Genetic Discrimination

[Remiel]

My question comes from this article: http://www.healthzone.ca/health/newsfeatures/article/992995--young-woman-faces-insurance-hoops-due-to-father-with-huntington-s?bn=1#comments

Basically, my question is this: is it right to be able to discriminate against people, for purposes of insurance or employment, because they may be at risk for a debilitating and costly health condition through no substantial fault of their own?

In the past, it may have seemed like bad luck or providence when someone was afflicted by such conditions or diseases, and risk was accordingly pooled through the whole group. But as our powers of detection became greater and more profound, suddenly we could make predictions about the chances of an individual in developing something like Huntington's. But should insurance be able to charge more to people who may be genetically predisposed? After all, they are not allowed to discriminate based of other factors, such as race, which are merely genetic differences in essence.

Also, I think it could be intelligibly argued that exorbitant insurance costs might increase the likelihood of developing a debilitating condition, if that money otherwise would have allowed the person in questio to lead a healthier life (less stress, better food, et cetera). Or, in particular, if they were denied employment for this reason it could have a very substantial impact on their health for that reason in itself.

Personally I think it should be outlawed.

[Bonam]

But as our powers of detection became greater and more profound, suddenly we could make predictions about the chances of an individual in developing something like Huntington's. But should insurance be able to charge more to people who may be genetically predisposed? After all, they are not allowed to discriminate based of other factors, such as race, which are merely genetic differences in essence.

Insurance companies charge premiums based on the perceived risk. I tend to agree with the statement in the article:

Frank Zinatelli, vice president and general counsel for the Canadian Life and Insurance Association, argues that requiring someone with a higher risk of illness to pay higher premiums is only fair to other policyholders.

“If you don’t assess the risk properly then what you are really saying is let somebody else pay for my risk,” he says, noting that pooling risk is the whole concept behind insurance.

“Who do we want to pay for someone who is a higher risk? Is it the job of other policyholders?” he asks.

Why should other people pay higher premiums so that someone with a genetic predisposition to a costly disease can pay lower ones? The money has to come from somewhere. Either she pays a higher rate, or everyone else does.

Consider the example of car insurance. Insurance companies discriminate in their rates based on age and gender. And that's just for statistical reasons. If you are a young male, you will be charged exorbitant rates. And that's without even knowing anything about you specifically, you might be a very skilled and cautious driver. I would certainly expect no less if someone carried a gene which made them a reckless driver (not that I believe there is such a thing, just an example), the insurance companies better charge them more.

The real solution to this problem, from my point of view, is simple. Let people opt out of mandatory insurance and instead save money to self-insure. Nothing to complain about then. Set your own premium, assume your own risk, pay out of your own saved up money.

Edited May 19, 2011 by Bonam

[kimmy]

Insurance companies discriminate against people for lots of reasons that are beyond that person's ability to change. Male? Young? Old? Have a medical condition? Too bad.

Yes, it's unfair that this woman is being penalized for her father's medical condition. But why is it any different than any of the other discriminatory practices of the insurance industry?

-k

[cybercoma]

The insurance industry is dirty like that, but it's their prerogative. People can get the message out there and try to stop others from doing business with them. If the movement is large enough, perhaps there will be an insurance company that will put it in their policy not to discriminate for those reasons.

While I don't disagree with insurance's ability to do this, I do, however, disagree with employers ability to do this. If employers will be entitled to discriminate based on genetics, after all the invest in their employees and they don't want someone who's going to get sick or die on them, then the government better be setting up a massive multi-billion dollar social safety net for those that find themselves unable to work through no fault of their own. Having a genetic predisposition to particular illnesses ought to then be covered under the disability act, since employers will be reluctant to hire you.

[Topaz]

I think she should have gone and gotten tested and she may have found she didn't have it and then showed the insurance they were wrong. She may take after her mother more than her father. Not ALL children will get the disease their parents have, it may even skip a generation and go to the next. Insurance companies don't need a reason to up rates or refuse claims. Watch insurance rates go up again over these floods.

[TimG]

Not ALL children will get the disease their parents have, it may even skip a generation and go to the next.

That is the reason why she is even allowed to purchase insurance in the first. If it was 100% known that she would get the disease she would un-insurable.

That said, I have noticed that insurance companies tend to deny insurance entirely instead of negotiating exclusions on a case by case basis. i.e. this women should be entitled to purchase insurance that covers all risks except her genetic disease.

If the law is to be changed it should be changed to require companies to offer insurance with case by case exclusions at regular rates.

Edited May 19, 2011 by TimG

[guyser]

The problem as I see it the genetic testing is ahead of the statistical probability of acquiring that disease.

Lets take Person A , he is tested for genetic traits and it shows Cancer. But it wont show what the likelihood of him getting cancer is.

Then the actuary has to figure out how many of these insureds w cancer will buy the insurance and how many will let it lapse, non-renew, miss payments and so on.(thats how money is made)

The truth is that as we advance a lot of us will be surprised to find we may have the genetic trait for many things, most of which will never manifest themselves.

So the testing "for" needs to be countered by the discerning of "when or if" it will appear in a policy period.

Let me suggest something else along the same line.....if person A has genetics that say Cancer, but family history suggest not until age 60 then an insurance company may very well insure from age 20 to 60 but no beyond.

We are not there yet.

[bloodyminded]

The truth is that as we advance a lot of us will be surprised to find we may have the genetic trait for many things, most of which will never manifest themselves.

A great point. Notably with cancer: the rates are so high that the number who are potentially genetically predisposed may well be a majority of the population.

[guyser]

If you reverse these two paragraphs all is fine

That said, I have noticed that insurance companies tend to deny insurance entirely instead of negotiating exclusions on a case by case basis. i.e. this women should be entitled to purchase insurance that covers all risks except her genetic disease.

If the law is to be changed it should be changed to require companies to offer insurance with case by case exclusions at regular rates.

It is the Courts that have convinced the ins co's to deny case by case rating.

Find one case the ins co allows it, then by default they lose on every single case of similar situation.

Edited May 19, 2011 by guyser

[guyser]

Insurance companies don't need a reason to up rates or refuse claims. Watch insurance rates go up again over these floods.

Ins co's are heavily regulated and cannot up rates for no reason nor can they refuse claims for no reason.

Of course we are not hitting on the market aspect of this and what "upping rates" would mean to the competitor

[guyser]

The real solution to this problem, from my point of view, is simple. Let people opt out of mandatory insurance and instead save money to self-insure. Nothing to complain about then. Set your own premium, assume your own risk, pay out of your own saved up money.

And there is the crux of the problem.

You plowed into me (thus you are at fault) but you have saved $50,000 to self insure, but my car is worth $75,000 . So I would have to assume 'your risk' ....right?

Not a solution at all and is counter to self responsibility.

[TimG]

Find one case the ins co allows it, then by default they lose on every single case of similar situation.

I dont think you understood what I meant.

The problem is insurance policies refuse to write policies that vary by individual. They take a one size fits all approach.

This may be driven by how the courts work and if that is the case the laws need to change to allow insurance companies do this.

[guyser]

I dont think you understood what I meant.

Pretty sure I did.

The problem is insurance policies refuse to write policies that vary by individual. They take a one size fits all approach.

This may be driven by how the courts work and if that is the case the laws need to change to allow insurance companies do this.

An Ins co produces a one off policy for someone , and then someone else and so on. Before long there would be no standard policy and the courts would force the ins co to pay up.

Pretty much what is an exclusion on one is also on another.

The only place I dont think this applies is travel health insurance. Plenty of 'pre-existing' excluded stuff on those, and the reason why I suspect is that they are short term operations, and generally not susceptible to worsening conditions. ie....one buys insurance with an pre-exist clause and the pre-exist starts to kick in, many insureds pack up and return home without ever utilizing the insurance, unless they die (well duh) or they cannot travel quick enough of are too sick.

Years ago when we were all dumb and broke and travelled inot New York the consensus was if any of us were to become gravelly ill we were to put that person in a car and head for the border. We only had to make it to Niagara Falls and we were good to go.

Then we got smart and bought out of country coverage.

[TimG]

An Ins co produces a one off policy for someone , and then someone else and so on. Before long there would be no standard policy and the courts would force the ins co to pay up.

Why? It does not work that way for business insurance. And even if you are right then the law needs to be changed to allow this. Individualized contracts are the only way protect the right of insurance companies to set their premiums based on risk and to ensure that people can buy insurance to cover risks that have nothing to do with whatever genes they may have. Edited May 20, 2011 by TimG

[Remiel]

Individualized contracts are the only way protect the right of insurance companies to set their premiums based on risk and to ensure that people can buy insurance to cover risks that have nothing to do with whatever genes they may have.

I honestly do not believe that insurance companies really understand anything about risk. If they did, premiums would not go up every time something bad actually happened to you.

[TimG]

I honestly do not believe that insurance companies really understand anything about risk. If they did, premiums would not go up every time something bad actually happened to you.

If you make two claims you are higher risk. What is so complicated?

In any case, are you suggesting that government would be better at pricing risk?

[dre]

But here where it gets beautiful...

The smart insurance companies will insure people like this, and simply make a note of the trait. They will collect premiums from her for 20 years, and then if she makes a claim THEN theyll deny it

[dre]

If you make two claims you are higher risk. What is so complicated?

In any case, are you suggesting that government would be better at pricing risk?

Both public and private insurance companies can do either a good job or a bad job.

[Remiel]

If you make two claims you are higher risk. What is so complicated?

In the brute sense your risk after the claim is exactly the same as your risk before the claim.

[TimG]

In the brute sense your risk after the claim is exactly the same as your risk before the claim.

No it isn't because there may be a reason why you had two claims (undetected fraud, careless nature, etc). Sure it may be simply bad luck for some people but there are enough cases where there is an unknown underlying cause that your risk profile has gone up. Edited May 20, 2011 by TimG

[MiddleClassCentrist]

I disagree with insurance companies being able to charge men more than woman for car insurance. Women get in more accidents than men, men are more likely to get themselves killed... but the insurance money ends up going to their surviving wives/ex-wives anyways!

Charging insurance based on your genes predisposition to disease? That is capitalism for you. The disgusting side of capitalism.

"why should I pay for someone who is more likely to get cancer based on genes" - Conservative Minded Individual

Well, they didn't make a choice to get genes that are more likely to get cancer...

I would however, agree with being able to not hire smokers because they work less, take more days off and are less productive on the job. Because that is a choice you make.

Edited May 20, 2011 by MiddleClassCentrist

[cybercoma]

This whole insurance company issue I don't find nearly as interesting as the prospet of employers swabbing applicants and testing for genetic predispositions to disease, as a way to protect the employer's investment in that employee. In the US they do drug testing for just about every job and in Canada they test for specific ones that you wouldn't want someone high while doing (truck drivers, pilots, etc.). They take a person's license away if they're prone to seizures and whatnot. It's not a stretch of the imagination to consider a society where employers do genetic testing on employees for particular susceptibilities.

I'm curious how people think this should be handled. Would being susceptible mean you're eligible for "disability", since it makes it much more difficult to find a job? This creates a strange dynamic where a person is disabled before actually having the illness, I believe.

[TimG]

I disagree with insurance companies being able to charge men more than woman for car insurance.

Yet this makes insurance cheaper for women. So you are saying you think women should pay more?

[TimG]

This whole insurance company issue I don't find nearly as interesting as the prospet of employers swabbing applicants and testing for genetic predispositions to disease, as a way to protect the employer's investment in that employee.

I am not aware of any jobs today where a company expects an employee to say with them for life. i.e. there is no need to 'protect your investment' since that investment is likely to walk out the door at any time for any reason.

[guyser]

Why? It does not work that way for business insurance.

Actually it kind of does work that way. A business policy is a generic template for the most part now and then the client adds additional coverage specific to his needs.

And even if you are right then the law needs to be changed to allow this. Individualized contracts are the only way protect the right of insurance companies to set their premiums based on risk and to ensure that people can buy insurance to cover risks that have nothing to do with whatever genes they may have.

It is not against the law at all, but rather the interpretation of the courts is where ins co 's lose.

Under your scenario a court would deem that the ins co had offered the coverage to someone else but denied to someone in a similar situation and that is deemed unfair thus they would be oredered to pay up.

Even when ins co's are right they tend to lose, not always as we know.