Laws restricting health insurers' use of genetic information: Impact on genetic discrimination
Laws restricting health insurers' use of genetic information: Impact on genetic discrimination
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DOI：
10.1086/302714
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发表时间：
2000-01-01
影响因子：
9.8
通讯作者：
Rich, SS
中科院分区：
文献类型：
--
作者：
Hall, MA;Rich, SS
自1991年以来，已有28个州颁布了法律，禁止保险公司在定价、发行或构建健康保险时使用遗传信息。本文评估这些法律是否减少了健康保险公司的基因歧视程度。从多个站点收集的数据中，我们发现几乎没有健康保险公司在其承保决策中要求或使用产前基因检测结果的有据可查的案例，无论是（a）在这些法律颁布之前或之后，还是（B）在有或没有这些法律的州。通过与保险公司的面对面访谈和直接的市场测试，我们发现患有严重遗传疾病的前驱症状者在获得医疗保险方面几乎没有困难。此外，几乎没有迹象表明，难度的大小取决于一个国家是否对遗传信息的使用进行监管。然而，这些法律使得保险公司未来使用基因信息的可能性降低。虽然保险公司和代理人只是模糊地知道这些法律，但这些法律已经塑造了关于使用这些信息的合法性的行业规范和态度。
Since 1991, 28 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. From the data collected at multiple sites, we find that there are almost no well-documented cases of health insurers either asking for or using presyptomatic genetic test results in their underwriting decisions, either (a) before or after these laws have been enacted or (b) in states with or without these laws. By using both in-person interviews with insurers and a direct market test, we found that a person with a serious genetic condition who is presymptomatic faces little or no difficulty in obtaining health insurance. Furthermore, there are few indications that the degree of difficulty varies according to whether a state regulates the use-of genetic information. Nevertheless, these laws have made 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 shaped industry norms and attitudes about the legitimacy of using this information.