By Mark Ameigh

When the race to identify the entire length of the human genetic code finally ended, the media hailed the projects value for advances in scientific and medical research.

In the midst of the celebration, a long simmering controversy also erupted.

Concerned scientists and policymakers have weighed in on how genetic information might be used to discriminate against individuals in areas of health care and employment. And privacy advocates have had success in getting their concerns about genetic testing cited frequently.

Congress has been considering legislation that would restrict or deny the use of genetic test results by employers and insurers for almost six years. And now, some members of Congress are predicting legislation will be signed into law by the end of 2002.

Central to this discussion is an issue of prime importance to insurance people: how to keep the playing field level for applicants and insurers.

Many genetic testing opponents seem to assume that, lacking ironclad controls, information derived from personal genetic testing has a high probability of being used against people who have had such tests. Privacy advocates argue that stingy employers will deny employment, and greedy life and health insurers will deny coverage.

Unfortunately, such arguments take the narrow and deceptive view that discrimination and self-interest are limited to employers and insurers.

Isnt it also possible that individuals might use their own genetic information as a tool of anti-selection against employers, and life and health insurance companies?

For instance, a person who has undergone genetic testing and found he or she is carrying a gene for a debilitating or terminal disease could search out an employer with the most comprehensive employer-paid benefit programs. This person might then take a job at this employer, based solely on the rich benefit package, fully expecting to utilize the health and disability insurance benefits within a relatively short period after starting employment.

As a result of this premeditated act, the employer will sustain real financial losses. That can hit the business in a least three ways:

–Benefit costs increase as a result of utilization that was based on anti-selection.

–The productivity of the business falls as a result of the employees absence.

–The employer incurs additional hiring and benefit costs in order to secure a replacement employee.

Insurers, of course, suffer a similar threat. Using personal and private knowledge of genetic tests results, the people most likely to contract serious illnesses will become the people most likely to purchase life, disability or long term care insurance, while failing to disclose what they know about their health.

Should the privacy of personal genetic information be protected? Absolutely!

However, the fact that employers and insurers are equally at risk of being targets of misused genetic testing information should be a key consideration in developing the regulations surrounding this information.

Insurers could be prohibited, for instance, from requiring that new tests be performed to secure coverage. However, I believe they should be able to ask if genetic testing has been done prior to application. If it is determined testing was done, insurers should be able to see the results, as with any other medical procedure today.

Some people may question whether this is an issue, since cheap and reliable genetic testing is not available to individual consumers today. However, the nature of our economic system bears witness to an indisputable fact–if a market develops for such tests in the future, they will become available.

Privacy is a key issue in this discussion, no question about it. But fairness to all parties is equally important. The playing field must be kept level for individuals and employers and insurers.

Mark Ameigh is a partner at Disability Insurance Specialists, LLC, Bloomfield, Conn., and may be e-mailed at MAMEIGHc@dispec.com.


Reproduced from National Underwriter Life & Health/Financial Services Edition, February 4, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


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