::scr gene djinni

[Kate L Pugh]

On Tue 09 Apr 2002, Tom Forwood <tom@forwoods.org> wrote:
> The question is should insurance companies be able to look at your
> genetic predisposition to varius diseases and ajust you insurance
> premiums accordingly, or even refuse to insure you?

I think the answer depends on what you mean by "should".  I'm going to
answer as though you meant "is it fair".

There are two ways to look at that question.  Consider Alice, who is
genetically predisposed to a given disease, and Bob, who isn't.

(1) Is it fair to increase Alice's premiums?
(2) Is it fair to refuse to decrease Bob's premiums?

    (You need to remember that the medical questions you get
    asked on a life insurance form are there because there is
    statistical evidence that people over a certain age, or with
    particular smoking/drinking/rockclimbing habits, or with a
    history of certain types of illness, or with a BMI outside a
    given range, etc, etc, are likely to die sooner.  It's all
    about risk: what risk is there that this person will die
    before the money they've paid us has earned more than the
    minumum amount of money that we've promised to pay out on
    their death?)

Perhaps I think the answer to (1) is "no, it's not fair", because it's
not her fault that she has this predisposition, and it's unfair to
"punish" someone for something that isn't their fault.  But in that
case, I'll also need to say that it's not fair to increase premiums
for someone who has a history of illness, or has had to have lots of
X-rays, or has cancer; after all, it's not their fault they got ill.

So let's only ask questions about things that are "your fault", like
maybe drinking/smoking/rockclimbing/BMI/drug use/having had an AIDS test.
But now we're in the situation where we have to make a value judgement
about what is or isn't someone's fault; moreover the financial penalty
on Bob, who I forgot to mention had a really shitty childhood and is
now trying to kick various addictions, is much higher than it would be
were the "not your fault" risks taken into account.

Hm, I think that's pretty unfair.  Possibly more unfair than punishing
people for things that aren't their fault (meta-ness-level mismatch
detected here, I think, but I shall plough on).

Well, we'd better not do that, then.

So now we're going down the route of forgetting about the medical
forms and making everyone pay the same premiums, oh, even the
centenarians, whoops, that's going to send the premiums sky-high,
because now we have to insure people who would previously have been
considered uninsurable, so the risk to the insurers is enormous, so
the premiums must also be enormous to compensate.

We've dug ourselves into a bit of a hole now, and the only way out
seems to be to say "well, some people just *are* uninsurable; we won't
insure them at all, but everyone else will pay the same premiums".
And to decide which people are uninsurable, we'll make them fill in
this medical form...


I'm sure there are big gaping holes in all that somewhere, because
it's not something I'd thought about particularly before I started
writing this.  Would be nice if someone could point them out.


Kake