Let’s start with insurers. First, it may well be viewed as “generally accepted” and hence covered as a result of contract language. But, more fundamentally, it should save insurers money. Testing 1,000 women at $1,000 each would cost $1,000,000. If that led to the prevention of the births of 5 babies with serious genetic problems, the insurers would benefit if the babies’ health care costs (net of the abortion) exceeded $200,000 each. Between short-lived but intensively ill children and longer lived but chronically ill children (consider, for example, the need for heart surgery in many Down syndrome children), that seems plausible – and 5/1,000 is a fairly conservative estimate.

So, why do I estimate a 50 – 80% testing rate? This method takes only a blood draw – it doesn’t require an intrusive, unpleasant, expensive and somewhat risky test, like amniocentesis or chorionic villi sampling. Note that the miscarriage risks of these tests have meant that OBs have not recommended them to many pregnant women and insurers have not covered them without a recommendation. It will be, I expect, insured (with a big question mark about state medicaid programs, which pay for a very large percentage of US births). It is likely to become the legal standard of care for an OB to at least offer it. Consider the wrongful birth lawsuits when parents have a severely disabled child who they say they would have terminated had they known about the risk but the OB didn’t offer the test. And about 80% or more of women in California do the screening tests for Down syndrome and neural tube defects.

I did not say that I am concerned about parental choices of genetic traits for their children. I said our society will need to decide how it will react and that we are not yet thinking about it. We need to.

Oh, and I’ve actually been working in this area for nearly 20 years. How about you?

This post was mentioned on Twitter by logicalextremes: How should we deal with the arrival of very common prenatal testing for a broad set of genetic characteristics? http://bit.ly/2QAIJQ...