Heads they win; tails you lose--genetic testing and insurance

While the U.S. legislature debates whether discrimination is occurring in insurability of its citizens, many Canadians are paying higher premiums for critical care insurance even when genetic tests are negative. This report comes from cbc news.

Canada has public health care for ordinary illnesses, with more limited protection for debilitating conditions such as cancer. People can buy additional insurance to cover these potential problems, and insurance in this category is a fast-selling product. It covers such things as strokes, heart attacks and some types of cancer or diabetes.

Susan Goldberg of Thunder Bay, Ont. didn't inherit the genetic mutation that led to the deaths of her mother and grandmother from cancer; but she still pays 75 per cent more for her insurance than the typical client. A test showed that [she] didn't inherit the genetic mutation that led to the deaths of her mother and grandmother from cancer.

Why wasn't her negative test result taken into account in determining the insurance premium? It turns out that insurers

. . . sometimes set rates for a client based on their family history, even when genetic tests show that the individual doesn't have the genetic mutation that has made their families high-risk in the past.

That is, insurance companies rely more heavily on family history than genetics.

So in assessing someone looking for insurance for breast cancer, the company would consider such things as:

  • Whether her breasts were exposed to radiation.
  • Whether she had her first child after the age of 30.
  • Whether she had prolonged hormone replacement therapy after menopause.
  • Whether she had a positive genetic test.

A check mark beside any one of those things is likely to increase the premium. But there's no box to check in the absence of any one of those conditions, and nothing saying how negative genetic test results would affect a rating.

Although insurance companies--by law--cannot require someone to have a genetic test, they can use the results if the person has had such a test. In fact, not revealing the results of such a test can be considered insurance fraud.

Oh, you say, that's Canada, not the U.S. Have you any idea how U.S. insurance companies decide to charge higher premiums or deny insurance? Probably not.

Is there discrimination based on genetic makeup? Yes, I believe there is.

Marie Godfrey, PhD

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