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Comment by panta | Hacker News Reader

taken to the extreme, if complete data availability allowed to predict the future with enough precision, then everyone would pay an insurance premium corresponding to their insured negative events. In practice insurances wouldn't have any reason to exist. The foundational premise of the insurance concept is that risk is spread across every participant in an equal manner.

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Really important comment!

Is having a bad recessive a “pre-existing condition”? Or do genotypes form already legally protected classes?

Clearly we need good lawyers here, or careful regulation, or public medical insurance.

I hope it doesn’t go the way of car insurance.

While this is an interesting idea, no doubt, epigenetics casts major doubt on whether knowing the DNA expression at a particular time is diagnostically useful.

Sure. There are some conditions that are purely genetic, but many genes can be switched on and off depending on the environment - or even recoded in the replication process. DNA isn’t as static as we once thought and knowing a person’s DNA is not quite as useful as we imagined.

This isn’t as big of a deal as we imagined. It’s going to take some incredible processing to uncover causal patterns, and a huge amount of experimentation to determine whether they are stable against epigenetic changes. In my opinion, this is quite exciting.

Why wouldn't insurance have a reason to exist? Even the healthiest people need medical insurance because anyone can experience accidental injury requiring hospitalization and/or on going medical care.

Then only insurance for actual accidents would make sense, but even then insurance companies could start analyzing more meticulously the individual probabilities of having accidents: do you have an active lifestyle? you pay a premium; do you practice sports? you pay a premium; travel more than the average human? pay a premium; are you getting older? insurance rate grows exponentially; already had an accident? sorry, you no longer a desirable customer.

This is presuming perfect knowledge; it's a thought experiment. In this hypothetical world, your insurance company does know that in 13 months you're going to get in a car accident that flings a 1.27mm shard of glass into your eye, that it's going to take 27 minutes to complete the surgery that fixes it, that you'll have an infection after that and the first 2 antibiotics won't work but the third one will.

It's basically just pointing out that perfect knowledge makes risk 0, and that insurance doesn't make sense in a world with no risk. At that point the question is basically just whether you distribute medical costs evenly across everyone or let there be winners and losers on those costs.

> The foundational premise of the insurance concept is that risk is spread across every participant in an equal manner.

Applying this broad principle to auto insurance, it isn't doing well. Auto ins is ~mandated. Participants are forced to pay for risk pools they aren't part of.

ex: Car repair costs are skyrocketing. Premiums are also skyrocketing, including for people who don't carry collision.

Everyone can make disasters at the wheel though. If you didn’t mandate insurance, there would be victims with no recourse.

Sure. But insurance companies leverage that mandate; they make people who don't choose (or can't afford) collision policies subsidize people that do. With this, the bargain of shared risk is quietly killed and replaced with exploiting the poor (or frugal) to pay for the non-poor (or lavish).

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