A Cure for Health Costs?

By Mary Carmichael
What's the secret to improving public health while cutting costs? The question has consumed Washington, but it's being answered elsewhere, by doctors offering a new test for more than 100 rare recessive genes, some of which cause fatal diseases. The test, Counsyl, lets potential parents assess their genomes to see if their future kids are at risk. They can then decide, with in vitro fertilization and preimplantation genetic diagnosis (PGD), to carry only healthy embryos.

This is as preventive as medicine gets: the test could eliminate all single-recessive-gene diseases. It's also a money saver at $350--nothing compared with the lifetime cost of caring for a sick kid. Since May the test has caught on with big-name thinkers and hundreds of elite fertility doctors. It's popular abroad, too; the Taiwanese government may soon offer it to everyone, free.

The U.S. could do likewise, but there are roadblocks in the choices the test enables: it would likely increase the rate of PGD (and thus the deaths of embryos), and abortions if people don't get tested until they're pregnant. It might also alarm people who worry that genetic testing of any kind can ultimately lead to eugenics. Counsyl may be a secret some American politicians will want left that way.