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Some Still Want To Know When There's Nothing to Be Done

MANAGED CARE November 2006. © MediMedia USA
Managing Editor's Memo

Some Still Want To Know When There's Nothing to Be Done

Frank Diamond
MANAGED CARE November 2006. ©MediMedia USA
Managing Editor's Memo

Frank Diamond

Even in the working-class neighborhood of my youth, the idea of prevention — while occupying nothing like the cult-like status accorded it today — did, in fact, have currency. It was called the yearly checkup, and everybody who wore a hard hat and carried lunch in a rectangular metal container was nagged to get one by others who heard about this or that going around while hanging their wash. (The wash-hangers would in turn also be nagged.)

Records on just who heeded this advice and who didn't are difficult to come by. I do, however, remember the rebuttal: "I don't want to know."

Even back in 1962, that did not translate, exactly, into "Who could possibly know?" However, it seems that it might have been what some people were getting at.

Our cover story on genetic testing suggests that people will soon be able to know a lot — in some cases, an awful lot.

Not to belabor the point made by our cover illustration (oh, OK, you caught me, I am belaboring it): Genetic tests open up a raft of coverage issues.

Contributing Editor Maureen Glabman deftly guides us through some of the issues that not too long ago seemed a lot like science fiction. She also offers case studies of health plans that have decided that genetic tests and prevention go hand in hand.

Of course, it's never that simple. What about very expensive tests for very rare conditions? Or a genetic test that's 90-percent accurate versus a more traditional test that's 80-percent accurate?

Tough decisions lie ahead. Unlike the strong men and women of my youth, we cannot simply throw up our hands and say: "I don't want to know."