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Russell Wangersky: Insurance can be a slippery slope

Riding the wave
Riding the wave

I am a pre-existing condition. I’ve been one my whole life, and, for that matter, so has everyone else.

Russell Wangersky

The only benefit, I suppose, is that I don’t yet know exactly what that condition will turn out to be. Eventually I will. And, eventually, as genetic research gets better and better, maybe my insurance company will, too.

I started thinking about this as I watched the planned changes to U.S. health insurance following the Congressional repeal of Obamacare. (Don’t worry, I’m not going to devolve into a column about American governance.)

The bill that was passed last week in the U.S. Congress made many changes, but one of the most interesting things was what happened to customers with pre-existing conditions. They may now end up paying much more.

And the list of pre-existing conditions is huge. You could have to pay substantially more for health insurance if you have any one of 50 issues, including obesity, mental disorders, diabetes or Crohn’s disease. There are suggestions that you’d also pay more if you had issues like acid reflux, heartburn, Lyme disease, migraines, sleep apnea, and the list goes on. Trouble for other people far away, right? Yes and no.

Problem is, the world — and the insurance world in particular — is learning more and more about risk, and more and more about the intimate details of the people it chooses to insure. It’s a simple fact of business that insurance is, in fact, business.

If an insurer could find a way to screen out poor risks — if the industry could find a way to drop poor risks altogether — it would do better financially.

Right now, my smartphone keeps track of the distance I walk every day. I didn’t actually ask it to do that, but it has records going back to when I got the phone. It’s interesting data my insurer might like to have and might even request. It’s not inconceivable that my phone might prove whether or not I lied about the amount of physical activity I do in a week.

I remember well when I first got life insurance separate from work and an extremely pleasant relative of Count Dracula showed up at my house, stuck a needle in my arm, and drained several vials of blood to screen me for things that would make me a poor prospect.

I’m sure they’d like to screen for more issues, and I’m sure that, as the years go by, researchers will have a better and better idea about what I’m predisposed to have happen to me. Eventually, researchers, doctors and insurers will probably have a pretty good idea what will finish me off — unless, of course, it’s a careless step off a curb and an intemperate meeting with the front end of a speeding bus.

They might not get an exact when and why, but insurance companies will always want to shed risk. It might even lower insurance premiums for those outside the risk pool — but in a way, it will also stop being insurance.

Canadian insurance companies agreed to voluntarily halt asking potential customers to reveal any genetic testing they’ve undergone if the customer is looking for $250,000 or less in life insurance. The pledge came only after a proposed law was put forward banning the practice in Canada — the law was proclaimed last week, but the federal government plans to refer the law to the Supreme Court.

But as our neighbour to the south proves all too well, things change.

If you are the perfect client for insurance, you’re someone who pays in, without ever filing a claim.

When will illness stop being fate, and start being predisposition?

Quicker than you think. We’re more than halfway there now.

Russell Wangersky’s column appears in 29 SaltWire newspapers and websites in Atlantic Canada. He can be reached at rwanger@thetelegram.com — Twitter: @wangersky.

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