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Rabbi Bulka's Weekly Question

Rabbi Bulka's Weekly Question

Is it ethical for insurance companies to deny coverage based on genetic information?


It is not clear that the issue you raise is a matter of pure ethics.

If an insurance company is up front in defining who and how it will ensure, and the limitations to its coverage, it is arguable whether this is a breach of ethics. It does not seem right, but may not be unethical. For the moment, though, let's work with the presumption this is an ethical matter.

A corollary to your question would be - is it ethical to charge more based on genetic information? Is charging more for that reason less ethically objectionable than not granting coverage?

In actual fact, I think it is a generally accepted practice for insurance companies to charge more for vulnerable people, genetics aside. People who admit to having a family history of illness are likely to be charged more for health insurance. Smokers are similarly more likely to pay a higher premium.

The insurance company is taking a greater risk with individuals having a bad history or bad habits. You did not ask about this ethical issue, but arguably charging more is not that much different from denying coverage.

In many instances, charging more is tantamount to denying coverage, especially when the prohibitive cost makes it impossible to purchase the insurance plan.

Given the massive costs that insurance is designed to cover, it is safe to say that we must do everything within our power to assure that people are covered for expenses that are likely to occur and the costs for which are prohibitive, beyond the capacity of the average wage-earner. We already do this with car insurance. It is illegal to drive without car insurance.

Should we extend this operating principle to other necessary insurances? For example, should we have some regulatory principles for life insurance or for education-for-the-children insurance?

Your question raises the larger issue of the ethical responsibilities we all have to and for each other. For example, would those who can afford it be willing to pay a higher premium if that were to make it possible for others not so blessed to afford insurance?

The taxation system works somewhat along those lines. Those who earn more pay higher taxes that help sustain services available to the more needy.

The greater question, ethical or otherwise, is: what can we all do to make insurance accessible to those who need it?


Originally published in the Ottawa Citizen on  November 9, 2013

Thu, November 15 2018 7 Kislev 5779