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PubMed2002

Health insurance and discrimination concerns and BRCA1/2 testing in a clinic population.

The discovery of the breast cancer genes BRCA1 and BRCA2 has afforded those who seek breast and ovarian cancer risk counseling the option of genetic testing. Concerns about cost, confidentiality, and the potential for discrimination, however, may prevent some women from pursuing genetic testing. To determine the impact of these concerns on BRCA testing, we studied a cohort of 384 patients presenting de novo to a Breast and Ovarian Cancer Risk Evaluation Program, between January 6, 1997 and March 13, 2000. Of the 184 individuals who were themselves primary candidates for testing, 106 (58%) underwent BRCA1/2 sequencing. Of the 78 eligible patients who declined testing, 48 cited concerns about cost and insurance discrimination as their reason. On the basis of the number of positive results ascertained in the tested group, we estimate that approximately half of patients declining testing because of insurance coverage concerns would be positive for a BRCA mutation. We were unable to document any experiences of test result-based discrimination, although there were other negative insurance-related experiences. We conclude that in a high prior-risk clinic population, approximately one-quarter of patients eligible for BRCA testing may decline because of concerns about cost, confidentiality, and discrimination. Our research provides evidence that these fears may be discrepant with the actual experiences of patients in high-risk clinics.

Adult↗
PubMed1979

[Health insurance and hypertension. Review of current data].

Medical insurance gives a very incomplete view of the spectrum of hypertensive disease, based only on the results of clinical examination of persons undergoing check-ups in the Medical Examination Centres: 39 850 in 1976, or on those examined by consulting physicians according to article L293: 23 308 in 1976, or being examined for invalidity allowance: 11 471 in 1976. The complications of hypertension do not appear in these statistics under the label of hypertension. They have been estimated and, when taken into account, increase the total number of hypertensive patients detected in 1976 by the Medical Insurance to 99 318, that is to say 0,25% of the covered population. An inquiry carried out on 130 male hypertensives in the Paris region tends to approach the medico-economic profile of the hypertensive patient with respect to age.

Adult↗
PubMed2002

[Appropriate health insurance for traveller abroad].

BACKGROUND: Increasing numbers of Norwegians are residing abroad temporarily or permanently; one out of three of them will contract illness. There is, however, uncertainty as to what coverage various insurance plans provide. MATERIAL AND METHODS: The insurance terms and conditions referred to in this study have been obtained from the biggest Norwegian insurance companies and from the national insurance scheme in Norway. RESULTS: The national insurance scheme only provide partial coverage of expenses for its members if they fall ill abroad. To be ensured full coverage, travellers must have additional private medical insurance. INTERPRETATION: The terms offered by insurance companies are unclear and should be restated so that individuals travelling abroad know with certainty whether or not they are covered. New types of insurance policies should be offered so that all travellers can be sure that their expenses will be covered in case of illness abroad.

Humans↗