as we develop the ability to tailor treatments to individuals, we should expect that someone who can pay for the best treatments for their particular DNA sequences to achieve far better health-care outcomes than someone who can't afford the best treatments and has to settle for general therapies rather than individualized medicine.
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in title, tags, annotations or urlGenomics and health-care inequality: Get your genome out of my risk pool | The Economist - 0 views
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we're going to increasingly know who is or isn't likely to respond to treatment, and we may often know this in advance. For instance, genomics is already having a significant impact on breast-cancer treatment: by analysing the DNA of both the patient and the cancer cells, doctors can now identify 25% of cases which won't respond to standard chemotherapy. That's great; it saves money and needless suffering. But to the extent that a result like this is based on a patient's genetic profile, the cost effects can be predicted in advance and passed through to insurance premiums.
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individualised medicine breaks down some of the egalitarian presumptions that lie behind health insurance. Part of the logic behind insurance is that it's a risk pool; none of us knows when we're gonna go, so we agree to split the costs. But genetic profiling may increasingly give each of us our own set of pre-existing conditions, good or bad. And that may test people's willingness to chip in for the health costs of their fellow-citizens. When "it coulda been me" turns into "nope, it couldn't", we may start seeing...hm, I was about to say "a breakdown in social solidarity", but then I remembered we're talking about America here. How about "even less willingness to do anything for people who aren't as lucky as you are."
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