What’s in YOUR Genes?

by hgstern | Sun, 02/11/2007 - 9:18am | permalink

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Featured in: Insurance Dispatch

Genetic testing for insurance and employment is in the news again. What’s up with that?

In the previous congress, Sen Olympia Snowe introduced Bill 306, which
would have prohibited discrimination on the basis of genetic
information with respect to health insurance and employment. It
addressed small group plans, individual medical, and medicare
supplements.

That bill never made it.

So Sen Snowe, persistent if nothing else, has reintroduced her bill, S 358,
the Genetic Information Nondiscrimination Act of 2007. She (and her 25
cosponsors), hope to succeed this time around. It’s already been
approved by the Senate’s Health, Education, Labor and Pensions
Committee.

The goals seem reasonable enough: to prohibit insurers from declining
cover for folks with unfavorable genetic predispositions, and employers
from declining to hire them. Some states already have such laws; this
would bring the matter under the federal umbrella.

Aside from the obvious benefits, such a moratorium may encourage people
to undergo tests that they might not have previously considered, out of
fear of rendering themselves uninsurable or unemployable (or both).
It’s not clear just how many of us have considered this, but I suspect
it’s a minority. Still, anything that induces people to take a more
proactive role in their own health care shouldn’t be lightly set aside.

On the other hand, the danger exists that an inappropriately worded bill could have dire consequences on the insurance system. America’s Health Insurance Plans (an insurer lobbying group), wants to make sure that “consumers
know genetic information would not be used by health insurers to
discriminate or deny coverage, but would only be used in appropriate
ways to improve the quality of health care.” Fair enough.

A major problem with this bill is that it would prohibit insurers from
adjusting premiums based on genetic factors. Currently, HIPAA bars
carriers from charging individuals in a group different premiums based
on their health, and that’s fine. But this goes a step beyond, and
requires insurers to ignore basic risk factos in setting rates. That’s
just unacceptable; risk assessment demands that such factors be taken
into account.

As a member of a population with just such a predisposition (Ashkenazic Jews),
I’m sensitive to the issue. On the other hand, as one who adheres
strictly to insurance as a risk management tool, I know that
underwriters need to have information in order to properly assess the
risk. As an independent agent, I represent the company (carrier), but I
work for my clients, whose interests must be given priority.

I also think that there is something Orwellian in the use of genetic testing to decide whether or not someone should pay more for their insurance, or even be covered at all.

Be well.

Henry Stern, LUTCF is an independent insurance agent in Dayton, OH. A
licensed Continuing Education instructor for Ohio and Kentucky, he has
well over 20 years of experience in “the biz.” He blogs every day
(or so it seems) at InsureBlog.

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#1: Insurance Dispatch...

from InsureBlog on Sun, 02/11/2007 - 9:21am

Genetic testing is back in the news, and this week's column has the latest as it relates to insurance and employment.

Comments (7)

#1: A sensitive subject ...

Submitted by Vreni Gurd on Sun, 02/11/2007 - 2:59pm.

Hi Henry,

This is indeed a topic full of mine fields. I am hoping that science will
put more effort into looking at our genetic and biochemical differences so that we can come up with treatments that deal with these differences. In my humble opinion, the tendency towards one-size-fits all treatment is why risk assessment works for the insurance industry in the first place.

Currrently science is stopping at the determination that this person as opposed to that person is more susceptible to this particular disease, and hence insurance companies base their premiums on that determination. That determination should be the BEGINNING of the important scientific research - WHY is this person more susceptible - and examine the dominances in the functional homeostatic controls of that individual. Once science has a better understanding of individual differences and how to treat individuals instead of diseases, insurance companies will probably feel more comfortable with "not discriminating", because there will be no
reason to. We will be able to successfully treat the individual according to
their biochemical requirements, and different individuals will need far
different treatments for the same disease.

The role of the physician / health-care practitioner will become to
determine the dominances in the functional homeostatic controls of the patient presenting, and that will determine appropriate approach for that individual on a preventative basis and a treatment basis.

Although some work has been done in this genetotrophic approach, not enough attention has been paid to the wide variances in "normal", and all
its implications. Until science catches up, and the medical paradigm changes, the insurance industry will be in a bind if they are prevented from setting premiums based on so called risk factors ...

Thank you for your interesting, thought-provoking post.

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

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#2: Thanx, Vreni...

Submitted by hgstern on Mon, 02/12/2007 - 6:40am.

Appreciate your thoughtful comments.

It's a tough dilemna; obviously, underwriters need to take some of this into account. But "biology is not destiny" comes into play here, as well, I think.

In the event, I don't see any simple answers, either.

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#3: A different approach

Submitted by Vreni Gurd on Mon, 02/12/2007 - 9:16am.

I was thinking about this last night again - maybe the approach of insurance companies will change to take a bigger look at lifestyle factors. Smoking is already considered - maybe questions about fast food intake, packaged food intake (food that didn't exist in preindustrialized times), if their home or workplace has mold, if they are exposed to dangerous chemicals at work, have they been to their doctor to be cleared of parasites, fungus, food sensitivities etc. - the base causes that move people towards diseases. How many times a week they exercise....

Of course, this would be considered very "big brotherish", and an invasion of privacy, too.

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

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#4: Not necessarily *bad* ideas...

Submitted by hgstern on Mon, 02/12/2007 - 9:23am.

but I'm looking at some typical health apps, all of which run to 50-75 questions (ouch!). Adding more seems, well, iffy. And I'm not sure how many folks are privy to some of that info anyway (maybe they should be).

OTOH, I also notice that at least some of the health questions relate to lifestyle (excercise, etc). And, of course, folks who smoke, are overweight, and/or have high cholesterol (among other things) pay a higher rate than those who don't.

Other than the cholesterol, though, not sure what most of those have to do with genetic testing issue (not that I mind going a bit OT).

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#5: What I meant was ...

Submitted by Vreni Gurd on Mon, 02/12/2007 - 8:29pm.

Hi Henry,

What I meant was if you are not allowed to consider genetic factors and all those questions are removed, another option may be to differentiate premiums based on lifestyle factors. May even motivate people to improve their lifestyle if it reduced their insurance premiums ...

Lifestyle factors would be pretty hard to verify, and patients probably won't think it is any of your business, but it might work.

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

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#6: Aye, thar's the rub...

Submitted by hgstern on Tue, 02/13/2007 - 12:13pm.

"Lifestyle factors would be pretty hard to verify"

Exactly.

It's really a trade-off: invasive underwriting, or realistic questions. How does one prove that one jogs 5 miles a day, and/or eats healthy foods, etc?

Life
insurance companies routinely require blood, urine, even an occasional
EKG when underwriting a mere $100,000 of coverage, yet health carriers
issue what is essentially a $5 million line of credit on the written
answers to some questions.

'Tis a puzzler.

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#7: icFaGKPHOYFR

Submitted by Ali (not verified) on Sat, 09/15/2012 - 3:57pm.

Hi Sunshine,Individual health inacnsrue is must for following reasons:1. Whether you have any financial dependents or not, you are responsible for your own health care expenditures. And cost of medical treatments are rising every day.2. Now days it is very common for people to switch jobs, so when you switch you are medically un insured till you join new job. It also changes the type of cover offered by every employer and may not suit your needs.3. Also medicliam offered by your employer usually doesn't cater for critical illnesses, which is also important now days.So it is important for every earning individual to have individual health inacnsrue. Regarding denial rate, if you take precautions then there won't be any denial for a valid claim.I do have critical illness care and surgi care policy from HDFC Standard life and I am satisfied with it.If you need further explanation, you may contact me or any financial planner.Regards,Pranav

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