| When scientists started studying the genetics of | | | | incentive not to insure someone at risk of |
| breast cancer, they hoped to understand the | | | | Huntington's Disease - a progressive neurological |
| mechanism by which the disease developed and so | | | | disorder which can lead to many years in hospital. But |
| reveal new ways of treating it. They did not expect | | | | life insurance provides cover against someone dying |
| to end up furthering the commercial interests of | | | | during the currency of the policy. |
| insurance companies. | | | | And, while some genetic tests may predict what you |
| Yet insurers in Britain have been taking account of | | | | may die of, they do not predict the timing of death. |
| the results of genetic tests for breast cancer in | | | | So the tests are not relevant to life insurance, which |
| granting insurance cover, even though two separate | | | | is more important in Britain than healthcare insurance. |
| Government Commissions have recommended a | | | | Secondly, it is gradually becoming apparent that, |
| moratorium on the use of such information. Only | | | | because of the rarity of the inherited forms of |
| after a public outcry has the Association of British | | | | breast cancer, the numbers of cases involved are |
| Insurers accepted a voluntary, two-year ban on the | | | | tiny. It is inconceivable that an industry with an annual |
| use of genetic test results for policies over | | | | turnover of billions could be seriously threatened by |
| £300,000. | | | | their occurrence. |
| Insurers have a legitimate fear of 'adverse selection', | | | | The two genes (BRCA1 and BRCA2) that have been |
| whereby a known 'bad risk' might take out a very | | | | linked with breast cancer account for less than five |
| high insurance policy without disclosing their genetic | | | | per cent of all cases. Those who have one of the |
| status. In theory, if one company were unlucky | | | | genes are not certain to develop the disease and |
| enough to have several such clients, it could | | | | can, in any case, take steps to minimise their risk. |
| endanger the financial stability of the company. | | | | Why then do the insurers persist? One suggestion is |
| Insurers make their money by charging higher | | | | that they are not really interested in the single-gene |
| premiums to anyone with a higher-than-average risk. | | | | disorders, like Huntington's and the few inherited |
| Genetic test results offer one way of stratifying the | | | | breast cancers, but are laying down a marker for the |
| risks that the company insures against. | | | | future, when genetic susceptibility tests might be |
| But in my view the insurers are both overestimating | | | | available for all the common diseases of the West. |
| the importance of genetics and learning the wrong | | | | If there is even a glimmer of truth in this rather |
| lesson from experience in the USA. The results of | | | | cynical view then the struggle to keep genetic test |
| genetic tests do matter in the US, where health care | | | | results private is a matter of concern not just for |
| is backed by private insurance, but not in the UK, | | | | the small number of families affected by genetic |
| where health insurance is compulsory and universal. | | | | disease, but for everyone. |
| Private health insurance companies have a powerful | | | | |