The issue of the insurability of known bad risks has NOTHING to do with whether or not the business is profitable. The problem is that genetic testing opens up deeper issues with the insurability of long term care for a certain segment of society, problems that ultimately can only be addressed through making such care the responsibility of the government by declaring it a public good. It is essentially an extreme example of the broader problem of health care insurance as a private enterprise in the US.
For example, we don't seem to have a problem with insurance companies charging much higher rates for people with very bad driving records. That makes sense to us, because if such people keep getting into accidents, why should they only have to pay the same amount of money as a good driver with a clean record? We believe that personal responsibility and self-determination justifies this difference in treatment.
Similarly, we also believe to a large extent that a similar principle applies to health care. If you try to live a healthy lifestyle and avoid illness and injury, you should not have to pay as much to insure yourself. The problem is that lifestyle choices only account for a portion of our overall health. Age and genetic factors are out of our control. And we all eventually become infirm. So health care has this problem of insurability because we can't control several important factors that increase our exposure. This is why the government steps in with programs like Medicare. This is also why other countries have seen the wisdom of going all the way, with universal health care. It becomes a public good, like having roads, municipal water systems, and other infrastructure.
Insurance of long-term care is trickier than health care because not everyone needs it. But if you can find out if you will need it, while prohibiting insurers from using this knowledge, then this is not insurance. From an actuarial perspective, this is no different than prohibiting insurers from adjusting auto insurance rates based on driving record. True, you can't control your genes. But as I have already pointed out, the correct remedy is not to prohibit rating based on such factors, but to have the government fund long-term care for such individuals as a public good.
For example, we don't seem to have a problem with insurance companies charging much higher rates for people with very bad driving records. That makes sense to us, because if such people keep getting into accidents, why should they only have to pay the same amount of money as a good driver with a clean record? We believe that personal responsibility and self-determination justifies this difference in treatment.
Similarly, we also believe to a large extent that a similar principle applies to health care. If you try to live a healthy lifestyle and avoid illness and injury, you should not have to pay as much to insure yourself. The problem is that lifestyle choices only account for a portion of our overall health. Age and genetic factors are out of our control. And we all eventually become infirm. So health care has this problem of insurability because we can't control several important factors that increase our exposure. This is why the government steps in with programs like Medicare. This is also why other countries have seen the wisdom of going all the way, with universal health care. It becomes a public good, like having roads, municipal water systems, and other infrastructure.
Insurance of long-term care is trickier than health care because not everyone needs it. But if you can find out if you will need it, while prohibiting insurers from using this knowledge, then this is not insurance. From an actuarial perspective, this is no different than prohibiting insurers from adjusting auto insurance rates based on driving record. True, you can't control your genes. But as I have already pointed out, the correct remedy is not to prohibit rating based on such factors, but to have the government fund long-term care for such individuals as a public good.