Well, for starters, because to properly eliminate genetical diseases, you will eventually need to forbid carriers of undesirable genes to procreate. That gets nasty.
So you have a voluntary regime, and the rich and well-educated (generally) make sure their children are free of genetical disorders, while the lower classes (generally) don't. Two generations later, you have "clean" people and "dirty" people. Why should the "clean" people, who did as they were encouraged to by the Department of Health, pay high insurance premiums/health tax to subsidize the totally preventable diseases of the "dirty" people?
> Well, for starters, because to properly eliminate genetical diseases, you will eventually need to forbid carriers of undesirable genes to procreate. That gets nasty.
I'm not sure I agree here. We can use fertilisation treatments to ensure that the fertilised eggs lack the mutation causing Tay-Sachs. Give couples the choice as to whether they want to have children the old fashioned way or go a genetically screened IVF route to avoid it and it'll be weaned out in a few generations.
> So you have a voluntary regime, and the rich and well-educated (generally) make sure their children are free of genetical disorders, while the lower classes (generally) don't.
Not here in the UK you wouldn't. Nor in most of Europe. People in the lower classes would be told about the genetic markers and given the option to have the screening, depending on the cost of treatment and impact of the disease.
> Why should the "clean" people, who did as they were encouraged to by the Department of Health, pay high insurance premiums/health tax to subsidize the totally preventable diseases of the "dirty" people?
Why should the "dirty" people suffer, or even exist in the first place? It seems like the combination of a medical system predicated on insurance and a selfish view (by which I mean orientation towards the self) is the heart of the creation of a two-tier system, not the combination of a well-run public healthcare system and a moral obligation for all people to support each other.
I realise this doesn't answer your question, but I wanted to highlight that your use case doesn't apply in quite a few parts of the world, although sadly it does in many.
> Not here in the UK you wouldn't. Nor in most of Europe. People in the lower classes would be told about the genetic markers and given the option to have the screening, depending on the cost of treatment and impact of the disease.
People in the lower classes are told about, and (in the UK) offered for free, birth control. Yet unplanned pregnancies are common, and much more common in the lower classes. You're not going to get fertilisation treatments if you're not planning to get pregnant.
> Why should the "dirty" people suffer
Why should anyone suffer? Yet some do, and we have finite resources and have to prioritise them - it's not an artefact of private health insurance, public health care has to be paid for as well. A very common argument in fighting smoking is that smokers are a drain on the public health system - that's selfish, yet reasonable, on part of the non-smokers. Every once in a while, a variation on the theme of "we should put alcoholics/narcotics/morbidly obese/obese/overweight at the end of the queue for 'lifestyle diseases'" surfaces in Denmark. It hasn't gone anywhere, but all health services (private and public) are under pressure from increasing costs from more advanced treatments, and prioritisation is a constant issue.
> or even exist in the first place?
Why they exist? Well, that's very existential, but they do, and short of sterialisation, they will continue to for a number of generations. The problems with eugenics isn't what happens when you're done, it's how you get there.
So you have a voluntary regime, and the rich and well-educated (generally) make sure their children are free of genetical disorders, while the lower classes (generally) don't.
This is the general situation with all sorts of positive interventions one can make with one's children.
For example, you can have a voluntary regime of teaching your children a work ethic/engaging in education/not abusing drugs. The rich and well educated will teach their children such things, while others will not. In one generation, the children of the rich will work hard while the children of the poor will not.
Your argument against eugenics applies equally well to basically any intervention one can make to improve one's children. That suggests it is overly broad, and perhaps invalid.
First, I didn't actually mean to make an argument against the usage of genetics in eliminating disease, merely to point out how good intentions could disintegrate into something more dystopic.
Second, I think there is a big difference between something that's irreversible at the point of conception and something that, while giving you a disadvantage, can be fixed later.
So you have a voluntary regime, and the rich and well-educated (generally) make sure their children are free of genetical disorders, while the lower classes (generally) don't. Two generations later, you have "clean" people and "dirty" people. Why should the "clean" people, who did as they were encouraged to by the Department of Health, pay high insurance premiums/health tax to subsidize the totally preventable diseases of the "dirty" people?