Access to health insurance: Experiences and attitudes of those with genetic versus non-genetic medical conditions

被引:22
|
作者
Kass, Nancy E.
Medley, Amy M.
Natowicz, Marvin R.
Hull, Sara Chandros
Faden, Ruth R.
Plantinga, Laura
Gostin, Lawrence O.
机构
[1] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, John Hopkins Berman Inst Bioeth, Dept Hlth Policy & Management, Baltimore, MD USA
[2] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[3] Cleveland Clin Fdn, Dept Neurol, Cleveland, OH 44195 USA
[4] NHGRI, NIH, Bethesda, MD 20892 USA
[5] Johns Hopkins Med Inst, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA
[6] Georgetown Univ, Ctr Law, Washington, DC USA
[7] Johns Hopkins Univ, Ctr Law & Publ Hlth, Baltimore, MD USA
[8] Georgetown Univ, Kennedy Inst Eth, Washington, DC USA
关键词
access to health insurance; genetic discrimination; hereditary disease; cross-sectional survey;
D O I
10.1002/ajmg.a.31576
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
While studies reveal that individuals with both genetic and other chronic medical conditions have difficulty obtaining health insurance, no large-scale studies have compared the health insurance experiences of these groups. The goal of this study was to document and compare the health insurance experience, attitudes, and beliefs of persons with genetic conditions to those of persons with or at risk for other serious medical conditions. We interviewed approximately 100 adults or parents of children with one of each of the following medical conditions; sickle cell disease (SCD), cystic fibrosis (CF), diabetes, and HIV, and 200 adults with or at risk for breast (BC) or colon cancer (CC). The interview included items related to respondents' experiences and attitudes regarding health insurance. Twenty-seven percent of 597 total respondents self-reported having been denied health insurance or offered insurance at a prohibitive rate. Respondents with single-gene disorders (CF and SCD) were twice as likely to report this as those with non-genetic conditions. Legislation that exists to limit genetic discrimination in insurance addresses genetic risks or traits only, however, rather than protecting those with actual disease. Thus, current legislation may not address the challenges faced by individuals like those in this study, who try to maintain access to health insurance when they or their children are symptomatic with a genetic or other serious health condition. More than one-third of all respondents thought there was a high chance they would be denied health insurance in the future or their insurance would become unaffordable. That individuals with all six health conditions expressed concern regarding their ability to obtain future health insurance suggests policy proposals should be broad-based, addressing the needs and concerns of individuals with diverse health conditions. (c) 2007 Wiley-Liss, Inc
引用
收藏
页码:707 / 717
页数:11
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