The auto insurance company Allstate has announced a new program to improve driving safety in older drivers. The program, InSight, consists of some computer-based cognitive training programs that are supposed to improve visual processing. In turn, they think that will improve driving performance in seniors.
Whether or not the program will have significant beneficial effects is still in testing. But if it works, it appears likely that drivers who complete the training (or maybe just those who score well on a follow-up test) will get a discount on their insurance rates.
Sounds nice, and the basic premise makes good sense. If you can indeed train people to be better drivers by playing some simple cognitive computer games, then it’s a win-win situation. Right?
The potential downside I see is more long-term and big picture.
Right now the company is talking about privacy: during the phase where they’re still testing the InSight program, individual data will remain anonymous and aggregate. But if discounts end up being based on performance in a cognitive skills test (as State Farm has done in Alabama for a few years), then individual results will by necessity not be private anymore.
Which means it is a short step to insurance companies requiring all customers to take such tests, and adjusting their rates based on those tests. They already base rates on such variables as age, sex and marital status, so it seems natural and logical to also get data on an individual’s cognitive skill and use it to adjust their rates. But how invasive will they get?
A lot of people already think medical insurance companies (and potential employers, etc.) should be able to know whether you smoke, or eat fast food, or how much you exercise, in order to profile your risk factors and base your rates or job prospects on that information. Whether or not you agree with those specific examples — based on behaviors people choose — it’s harder to swallow the idea of similar decisions being made based on non-behavioral things you have no choice over.
For example, what if medical insurance companies only cover customers who submit to DNA sequencing that reveals potential short- and long-term health issues (and adjust rates accordingly)? If you have a slightly increased chance of health issues based solely on your genes, should you pay more than others? If you have a heritary condition that pre-disposes you to a type of cancer, should you not be covered at all (too risky to be viable for the company)?
The near-future speculative fiction movie GATTACA explored a scenario like this. In a world where most people undergo artificial genetic improvement in the womb, the main character Vincent is a ‘natural birth’. His genes include myopia and a minor congenital heart defect, and defective people like him are barred from many jobs based solely on their DNA sequence.
While our society is nowhere near that point (right now), we are moving ever-so-slowly in that direction. Over time people get used to small changes in their privacy, and the expectations of privacy renormalize to even radically different realities. GATTACA may seem an entertaining fiction right now, but in 30 or 50 years?
Currently, new parents face a hard choice when prenatal diagnoses show major life-threatening birth defects in embryos and fetuses; sometimes these are the basis for early-term abortion decisions. We are currently at the level of being able to selectively implant embryos for in-vitro fertilization based on sex, and probably based on traits like eye and hair color.
In 30 or 50 years, it’s plausible that we will be able to selectively implant (or actively manipulate) embryos to select any number of traits with heritable factors, like intelligence level or positive emotionality. (I’ve written previously about modern eugenics and designer babies).
Should people with ‘inferior’ DNA be discriminated against in medical coverage, insurance rates, job selection, and the like? Or put another way, should private companies have the right to choose their employees, or who they insure, based on this information? These issues will have to be dealt with in the near future, but I suspect that the inevitable march of technology combined with baby steps in changing privacy norms will eventually push us in the direction of DNA discrimination. And by the time it happens, we’ll all be okay with it, because it’ll be normal.
Some will argue that even with increased technology, we will be able to keep our DNA private in the future. Even today, though, the United States ‘Patriot Act’ (Section 503) allows the state to collect DNA on anyone convicted of a violence crime and put it in a database. In early 2008, the government announced a plan to collect DNA samples on anyone arrested (not convicted!) in connection with any federal crime. Oh yeah, and the FBI announced this year it wants to start a huge biometric database of not just criminals, but job seekers and others.
At first it seems like this stuff doesn’t affect us. “DNA database of criminals? Great idea, it’ll solve crimes!” But it’s baby steps. We accept the extreme cases at the edge of the spectrum, where it doesn’t affect us. Then we accept it in private business, as long as it’s voluntary. “Oh, I can get an auto insurance discount just for getting a blood test? Okay!” Baby steps. Pretty soon, it’s still voluntary but our choices are narrowed. “I can’t get affordable medical coverage unless I let them put my DNA on file in a big database? Shit, guess I have no choice.” Pretty soon, it’s normal, it’s natural, it’s institutionalized, it’s GATTACA.