How is the trade-off between adverse selection and discrimination risk affected by genetic testing? Theory and experiment

J Health Econ. 2019 Dec:68:102223. doi: 10.1016/j.jhealeco.2019.102223. Epub 2019 Oct 1.

Abstract

We develop a theoretical analysis of two widely used regulations of genetic tests, Disclosure Duty and Consent Law, and we run an experiment in order to shed light on both the take-up rate of genetic testing and on the comparison of policyholders' welfare under the two regulations. Disclosure duty forces individuals to reveal their test results to insurers, exposing them to a discrimination risk. Consent Law allows them to hide any detrimental information, resulting in adverse selection. The experiment results in much lower genetic tests take-up rates with Disclosure Duty than with Consent Law, showing that subjects are very sensitive to the discrimination risk. Under Consent Law, take-up rates increase with the adverse selection intensity. A decrease in the test cost, and in adverse selection intensity, both make it more likely that Consent Law is preferred to Disclosure Duty.

Keywords: Consent Law; Disclosure Duty; Personalized Medicine; Pooling health insurance contracts; Test take-up rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disclosure / legislation & jurisprudence*
  • Female
  • Genetic Testing / legislation & jurisprudence*
  • Humans
  • Informed Consent / legislation & jurisprudence*
  • Male
  • Patient Acceptance of Health Care*
  • Precision Medicine
  • Young Adult