Thursday, July 2, 2015

Moral dilemma: Genetics and insurance

Consider this question: Is it morally right if insurance companies took a person genes into account when determining that person's insurance fees? (For example, a genetic propensity for certain diseases would be grounds for higher insurance payments.)

When this question came up, my first instinct was: Of course it's immoral!

But then I started thinking more about it. Why exactly is it immoral? To understand why this question is relevant, consider the following:

Insurance is an optional service provided by some private corporations. (Insurance provided by a government using taxpayer money is a different issue, and depends a lot on the country. Some countries do not provide such a thing, and even in most countries where the government does, it does so only for an extremely narrow set of things.) This is, essentially, a service that wouldn't have to exist. It's a service provided optionally for those who want to use it.

Insurance companies always take a risk when the provide insurance. There is the real possibility that they will end up losing money, if they have to pay more than what they receive. They have to balance carefully the cost of insurance fees. If the fees are too high, less people would take the insurance. If the fees are too low, the company will end up losing money.

Obviously insurance companies want to draw in as many customers as possible. It's a money-making business after all (a business that, optimally, is also beneficial for the customers, as a safety net for unforeseen circumstances.) One way to draw more customers in is to lower the fees for low-risk customers. After all, if everybody had to pay the same as the highest-risk customers, this would drive many potential customers away, to other insurance companies (or to not take insurance at all.)

Is it wrong for an insurance company to charge more money from a high-risk customer than a low-risk one? Your mileage may vary, and there are probably as many opinions as there are people. However, in general I would guess that most people don't find it an enormous moral problem.

So we get back to the original question: Given that insurance companies already charge more or less depending on the risk factors of the customer, and this is somewhat ok, why would taking the customer's genes into account be any more wrong?

In particular: Why do introducing genetics into this mix give a much stronger instinctive feeling of uneasiness than anything else? We do not cringe if an insurance company charges more for elderly people (who are more likely to get sick), but we immediately cringe if a company would charge someone more based on their genes. Why? What's the crucial difference? Why do genetics make us instinctively uncomfortable? What is it with genetics in particular that causes this?

I think any argument one could present against using genetics to determine insurance fees can be used against all other determining factors as well. But this would end up with all insurance fees being the same. While this may sound to many as the ideal situation, would it really? If you have insurance, you would probably start paying more than you currently do. Would you be happy with that? And that only because the idea of using genetics to determine this makes you feel uncomfortable? Would you be ready to pay extra money to avoid that feeling?

It's not an easy question.

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