Hall M A
Wake Forest University, USA.
Jurimetrics. 1999 Fall;40(1):93-122.
Since 1991, twenty-eight states have enacted laws that prohibit insurers' use of genetic information in pricing, issuing, or structuring health insurance. This article evaluates whether these laws reduce the extent of genetic discrimination by health insurers. Using multiple data sources, it concludes that there are almost no well-documented cases of health insurers asking for or using pre-symptomatic genetic test results in their underwriting decisions either before or after these laws, or in states with or without these laws. At present, health insurers are not thinking about or interested in using genetic information of this sort. Using this information is not cost effective and is not seen as contributing significantly to underwriting accuracy. However, if genetic testing information were easily available, some health insurers would consider using it in some fashion if that were legal. In the future, such information could become much more relevant to health insurers than it is now. Therefore, the major effect of these laws is to make it less likely that insurers will use genetic information in the future. Although insurers and agents are only vaguely aware of these laws, the laws have helped to convince the industry that it is not appropriate or socially legitimate to use this information. Thus, these laws have caused the insurance industry to embrace more socially oriented norms and attitudes.
自1991年以来，已有28个州颁布了法律，禁止保险公司在确定健康保险价格、承保或制定保险条款时使用基因信息。本文评估了这些法律是否减少了健康保险公司的基因歧视行为。通过使用多个数据源，得出的结论是，几乎没有充分记录的案例表明，在这些法律颁布之前或之后，以及在有或没有这些法律的州，健康保险公司在其承保决策中要求或使用症状前基因检测结果。目前，健康保险公司没有考虑或对使用这类基因信息感兴趣。使用这类信息不具有成本效益，也不被视为对承保准确性有显著贡献。然而，如果基因检测信息很容易获得，一些健康保险公司会考虑以某种方式使用它，前提是这是合法的。未来，这类信息对健康保险公司的相关性可能会比现在高得多。因此，这些法律的主要作用是降低保险公司未来使用基因信息的可能性。尽管保险公司和代理人只是模糊地了解这些法律，但这些法律有助于让该行业相信，使用这类信息是不合适的，在社会上也是不合法的。因此，这些法律促使保险行业接受了更具社会导向性的规范和态度。
