Presently DNA tests are neither requested nor used when health insurances are taken out in Germany. However, most notably the private health insurances have investigated the possibilities for and the future implementation of genome analysis and any implications it would have for the health insurances market. The focus has been both the increasing accuracy, economic viability and the availability of diagnostic genetic tests and the demand on behalf of the insured.
The implementation of genetic testing is presently not included in the insurances' risk calculation. It needs to be investigated whether insurances should have the right to access their clients' genetic information. Although this implies that at present there is no apparent economic use (benefit) for genome analysis, it is possible that in the near future it could become profitable within the private insurance sector to do so.
The social health insurances and the Commission of the German Parliament see a new danger of further risk distinctions based on genetics, since individual companies will make use of every possibility to embrace so-called "low risks" and exclude "high risks" in their cost calculations. Considering the imminent deregulation of the insurance sector, discounted premiums and risk-money within the private sectors affect the member structure and structure of contributions of the social insurances. A bonus/ high risk premium system devised by the private health insurances on the basis of (voluntary) genome analysis would increase the difference in risk categories between the clients of social and private health insurance companies. Basic principles of solidarity of the German social security system would be endangered if such a far reaching genetically argued risk distinction came to fruition.
The Europeanisation of the insurance landscape that is resulting in increasing interconnection of large insurers in Europe, the shift of insurance companies from national markets to the European market and the increasing opportunities for the insured to select health insurance freely, calls for an international perspective when assessing the national situation.
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