. More knowledge is yet to come. When it comes, it may be accompanied by an inexpensive method for testing the genome of each individual to see if he or she has any genes for any diseases. Screening for all genetic diseases may become routine for newborns, just as testing for phenylketonuria (PKU) has been since the 1960s. A persons individual genome would become part of a data bank to which each of us, as well as our health care providers, would have future access. The advantage is clear: medical care from birth to grave could be carefully planned to delay onset, appropriately treat, and perhaps even cure genetically based diseases. The problem begins with insurability, and may end up in a form of discrimination that for genetic reasons prevents certain individuals from obtaining employment and, hence, medical services. Even with a government regulated program of access to basic health services, the need to purchase supplemental insurance to cover serious diseases makes many of us with certain genetic configurations vulnerable to discrimination. Insurance works by sharing risk. When risk is uncertain to all, then all can be asked to contribute equally to the insurance pool. Premiums can be equalized. Once the genetic disorders of individuals become known, however, this could justify higher premiums for those demonstrating greater risk. The greater the risk, the higher the premium. Insurance may even be denied those whose genes predict extended or expensive medical treatment. For three-quarters of Americans, medical insurance is tied to employment. Among the Fortune 500, twelve companies already report using genetic screening for employment purposes. Although screening in the past was justified initially for public health purposes, employers may increasingly be motivated to use screening to cut premium costs for the medical insurance they pay on behalf of employees. Underwriters already deny or limit coverage to some gene-r...
