Should genetic testing be used to set insurance rates?

[jay gw]

WINSTON-SALEM, N.C. – A new study – the largest to date of public attitudes about genetic discrimination – finds that 40 percent of people already undergoing genetic testing are worried that participation might affect their future insurance coverage.

"This study supports the view that public concerns about genetic discrimination are substantial," researchers from Wake Forest University School of Medicine and nine other centers write in the current (May-June 2005) issue of Genetics in Medicine.

The research team, headed by Mark Hall, J. D., reported that 40 percent of the 86,859 participants agreed with the statement: "Genetic testing is not a good idea because you might have trouble getting or keeping your insurance."

http://www1.wfubmc.edu/news/NewsArticle.htm?Articleid=1615

 

[EdipisReks]

i think the idea of genetic profiles being used by insurers is absolutely despicable.

 

[Rob Lister]

i think the idea of genetic profiles being used by insurers is absolutely despicable.

Why? To think this you must also think that insurance companies in general are despicable (which...given the money I have to pay them monthly, I'd agree)

That's how insurance companies work - by profiling.

It's all about risk assessment.

You can make a law that genetic testing is illegal but why draw the line there? Why not just make a law that an insurance company must charge exactly the same premiums to everyone that applies and must accept all comers no matter what?

 

[Dancing David]

There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

 

[Rob Lister]

There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

They account for those too, as best they can.

 

[TeaBag420]

There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

Wrong, and No.

Tay-Sachs.

Thank you for playing our game.

 

[Soapy Sam]

Seems to me there's a dilemma here for the insurers.

The more precisely they can target high risk groups, the fewers customers they leave themselves.

If I get a SuperDNA scan that tells me the probability I will die of ingrown toenails, and my risk is way up there, I may choose to have my toenails removed.
Conversely, if I turn out to be in a low risk group- and therefore insurable- I may decide I don't need the insurance.


Similar constraints apply to any group, whether we talk about car insurance, health insurance etc. The whole point of insurance is to spread the risk among as large a group as possible. If we can precisely pin down the risk, the whole notion of insurance becomes unworkable.

 

[Chris O.]

Conversely, if I turn out to be in a low risk group- and therefore insurable- I may decide I don't need the insurance.

Now, I voted "No" immediately upon reading the question. Because I believe random elements can foul up even the most sure predictions.

But I think Soapy brings an interesting point to the argument. If genetics tells me that I do not have the genes for a genetically determined disease, I'm not going to spend much on insurance. Except for the concerns about viral infections, and injury, my future looks fairly bright. Or course even viral infections may be negligable if it turns out I'm genetically predisposed to have a rhobust immune system. So why would I spend money on the off chance that I get hurt? I could see genetic testing causing a major reform in insurance as we know it. If insurance companies insist on only insuring low risk customers (which would be the smart decision) and low risk customers feel no need for insurance, I can envision insurance only being for accidents, much like car insurance is now.

They could genetically test for known disorders, then provide "act of God" insurance for the safe bets. Though, I could see them all going out of business under this system. Because, who honestly believes they're going to die in an accident. That always happens to someone else.

Edited for Spelling

 

[Chris O.]

Now, what about the injustice to the unfortunate few who are found to be vulnerable to certain disorders by genetic testing?
I think we'd see a national health care plan, covering everyone unable to recieve private health insurance. Much like those [bait] silly communist Canadians [/bait] up north. Of course, everyone would pay for it out of their taxes, but we've got to help our less fortunate fellow citizens. It would lose a lot of money on "bad tips for slow horses" but that's to be expected in a government program.

 

[Paracelsus]

A twisted discussion from the future...

Insurance company: "It says here that you are very likely to get breast cancer! 89 % to be exact... "
Not the customer: "Well I'm not that likely, because... "
Insurance company: "The genetic screening is accurate... "
Not the customer: "I'm a man, the diagnosis of breastcancer in males is quite rare... so I would consider it highly unlikely... "
IC: "The genetic screening is right and you are wrong Sir!"

 

[chulbert]

Though I don't like it, I had to vote yes.

I think we're inclined to think the system is unfair because it would "punish" the individual for something that's not their "fault". However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease. So we're left with a situation in which neither party is at fault but there is a cost involved. Who is responsible for that cost? Ultimately, I think it has to be the individual. Sometimes the universe simply deals you a bad card.

 

[Kopji]

They should just classify it as 'act of God' and get on with making their 40% profits.

 

[Rob Lister]

A twisted discussion from the future...

Insurance company: "It says here that you are very likely to get breast cancer! 89 % to be exact... "
Not the customer: "Well I'm not that likely, because... "
Insurance company: "The genetic screening is accurate... "
Not the customer: "I'm a man, the diagnosis of breastcancer in males is quite rare... so I would consider it highly unlikely... "
IC: "The genetic screening is right and you are wrong Sir!"

Then market forces would come into play, just as they will in the case of making genetic testing a requirement. If it is true that this male does not have an 89% chance of developing breast cancer then other companies will see the truth of his lesser risk and see a profit in providing him with lower rates.

This is not to suggest that I think the insurance industry does not require regulation, but I don't think it does as it regards their own internal statistical assessments of risk and how they go about distributing it. I feel confident leaving that part to the market.

 

[Rob Lister]

Though I don't like it, I had to vote yes.

I think we're inclined to think the system is unfair because it would "punish" the individual for something that's not their "fault". However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease. So we're left with a situation in which neither party is at fault but there is a cost involved. Who is responsible for that cost? Ultimately, I think it has to be the individual. Sometimes the universe simply deals you a bad card.

What's worse is when the client has more information about his or her condition than does the company. The reasons for that are obvious.

Genetic testing by insurance companies is going to be a reality in most of our lifetimes, especially as the science of it develops. There is no way around it except to socialize it completely.

I don't know my own genetic condition but I'm willing to bet that I don't want my insurance socialized in that fashion.

Betting is what the business is all about.

 

[Paracelsus]

This is not to suggest that I think the insurance industry does not require regulation, but I don't think it does as it regards their own internal statistical assessments of risk and how they go about distributing it. I feel confident leaving that part to the market.

Why shouldn't the people that does statistical assement be accredited to do the assesments(much like accountants)? Even today some Insurance companies reject claims or even applications for insurance with "statistics". The individuals doing the rejections are sometimes "impaired" in the field of statistics to say the least. My twisted mock-up conversations is sometimes reality today for some people in other forms.

Genetic screening is a powerful tool and the possibilities for abuse by people with little knowledge in the area are immense. If you look at it genetic screening and assessing the risk takes knowledge of medicin, genetics and statistics. So if it ever allowed for Insurance Companies to do genetic screening of individuals I do believe that the people doing the assesments need to be licensed in some way. Preferably by regulatory law.

 

[Rob Lister]

Why shouldn't the people that does statistical assement be accredited to do the assesments(much like accountants)? Even today some Insurance companies reject claims or even applications for insurance with "statistics". The individuals doing the rejections are sometimes "impaired" in the field of statistics to say the least. My twisted mock-up conversations is sometimes reality today for some people in other forms.

I think I'm getting your drift but I'm not positive. Your wording was questionable at best. If I got it, the answer is, because it is not necessary for the government to get involved (very much) regulating what market forces so efficiently handle. If they can't do the statistical math then they won't get a market share. Underestimate the risk (reduce premiums) and they lose in the payout. Overestimate the risk (increase premiums) and they can't get the market share. There is a need, and a instance of, regulation in terms of the stats. It has to do with how much escrow the company keeps in terms of potential payouts. It's fairly strict and based on government-fed 'accounting'.

Genetic screening is a powerful tool and the possibilities for abuse by people with little knowledge in the area are immense. If you look at it genetic screening and assessing the risk takes knowledge of medicin, genetics and statistics. So if it ever allowed for Insurance Companies to do genetic screening of individuals I do believe that the people doing the assesments need to be licensed in some way. Preferably by regulatory law.

Has nothing to do with anything, unsupported except by assertion, and a complete strawman from what I can tell. Perhaps I am misreading you however.

 

[kimiko]

However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease.

People have no control over their genes (yet), but insurance companies deliberately chose to go into that business. They are 'at fault' for choosing profit over people.

Sometimes the universe simply deals you a bad card.

Lucky us, we live in a society that protects the weak from the strong physically through law and order, so why not do so in business-supplied protections like insurance too?

 

[Rob Lister]

Huh!?!?!

I read, I furrowed my brows, I thought of visiting Neverland and spending the night with MJ.

People have no control over their genes (yet), but insurance companies deliberately chose to go into that business. They are 'at fault' for choosing profit...

If you someday choose to open a business, please let me know of its locale so that I can be the first at the door to get my goods for free. I'll sign a statement, if you like, swearing that I really 'need' what I decide to take.

 

[Shane Costello]

Originally posted by EdipisReks:
i think the idea of genetic profiles being used by insurers is absolutely despicable.

That was the attitude my genetics professor took as well. I don't think he went as far as describing genetic profiling for actuarial purposes as being despicable, but he was convinced that insurers wouldn't take into account the complex interaction between environment, lifestyle choice and genetic inheritance that's behind almost all chronic disease.

Originally posted by Rob Lister:
Genetic testing by insurance companies is going to be a reality in most of our lifetimes, especially as the science of it develops. There is no way around it except to socialize it completely.

I'm not so sure that genetic profiling is all that close to reality. Take breast cancer. Present scientific knowledge suggests that surprisingly few cases of breast cancer can be primarily attributed to genetic inheritance.

Of course cancer is ultimately a genetic disease, but it's my guess that as medical knowledge increases it'll probably become clear that environmental factors and lifestyle choice are more reliable determinants of future health than genetic inheritance. More to the point, what it'll probably establish is that the vast majority of us are a mixed bag in terms of the genes we inherit. A dispassionate look at my family tree suggests that there's a better than average chance I won't be asking my health insurer for a hair transplant, but that I could well need treatment for glaucoma in middle age. I'd hope that as medical knowledge about the basis of disease increases, so to does the efficiency of treatments, in terms of cost and effectiveness. Genetic profiling might prove to be irrelevant.

 

[Rob Lister]

Genetic profiling might prove to be irrelevant.

It very well might but I doubt it. The bet here is that you think that the science of meds will advance faster than the science of profiling. I think I'm willing to give you odds on that one. Not great odds. I'll go 1.5:1

But if you're right, you're right. Even if you're wrong (in the short or long term) then there will always be a market niche for the companys that don't bother with any such testing, just as there are morgage companies that don't make you prove your annual/monthly income. It comes at a slightly higher rate but that's the cost of doing that kind of business. More power to them, IMO. More power to the eventual companies they will require a profile too.