Use of Medical information by UK insurers

Abstract

B Thomson1Thomson B Time for reassessment of use of all medical information by UK insurers.Lancet. 1998; 352: 1216-1218Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar advocates the primacy of welfare-provision to all, according to need and independently of means-over the principle of fairness in the insurance contract (ie, equitable sharing of adverse consequences based on objectively assessed circumstances for those who voluntarily participate in the risk pool). Over two centuries of social strife seem to go unaccounted for.In affluent European countries we have combined the two approaches up to now. Universal and compulsory national health or social security systems rub shoulders with complementary voluntary insurance to provide a mix of public and private health care, varying in proportion from country to country. The main peril ahead is the threat of financial inadequacy of either system, given the unending rise in medical expenditure.But let us make no mistake. The two systems operate under different premises and mechanisms. Insurance needs to be fair to all who share risks, and transparency of information is the key issue. Take that away and injustice sets in: those “in the know” do better than the rest. Under current rules of voluntary health-care insurance, medical information on a predisposition to disease, genetic or otherwise, needs to be disclosed, assessed, and properly underwritten so that the system can operate in fairness.Genetic testing may provide information with important implications, medical and social, for the individual and for his/her relatives, and these need to be sensitively and sensibly dealt with. The insurance industry is attempting to do just that. B Thomson1Thomson B Time for reassessment of use of all medical information by UK insurers.Lancet. 1998; 352: 1216-1218Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar advocates the primacy of welfare-provision to all, according to need and independently of means-over the principle of fairness in the insurance contract (ie, equitable sharing of adverse consequences based on objectively assessed circumstances for those who voluntarily participate in the risk pool). Over two centuries of social strife seem to go unaccounted for. In affluent European countries we have combined the two approaches up to now. Universal and compulsory national health or social security systems rub shoulders with complementary voluntary insurance to provide a mix of public and private health care, varying in proportion from country to country. The main peril ahead is the threat of financial inadequacy of either system, given the unending rise in medical expenditure. But let us make no mistake. The two systems operate under different premises and mechanisms. Insurance needs to be fair to all who share risks, and transparency of information is the key issue. Take that away and injustice sets in: those “in the know” do better than the rest. Under current rules of voluntary health-care insurance, medical information on a predisposition to disease, genetic or otherwise, needs to be disclosed, assessed, and properly underwritten so that the system can operate in fairness. Genetic testing may provide information with important implications, medical and social, for the individual and for his/her relatives, and these need to be sensitively and sensibly dealt with. The insurance industry is attempting to do just that.