Although little documented evidence of adverse treatment of individuals in employment, health insurance or life insurance exists to date, concern about discrimination is widespread. Such concern should not be dismissed as irrational and unworthy of consideration for two important reasons. First, the amount of predictive genetic information in medical records is expected to grow tremendously as medical applications of genetic research move beyond rare, monogenic disorders to more common, multifactor, chronic diseases. Second, the fear of discrimination already is causing many at-risk individuals to forgo genetic testing, thereby failing to take advantage of the opportunity for prevention and early diagnosis. Thus, there is an important population health component of concern about discrimination.
We attempted to measure public attitudes regarding the likely effects of genetic information on policy insurance and pricing by life insurance companies. We asked: “Now I would like to find out what you think life insurance companies might do if they have access to genetic information. If a life insurance company has access to the genetic information of someone applying for a life insurance policy, do you think they would be likely to…” Subjects were asked to respond yes, no, or don’t know to each of the following options: refuse to sell the policy; agree to sell the policy at the regular price; agree to sell the policy at a higher price; and agree to sell the policy at a lower price; refusals also were noted.
Because life insurance is a highly competitive business and companies attempt to sell as many policies as possible, in theory, the effect of additional genetic (or other predictive medical) information would be neutral on overall availability and pricing of life insurance over 90. Thus, for example, one could argue that for every individual whose rates were raised from standard rates on the basis of being considered at a high risk, another individual’s rates would be lowered due to assumed low risk. Even if this assumption is correct, upward and downward adjustments in price are unlikely to be made on an equal-number basis. For example, a few individuals might be offered insurance at much higher rates (or not at all), and many individuals would have the same or only slightly lower rates.
In general, the public believes that genetic information would result in life insurance companies refusing to issue policies (85.1 %) or charging higher premiums (85.1 %). Only 26.7% said that companies would agree to sell the policy at the regular price, and only 19.5% said that genetic information would result in the issuance of a policy at a lower price.