|DNA scan 'could cut cost of insurance - even if results kept secret
The Times | March 28, 2009
Taking genetic tests to assess potential health risks could mean cheaper medical insurance even if the results are not disclosed, a senior industry executive has told The Times.
Customers who take personal DNA scans will pay lower premiums because insurers believe that they encourage a healthier lifestyle, according to Gil Baldwin, the managing director of Norwich Union Healthcare.
The advent of tests for DNA variants that affect common disorders such as diabetes and heart disease has prompted fears of discrimination and the creation of a “genetic underclass” who cannot buy cover. Mr Baldwin insisted that his company did not see genetics as a tool for cherry picking low-risk customers but as a way of helping them to manage and reduce their risk of disease with the aim of lowering costs for both parties.
In an interview with The Times, he said that people who take genetic screening are likely to act on the results and therefore present a much better risk profile. Insurers will reflect this in premiums, regardless of whether results are disclosed.
“The thing about genetic screening is I'm not interested in knowing what your results are,” Mr Baldwin said. “I'm interested that you are interested in going for a screen, because only a madman would get information saying you're at risk of a heart attack and do nothing with that information.
“The benefit to the insurer is in engaging people around the risks they have, and then devising programmes to help them manage those risks. This isn't a matter of knowing more about you so we can calculate your personal risk and charge you appropriate premiums. We'd charge you the same premium, but have a better conversation. In time, that leads to a lower premium.”
His comments were greeted with scepticism by those campaigning for tighter regulation of DNA technology.
Helen Wallace, of GeneWatch UK, said: “We welcome people in the insurance industry saying they don't want to use genetic test results to discriminate against people. However, we remain concerned about the use of DNA and legislation is still required.”
The role of genetics in insurance has emerged as a controversial issue, with the development of increasingly reliable tests for DNA mutations and variants that are linked to disease. It has long been possible to detect abnormal genes with severe effects, such as the Huntington's disease mutation, and recent research has identified hundreds of other variations that have a smaller influence over common conditions.
This has led companies such as 23andMe and deCODEme to launch services costing £300 to £700, which screen DNA variants to assess future risk of disease. Many scientists predict that it will be possible to sequence entire genomes for as little as £500 within a few years and that this will soon be offered universally.
This could open a new approach to medicine in which diseases can be predicted and prevented and drugs prescribed more safely and effectively according to patients' DNA profiles. But the same data could be used by insurers to raise premiums for those whose genomes suggest a high risk of illness, which could be a disincentive to taking tests.
The Association of British Insurers has placed a moratorium on genetic testing until 2014. The only exception is the Huntington's test, which companies can demand for life policies worth more than £500,000 and health cover above £300,000.
Privacy campaigners and some scientists have called for this to be hardened into legislation, along the lines of the Genetic Information Nondiscrimination Act passed by the US last year.
Mr Baldwin said that he understood why many people were concerned about genetic privacy and that he found the notion of using DNA to set premiums “quite Big Brotherish and nasty”.
But he said that DNA tests could still be useful in insurance if customers were allowed to keep them private. “We wouldn't necessarily need to see the genetic sequence,” he said. “That could be held elsewhere with the right confidentiality, so you couldn't use it for accurate underwriting.”
Most of the higher and lower disease predispositions that can be revealed by DNA are small and uncertain, he said, so people could still be insured according to the pooled risk principles that operate today. He added that as tests became cheaper and more sophisticated, insurers might pay for customers to take them and keep the results confidential.
However, Dr Wallace added: “We would be very concerned about insurance companies teaming up to market genetic tests.”