Science For Life: A Conversation With Nobel Laureate David Baltimore By Barbara J. Culliton
Health Affairs
May 16, 2006
(David Baltimore is the new president of the American Association for the Advancement of Science, soon-to-retire president of the California Institute of Technology, former president of Rockefeller University, and founding head of the Whitehead Institute at the Massachusetts Institute of Technology.
Baltimore shared the Nobel Prize in Medicine in 1975.)
Barbara Culliton: One of the questions is this: If the economists, the health policy people, and the health services research people could talk to the scientists, might we devise entirely new ways of approaching projects and problems?
David Baltimore: We might. It’s worth trying. Let me comment on one place where I think this is critical. We talk about universally available health insurance that would not depend on a person’s particular history but would provide health care coverage for everyone-the arguments that are made about this are arguments about availability, about cost. There’s another argument, which overwhelms all of those; it has to do with what the genomics revolution will produce in the future. The genomics revolution that we’re just living through is making it clear that we are all genetically hamstrung in one way or another. And the only way to treat people who have genetic diseases, and we all do, is to think about universal coverage. We can’t hold individuals responsible for their genetics. We must insure them nationally.
If we do hold people responsible for their individual genetics, then we will have a completely unacceptable level of discrimination. It’s inevitable, because insurance companies will say, I need to know your genetic constitution before I insure you. And they’re right.
Culliton: That is what the insurance industry does.
Baltimore: That’s what they’re about. That’s what they’re trying to do. That’s what they’ve always tried to do. And now we’ve given them this very powerful tool that could enable them to really discriminate. I think the implications of that powerful tool are that there should no longer be an insurance system that holds people responsible for inherited diseases, whether they be so-called Mendelian diseases, such as sickle cell or cystic fibrosis or Tay-Sachs, or complex diseases, such as cancer or heart disease.
Culliton: So that means you’d go to universal health insurance?
Baltimore: Absolutely, I think that it does.
http://content.healthaffairs.org/cgi/content/full/hlthaff.25.w235v1/DC1
Comment:
By Don McCanne, M.D.
“We must insure (everyone) nationally.”
Tinkering incrementalists, listen up!