UK considering requiring genetic tests for breast cancer and refusing private health insurance

The United Kingdom (England, Scotland, Ireland, and Wales) has a universal health coverage plan that is divided into Primary Care (regular doctor's visits, etc.) and Secondary Care (emergencies, surgery, long-term care, etc.). Every person in the country is entitled to care from the NHS (National Health Service).

In addition, some people purchase private insurance. The less-expensive private insurance typically covers primary care needs, such as giving you a better place in the queue (waiting list) for routine care. Providers of private health insurance have considerable leeway in what they will and won't cover and sometimes don't let patients know until the bills appear and are "not covered". For higher premiums, people can purchase insurance for more expensive conditions such as heart disease and cancer.

The news out of London the past couple of days concerns private insurance coverage for breast cancer. Because this condition generally means long-term, expensive care, private insurers will exclude the disease from low-cost coverage if a woman already has breast cancer when she applies for insurance. The newest twist is a proposed plan to deny even high-cost coverage to women who test positive for BRCA1 and/or BRCA2 mutations.

Mutations in these genes appear to be associated with about 5% of breast cancers and 10% of ovarian cancers. However, although a woman may have a mutation in one of these genes, she doesn't necessarily develop the disease.

What's happening in Britain (there's an NHS in all 4 UK countries, but the news discussed only Britain) is that the Association of British Insurers is petitioning the Genetics and Insurance Committee--the organization that advises the Government on the issue--to allow them to charge higher premiums or even refuse insurance for women who test positive for BRCA1/2. In addition, they want to be able to ask applicants if they have been tested.

At present, the only predictive gene test insurance companies can ask about is Huntington's Disease--because there are believed to be no environmental influences on developing the disease.

Last year, insurance companies agreed to a temporary ban on asking about BRCA genes until 2011. It appears they've changed their minds and now want to add BRCA genes to the Huntington's gene.

What happens in Britain may affect testing in other "commonwealth" countries such as Canada and Australia--and maybe even the US.

Read the whole story at http://www.thisismoney.co.uk/insurance/health-insurance/article.html?in_article_id=406969&in_page_id=39

Marie Godfrey, PhD