Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
AIDS and Insurance: A Response to Mark Scherzer
AIDS & Public Policy Journal 3, no. 3 (1988): 49-54 David K. Nelson
In an earlier issue of the AIDS & Public Policy Journal, New York attorney Mark Scherzer wrote a broadly based attack on human immunodeficiency virus (HIV) antibody testing by insurance companies. In the same issue, other authors presented the industry's position on this subject. It should come as no surprise that the life and health insurance industries are opposed to any efforts to restrict access to test results or burden their right to administer own series of tests or base their underwriting decisions on test results. The industry's arguments were well presented in that issue of the Journal, and it is not my intention to restate them. However, a detailed discussion of Scherzer's specific arguments may still be in order. Scherzer raises some issues to which industry spokesmen have not directly responded. Furthermore, these issues deserve reappraisal in light of our advancing understanding of AIDS. Finally, Scherzer's arguments (or at least his opinions) have found a sympathetic ear in some quarters, and the opinions set forth here may serve to fuel the continuing debate on HIV testing for insurance purposes. In restarting Scherzer's views, I will attempt to do justice to his position. Scherzer's arguments can be reduced to six main points: (1) If insurers are allowed to test for antibodies to HIV, gay men will be treated unfairly. (2) Even if unfair treatment of gay men does not result from HIV testing, gays are a disfavored minority and deserve "affirmative action." (3) If insurers are allowed to test, the information may be put to other, more damaging uses. (4) Insurance is so necessary that society has the right to interfere with sound underwriting standards in the name of larger social goals. (5) We do not know enough about AIDS and HIV infection to justify the use of HIV infection in underwriting decisions. (6) the insurance industry's argument that AIDS should be underwritten like any other serious impairment is inappropriate because AIDS is a special case. I intend to address each of these points in turn. A few preliminary comments are in order. Scherzer has written a "gay rights" piece rather than a medical or technical discussion of either AIDS as a disease or insurance underwriting, and he backs his position with some assertions that I frankly doubt he would state with as much force were he to argue his case today. While it may not be fair to discuss Scherzer's arguments as though he would continue to support them, such a discussion remains timely because his opinions continue to be cited with much force even though the factual underpinnings have been eroded.
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Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
