After reading Alana’s research essay, Alex and I (not surprisingly) debated whether genetic discrimination is good or bad. As Alana’s paper suggests, genetic discrimination does not actually exist, meaning that the arguments proposed for and against genetic discrimination are completely theoretical and hypothetical. Whereas Alex believes that genetic discrimination would not necessarily result in a negative outcome, I disagree and contend that genetic discrimination can cause great harm.
As Alex suggests, the act of discrimination in itself is not immoral; the ethicality of discrimination and whether it is moral or immoral depends on the intent and source of the discrimination. By Alex’s view point, insurance companies stand to make a profit and have a right to assess the risks of acquiring a specific customer. Furthermore, insurance companies have no obligation to help people acquire medical care. Although I agree completely with Alex that genetic discrimination is a positive action from the viewpoint of the firm, I feel that genetic discrimination greatly harms the public.
As we all know, health insurance helps countless people afford expensive medical treatments and procedures that they would otherwise not be able to afford. Subsequently, as a result of health insurance, not only are many lives saved, but the quality of many lives is drastically improved. If people were denied health insurance, two problems would arise. First, because fewer people would be able to acquire health insurance, the quality of their health and subsequently the quality of their lives could be compromised. Secondly, people who are allowed to apply for health insurance would have to pay larger payments in order to compensate for the smaller number of consumers.
For arguments sake, however, let us assume that “healthy” individuals (those that do not have “diseased” genes) continue to apply for health insurance while “diseased” individuals cannot obtain health insurance. Currently, according to American laws, if a “diseased” individual without healthcare were to go to the hospital in need of healthcare, doctors would have an obligation to care for the patient regardless of whether the patient could afford the treatment. If the patient had health insurance, the doctor would receive the appropriate payment for his services. If the patient did not have health insurance, however, and could not afford the procedures, the doctor essentially loses a profit. In such a scenario the existence of genetic discrimination creates a negative externality that can severely harm physicians. Even if the government were to step in and provide more health insurance (beyond Medicare and Medicaid), although the doctors would benefit, the economy could suffer; in order to increase finances, the government would need to siphon money from some other program or raise taxes, two situations that could be avoided if people were allowed health insurance.
Although I concede that genetic discrimination from some view points (namely the viewpoint of insurance companies) is a good thing, I believe that genetic discrimination from the point of view of a patient and from the point of view of a physician has negative consequences. I realize that genes are not completely deterministic and that the degree of genetic discrimination may not be as great as I portray it, but nonetheless patients would feel violated and immorally treated if they were denied health insurance on the basis of their genes.
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I would disagree. The problem lies at the foundation of Adam's argument, in his assumption that there are two opposing standards of conduct on this matter. Though it is true that there are two different perspectives, those are merely lenses to view what policy would be most advantageous to one side or the other, an argument that would fit better in Congress than in an ethical debate. Genetic discrimination is not wrong - in fact, the concept behind genetic discrimination is the very essence of medical insurance. Insurers cannot long survive with a policy that extends insurance to those who would very likely need to use the insurance. They must calculate the probabilities, and take a risk. If they decide that, due to bad genes, one person is extremely suceptible to disease, injury, etc., it makes no sense for the insurance company to insure him.
Of course, there is the argument that the insurance companies are out for a profit, so they would try to extend their insurance to only the select healthy few, thus placing at a disadvantage many other people because they did not test well enough genetically. This argument falls apart, however, once one understands that the supply of insurance and demand for insurance always reach a suitable equilibrium. Why is this? Because it is in the insurance companies' best interests to try to extend insurance to as MANY people as possible, up until the point where they become liabilities. This way, profit is maximized, while still maintaining a balance of people using insurance and people not using insurance.
What Adam would suggest is that insurance companies ought to be obligated to extend insurance to people who would not normally be able to obtain health insurance due to their genes. As altruistic as that sounds, it is not feasible. Running a company on a constant loss will result in bankruptcy, taking away insurance for eveyrone. This is a key point in the issue - no one is entitled to insurance. Feeling "violated" and "immorally treated" is not a sufficient or logical reason to claim that a certain practice is unethical. Insurance only exists because companies can make a profit off of it. There is nothing immoral in this. It has benefitted everyone thus far. There are those, of course, who would need it the most who cannot get it, but that would be the government's obligation to aid them, not the insurance companies.
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