Insurance

Personalized Health Insurance Plans In Danger From Reform
By Yamileth Medina
One major objection to the healthcare reform bill making its way through Congress is that it may have a chilling effect on medical innovation. Advances in genetic testing have led to personalized health insurance plans that take an individual's genetic makeup into account when prescribing treatment. Unfortunately, expert Dr. Francis Collins warns that the Obama administration's focus on comparative effectiveness research, meant to reduce health care costs, could endanger this emerging field. Research in comparative effectiveness discover which treatment for a particular illness works the best. Health insurance plans, including the proposed public option, would cover the successful treatment of medication. Using this method is likely to reduce the billions of dollars wasted on ineffective health care, also lowering insurance premiums as a result. However, Collins told Reuters that caution must be taken in order to avoid ignoring genetic factors. For example, while one treatment might be most effective for the general population, one group with a certain genetic makeup would see the greatest benefit from the other remedy.



The future of prescription drugs could be revitalized by the use of personalized medicine. New medications accompanied by diagnostic testing are being formulated and approved by the FDA. Testing for biomarkers (proteins, genes, etc.) present in the body will allow more individualized, effective treatments. These drugs will become increasingly prominent in the future. Although they are expensive, they will reduce the likelihood of multiple medication switches and continuous testing. Using genetics, laboratories may eventually figure out the cures for chronic conditions that cost health insurers billions. At the very least, treatments for these conditions will be more effective than some of the equally expensive drugs out there today. A healthcare reform bill might discourage research into these areas by companies like LineaGen.

While the federal government has provided grants for genetic research, their financial support may decrease after undertaking the burden of comprehensive health reform.


While seemingly more costly in the short run, personalized medicine has the potential to save more money if incorporated into healthcare reform. Genetic testing might convince some patients to avoid further, more expensive treatment. Take the case of breast cancer: in 2009, our health care system is projected to see a savings of $100 million from personalized gene tests. Exactly how does this happen? Breast cancer survivors can take a $3,500 test from Genomic Health known as Oncotype DX that predicts the likelihood of recurrence. About 50,000 women have taken advantage of the test this year, and many of them have found that they are at low risk for their cancer recurring. Studies have found that the majority of women judged as low risk for recurrence have opted against chemotherapy. This choice saves each patient $2,000, and their health insurance plans thousands more, which would have otherwise been spent on chemotherapy. Eventually, this will serve to lower the cost of cancer health insurance and make it more accessible. Women also benefit from not having to undergo grueling treatments that may be unneeded.

All in all, controlling the cost of health insurance plans is essential. Still, saving money can go too far and negatively impact the quality of care of those already insured. For decades, the United States has been renowned for its advances in medical technology, but several measures purport that actual health of our population lags behind other industrialized nations with slightly less innovative equipment. Personalized medicine through genetic testing is state-of-the-art medicine that may also serve to better prevent and diagnose diseases. It has the potential to be a worthwhile investment for future generations of Americans.

(Image: ghutchis under CC 2.0)
Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they don't have to go without health insurance plans while waiting for a public option, if it ever gets passed. Yamileth lives in Miami, FL.

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