Insurers, Citing High Cost of Health Care, Tell Panel of Need to Screen for AIDS

Health insurance officials, citing the high cost of treating AIDS patients, urged Friday that companies be allowed to screen individuals for the presence of AIDS antibodies before deciding whether to insure them.

Health insurers need an “objective benchmark on which to make a decision,” Dr. Donald Chambers, vice president of the Lincoln National Life Insurance Co., told the House Energy and Commerce health and environment subcommittee.

Chambers, testifying on behalf of the Health Insurance Assn. of America, said that the association’s 335 companies are “exploring the possibility” of using blood tests “to protect our policyholders” from high premiums that result when companies pay out AIDS benefits. The average hospital cost for an AIDS patient is $147,000, according to the federal Centers for Disease Control in Atlanta.

‘Unfair Subsidization’

Chambers, criticizing recent laws in California and Wisconsin that prohibit insurers from using the antibody tests, said that such legislation results in “unfair subsidization of the higher-risk group by the low-risk population.”

A positive test for antibodies does not mean a person necessarily has the disease, only that he has been exposed to it. Researchers say that only 5% to 20% of those who have been exposed to the virus contract the disease.

But Chambers asserted that those probability figures “may well underplay the level of seriousness of the carrier state.” He noted that about 25% of those exposed to the virus go on to develop symptoms of the disease, a condition known as AIDS-related complex, and that it too can be serious and costly.

Chambers said that the screening would apply to individual policies, not group policies. He cited the Defense Department’s recent announcement that it will screen all military personnel for the virus as evidence of the test’s usefulness. But critics have argued that when the government approved the use of such a test it did so only to help blood banks screen out blood contaminated with the AIDS virus, HTLV-III.

Amid forecasts of a continuing AIDS epidemic, concern has grown among insurers that mounting claims could put them out of business. Also, hospitals around the country assert that they are losing money on AIDS patients who are unable to pay because they have lost their health insurance along with their jobs.

Cost Predictions Difficult

Dr. Ann Hardy, an epidemiologist at the Centers for Disease Control who conducted a study on the patients, told the hearing that it is “difficult to predict” how much health care will cost for the next 10,000 patients.

The incurable acquired immune deficiency syndrome has struck more than 14,000 persons, killing half of them. The disease, which is transmitted through body fluids, attacks the immune system and leaves victims vulnerable to diseases that otherwise would not be fatal.

Rep. Henry A. Waxman (D-Los Angeles), chairman of the subcommittee, said that “when an epidemic strikes, special responsibilities arise,” adding that hospitals must not “hide from the costs” of caring for patients, and insurance companies “should not be permitted to use guesswork to underwrite risks.”