Comment by joering2 | Hacker News Reader

Comment by joering2 | Hacker News Reader

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Bingo! You just described 23andme, Anchestry and some others.

Fun fact: you can't make any reasonable profit off of sequencing human DNA at $49 per pop. Its just won't happen. Maybe with technology in iPhone250 in year 3560, but sorry not today.

Back in a day when I was a Noogler, I had interesing conversation on data scraping and purity of infornation in DNA sequencing database. Basically I was explain it will eventually be sold to insurance companies so that they could estimate your premiums better based on probability of your future diseases. As you can imagine that's a gold mine for any large or mid health insurance provider out there. I was also explained how data verofication makes sure of consistency; for example, if male order a kit (via credit card [prepaids dont work bc they cant know your identity]) but result came as female, such result would not be marked as purity and never sold. There are many other checks and balances, but you get the point.

Bottom line: if you want to get the kit and test your DNA out of fun, at least make sure your identity is not obvious.

23andMe costs $199, not $49. I used to do research based on DNA sequencing, and doing DNA extraction and high-volume sequencing costs way under $200 per sample. That being said, I don't know how many replicates 23andMe does per customer. If its a lot, or their prep process is more involved than I'd imagine, its possible their costs are over $200 a sample, but I doubt it.

Sometimes the sale price is $49 (during Thanksgiving), NOT including shipping costs which can be large depending on country

That was for ancestry only. They charge another $99 for the health service.

23andme does not perform sequencing. They do array genotyping, which is far cheaper. They recently abandoned their experimental exome sequencing product, which carried a far higher price.

https://www.buzzfeed.com/stephaniemlee/23andme-anne-wojcicki...

They do now. They did have a facility for developing sequencing assays, but eventually they gave up. I don’t know how long it will be until they try again. (In fact, they poached a number of our employees for that initiative.)

The Genetic Information Nondiscrimination Act (GINA) prohibits the use of genetic information to determine health insurance eligibility or premium

Which is not really an ironclad guarantee it won't happen (I'm thinking in terms of the law being modified or repealed, not in terms of companies ignoring it).

But the solution to the insurance problem is pretty obviously at the societal level. Once the testing is cheap enough, if they are allowed to, companies will just refuse carriage to people that won't submit the DNA (well, assuming that DNA profiling provides meaningful pricing information).

I don't think repeal of GINA is remotely likely, just look at the political discussion about pre-existing conditions on both sides of the aisle, there is no appetite for having companies accurately price insurance.

I think the fact that health insurance premiums are the #1 thing brought up in privacy discussions is basically evidence of the fact that we all know that insurance is a bad model for healthcare, but we can't bear to socialize it yet.

But allows for life insurance, disability insurance, long term care, Amazon Prime, pretty much anything other than health insurance and employment.

Should we be socializing the cost of Amazon Prime and life insurance?

Because that's what removing information from the pricing of premiums does, it shifts costs from higher risk individuals to lower risk individuals.

For life insurance, something like the US already does with Social Security (directly providing support payments to minors) probably makes more sense than forcing private insurers to omit information from their pricing. I'm a little less certain about disability and LTC, but those are also already somewhat socialized (Medicaid is the payer of last resort in both situations).

But for life insurance? There's nothing pernicious about someone paying the correct actuarial price for a multi-million dollar contract.

This is a good point and I suppose it’s for society to determine.

Since your genes are unchangeable (currently) it means some people in society will not be at a significant disadvantage if they can’t buy disability insurance or long term care insurance. This has ramifications throughout society.

There’s a lot to be said for paying the correct actuarial price. But I suppose you could also charge different races different prices for their actuarial differences.

So society needs to determine what things they distribute for justice. Social security is one form of this. But it seems unfair that one person with Alzheimer’s will suffer and die in a Medicaid nursing home because they can’t afford long term care insurance during their asymptomatic years while another with Alzheimer’s will use their long term care for appropriate end of life care.

There’s a separate issue of why the poor have bad end of life care. But today the current example takes place because gene testing excludes some from insurance.

How long do we expect that to stay on the books, or for it to be "missed" as a correlating input in an algorithm sourced actuarial rate?

>if you want to get the kit and test your DNA out of fun, at least make sure your identity is not obvious.

DNA can be used to identify the person it came from!!!

If you send off your DNA with a different name, there are many ways that they can use to determine that a different name was used. Traits estimated by the DNA could, at least in theory, be used to figure out who you might be. And if your relative is already in the system, your identity may be trivial to uncover.

They are prohibited from doing exactly that. https://www.hhs.gov/hipaa/for-professionals/special-topics/g... Life insurers can.

I worked in insurance. I have a pretty jaded view of it.

I wouldn't hold my breath counting on every insurance company to do right by their policyholders. If the world were so filled with paragons of virtue, we wouldn't need to make laws about it and detail what the consequences are for disobeying them.

Sure champ. Google never broke the law only to apologize and pay 0,00001% of their revenues as a penalty.

> if you want to get the kit and test your DNA out of fun, at least make sure your identity is not obvious.

Once a relative uses the service with their real identity, even if you don't use the service yourself, wouldn't the company know your family (and thus you) have a high chance for X disease or traits?

Short answer is yes, but it depends on the relationship and the disease. For example, if a parent takes the test and is positive for a breast cancer risk genetic variant, then all offspring will have at least a 50% chance of the same result. If, instead of a parent, a grandparent is tested, that percentage drops to 25%.

The cost to sequence has been dropping very rapidly, though. Illumina's 'desktop' scanner claims to be as cheap as $25/sample[1] (and that would be high compared to doing higher volumes on the bigger machines). I would expect there to be hard limit for the reagents etc. but it wouldn't blow my mind if it isn't in the $5-$10 range.

1: https://www.forbes.com/sites/matthewherper/2018/01/08/illumi...

As long as you have some sequenced relatives, you re already profileable

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