Discrimination might manifest in several ways. The use of genetic information by insurers figures prominently in assessments of public attitudes and fears about genetic research and medicine. Theoretically, genetic tests obviate the need for the family medical history common in medical underwriting practices. Relatively few instances of discrimination by an insurance company have been reported, whether because discrimination is difficult to recognize or prove, or because the practice is not prevalent (Rothenberg and Terry).

Within the context of life insurance, the question is whether companies should either require genetic testing or have access to the results of genetic tests documented in medical records in deciding whether to underwrite a policy.

Insurance is characterized by a commercial transaction in which the company pays a benefit upon the death of the policyholder in exchange for a premium proportional to the mortality risk assumed by the insurance company (Cook; Nowlan). The fear is that a life insurer would decline to underwrite a policy for a person or family of persons who possess genetic variations that suggests early death. Insurance companies wish to avoid financial harm caused by adverse selection. Adverse selection results when persons who believe they are at a lower risk of illness or early death choose to purchase less insurance or leave the market, while persons who believe they are at higher risk purchase greater amounts of insurance. Ultimately, the money paid in premiums by persons of lower risk is no longer sufficient to cover the expense incurred by insuring persons of higher risk.

Medical underwriting is not as common in the context of medical or health insurance as compared to life insurance (Nowlan). Countries with a national health service extend resources to nearly all citizens without regard to health status; medical underwriting becomes relevant only in the small market for private health insurance. Nevertheless, fears are particularly pronounced in the United Kingdom, where— contrary to other countries, including the United States— life insurance is a requisite to the purchase of a home or other real estate (Cook).

The private health insurance market is much more prominent in the United States than in other countries, but is made available primarily through group plans subsidized by the employer in a voluntary arrangement (Rothstein, 2000). Medical underwriting is a greater possibility in the relatively small market of private individual policies, which can be very expensive.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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