Pokorski R J
Swiss Re, Fairfield, CT 06430-3544, USA.
Am J Hum Genet. 1997 Jan;60(1):205-16.
Genetic technology is assuming a greater role in the practice of medicine. Insurers have a vested interest because individually underwritten insurance cannot be sold without risk classification, and much of the medical information needed to classify risks will have a genetic component. This paper reviews recent genetic advances and their potential impact on life, disability income, long-term care, and critical illness insurance. Alzheimer disease is chosen to illustrate the effect of an organized effort to withhold medical information from insurance companies. Consumers will not support a private insurance mechanism with extensive cross-subsidization among policyholders and where medical information becomes inviolate simply because it is genetic. A framework for deliberations with the medical community is proposed.
基因技术在医学实践中发挥着越来越重要的作用。保险公司对此有着既得利益，因为没有风险分类就无法销售个人承保保险，而进行风险分类所需的许多医疗信息都将包含基因成分。本文回顾了近期的基因进展及其对人寿、残疾收入、长期护理和重大疾病保险的潜在影响。选择阿尔茨海默病来说明有组织地向保险公司隐瞒医疗信息所产生的影响。消费者不会支持一种在投保人之间存在广泛交叉补贴且医疗信息仅仅因为是基因信息就变得不可侵犯的私人保险机制。本文提出了一个与医学界进行商讨的框架。
