HIV and Insurance Testing - by Joshua Frear

William Gifford argues against HIV tests for health insurance applications. His argument, in part, hinges on a view of health insurance that I believe is incorrect. For Gifford, health insurance is a right of everyone. Health insurance is actually a cost-benefit analysis by a private, for-profit firm. This works for societal benefit, because (reminiscent of Adam Smith), the benefit of the company lines up with the good of the members of society. The insurance company wants its insurees to stay healthy, and if they do get sick, to recover to health quickly. That is also what insurees want. But what about those who are already sick and now wish to get health insurance? The company, if it takes on sick individuals, is guaranteed to lose money in the deal. There seems to be some aspect of fair play that is being violated here, when sick individuals get health insurance. They weren’t willing to pay the monthly premiums before, but now, they want the benefits. Clearly, if health insurers had to take on sick individuals, they would be out of business within the year. People would wait until they got sick to get health insurance, and there would be no way the company could even pay its employees.

I don’t think that Gifford wants to allow all sick people to be insurable; he just wants those who have HIV but not AIDS to get insurance policies. HIV can remain latent and asymptomatic for over a decade. The policy would not be covering AIDS care as much as it would be covering other health care. The primary problem with this view is that HIV is not unique in its ability to remain latent for long periods of time. If HIV carriers can be insured, then latent TB carriers and latent syphilis carriers, for examples, have to be able to be insured, too. The link between HIV and AIDS is clear and unmistakable. If it were not, then insurance companies would be willing to take a risk on HIV carriers. The uninsurability of HIV carriers has nothing to do with racism, despite Gifford’s allegations. It has to do entirely with money and risk. That is the necessary basis of all types of insurance.