DNA testing and disclosures
Sydney Morning Herald
Tuesday February 16, 2010
GENETIC testing is a subject many people view with dread. Some would rather not know the odds in the lottery of life. For others with a family history of a particular disease, a DNA test can provide a way of fighting the odds - by allowing them to take preventive steps in diet and lifestyle, and more frequent check-ups so that symptoms can be addressed early - or to relieve anxiety, by showing the feared genetic susceptibility has not, in fact, been inherited.But it is an area where people should step with an understanding of the consequences, and it is not at all clear that these have been properly explained by the health insurer NIB in its offer of cut-price genetic tests to its customers. The company is no doubt correct in saying it has no ulterior motive. In Australia, health insurance is not "risk-rated" - with no surgical intervention meaning that premiums are not charged in line with the subject's risk of developing certain disorders - so neither NIB nor any other insurer could raise the premium or refuse cover if the DNA test showed a high risk.But this is not the case with the life insurance industry and the closely related superannuation sector. Here risk is everything in driving the profitability of these businesses.People taking out any form of life insurance or raising their cover are obliged to disclose the results of any previous DNA test, as well as face questions about their habits and family medical history. This can result in higher premiums and certain illnesses being excluded from cover. If the test is concealed, payouts can be denied.But it is only in the fine print that NIB customers are told the DNA tests could create privacy and financial issues, and that they and their relatives might be obliged to notify the results to life insurers and superannuation funds when seeking new cover.At professional level, Australia is quite advanced in ethical guidelines against genetic discrimination. DNA screening does not yet appear to be an issue in employment. Life insurers have agreed not to demand DNA tests for existing or new customers, though the latter have to disclose if they or relatives have had one. Decisions about premiums or exclusions based on DNA results or family history must be based on strict actuarial assessment, and subject to appeal and scrutiny. But the implications are not widely known at the popular level. Schemes such as the NIB offer need to spell out these implications clearly and prominently.
© 2010 Sydney Morning Herald