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Of Genes and Pink Slips: Genetic Testing Goes to Work

Genetic testing was first labeled an advancement, allowing us to improve preventative medicine. Now it's being used in workplaces to label employees -- and some call that a violation of privacy.

When it first became possible to test for the genetic risks of isolated diseases, the advance was widely hailed as a modern medical near-miracle, sure to improve preventative healthcare and treatment. People with the potential risk of contracting inherited conditions such as breast cancer, colon cancer and Huntington disease now commonly undergo genetic testing to gauge their chances. As of April 1999, more than 550 genetic tests were being used to diagnose disease.

But the powerful information can also pose a triple-edged threat to tested workers' jobs, health insurance and privacy.

Some employers-about 10% and growing, according to a 1998 survey by the American Management Association -- now routinely test employees for genetic predispositions to diseases.

Privacy experts warn that genetic test results will be misused to target and fire employees who may run up company health insurance costs or to deny them coverage. And without specific privacy controls on the evolving medical information, they claim the hardship of diagnostics can follow workers from job to potential job, hampering their chances at finding additional work.

For too many people, the fears are already a reality. According to a 1996 Georgetown University poll of 332 families with perceived genetic risks:

  • 22% reported they had been refused health insurance, and
  • 13% had been fired from their jobs based on their perceived genetic risks.

About half the states now have laws that either protect against genetic discrimination or prohibit the testing in employment or insurance decisions -- and dozens more bills are pending to get these protections in place. The next frontier is likely to be federal legislation curbing the use and abuse of genetic testing in the workplace.

Currently, the only federal law that directly addresses the issue of genetic discrimination is the 1996 Health Insurance Portability and Accountability Act, which prohibits group health plans from using genetic information as a basis for denying or limiting coverage or for charging an individual more for premiums.

But that law will not prevent employers from firing -- or refusing to hire -- people because of genetic information they learn about them. The Americans With Disabilities Act protects people who show symptoms because of genetic disabilities. But it does not protect workers who are identified through genetic testing as being at a high risk of developing a disease, but who do not yet have the disease.

August 17, 2003  New York Times

Factories Move Abroad, as Does U.S. Power


MANUFACTURING is slowly disappearing in the United States. That does not mean we should rush to preserve the remaining factories as historic landmarks. America will still be a manufacturing power in our grandchildren's lifetime, but that status is gradually eroding.

Why does this matter? Well, the essence of a great world power is its edge in producing not services but manufactured products that other people want Boeing's airliners, for example, Intel's semiconductors and Caterpillar's earth-moving equipment. To the extent this output passes to foreign manufacturers, or even to Americans operating abroad, we lose the means to buy what we, in turn, want from others.

More than half of the manufactured goods that Americans buy are made abroad, up from 31 percent in 1987. If we continue on our path of ceasing to make merchandise that others want to buy from us, the danger is that these imports will be unaffordable for our descendants.

For that to happen, "you have to assume that manufacturing will continue to disappear," said David Heuther, chief economist at the National Association of Manufacturers. He does not make that assumption himself. He contends that America's high-tech advantage and its ingenuity will sustain the nation's manufacturing base.

Maybe. Right now, however, the exodus continues, at a stepped-up pace, government data show. The proportion of the work force employed in manufacturing has fallen to 11 percent from 30 percent in the mid-1960's. Two of the 19 percentage points disappeared in just the last 28 months. On another level, manufacturing's share of real gross domestic product representing all the goods and services produced in the United States has edged down, even including in the count the output of foreign manufacturers operating here. The share of real G.D.P. has dropped to between 16 and 17 percent, from 18 to 19 percent in the 1950's.

Given manufacturing's importance in maintaining our status as a world power, the downward trends are alarming. The public, nevertheless, focuses only occasionally on the dismantling. It does so when lots of people are suddenly hurt, as they were in the early 1980's, when an onslaught of high-quality foreign imports coincided with a severe recession. The combination forced plant closings and layoffs on a scale not experienced since the Depression.

"Rust belt" and "deindustrialization" were coined in the bitter debate that surrounded that frightening national experience. Those were the years when wage inequality became too persistent to ignore. Blame fell partly on the destruction of factory jobs, and the relatively high wages earned by those workers.

Two decades later, the shrinking manufacturing sector is again a source of public agitation, this time because so many American manufacturers are decamping to China and India, where they employ increasingly skilled but inexpensive workers to make merchandise that is then shipped back to the United States, swelling imports and subtracting jobs at home.

What's to be done? Many economists bank on the marketplace for a solution. They note that the growing volume of imported merchandise would not be possible without loans from abroad to buy these goods. As this debt balloons, foreigners will lose confidence in the United States as a place to put their money, these economists reason. As foreigners retreat, their demand for dollars to lend to America will drop off, and so will the dollar's value.

HAT will make imported manufactured goods prohibitively expensive, while merchandise exported from the United States will fall in price, when sold in yen or euros. Responding to this price incentive, manufacturers will rebuild in America, says George A. Akerlof, a Nobel laureate who is an economist at the University of California at Berkeley. "Manufacturing has to come back," he said. No other sector is likely to be as responsive to dollar devaluation.

For Mr. Akerlof, retooling is the easy part. Other experts disagree. Too many products are no longer manufactured here, they argue, and the skill to make them has disappeared. Resurrecting that skill is difficult. Dollar devaluation does not easily overcome that barrier. Nor does it easily woo back American companies that have invested huge sums in large, modern facilities abroad. Getting them to abandon those facilities and rebuild in the United States might require an outsized 60 percent devaluation of the dollar as an incentive, says Daniel Luria, an economist at the Michigan Manufacturing Technology Center in Plymouth.

The fallout would be painful. The Nissan Maxima, made in Japan, that I bought in 2000 for $25,000 would cost at least $40,000 to replace. That's over my head.