out for legislation. But it is an illusion to suppose that this genie can be kept bottled up indefinitely.
In the future, says Professor Paul R. Wolpe of the University of Pennsylvania’s Center for Bioethics, genetic testing will be “a fundamental, ubiquitous part of our health care.”
But Wolpe says there may be less obvious solutions to some of these problems. An employer’s motive for not hiring someone with a genetic susceptibility to a particular disease, for example, generally will stem from a desire to avoid large medical expenses for that employee. But what if we had a different system of health care, in which such expenses fell not on individual employers but on society as a whole? That motive for discrimination would disappear.
By throwing his support behind the effort, President Bush has substantially boosted the prospects for a bill to ban genetic discrimination. But this is an issue with many layers of complexity, and it won’t be solved by a single piece of legislation.