The life insurance industry’s policy of excluding HIV=20 carriers from assurance is short-sighted and=20 irrational, argues Ryan Goodman
PAUL Truyens’ response to Cheryl Carolus’ criticism of=20 the life insurance industry’s policy on HIV and Aids,=20 (M&G June 15 to 22), cannot go unanswered.
Truyens’ argument that the life assurance industry is=20 justified in excluding people from all forms of life=20 assurance — and thus in cutting them out from access=20 to financial services such as home loans — is short- sighted and irrational. It also fails to meet the=20 central thrust of Carolus’ argument, which is that life=20 assurers in South Africa owe a duty of social=20 responsibility to our society as a whole. In this the=20 life assurance industry is at present abjectly failing.
Everyone in South Africa will be affected by Aids. To=20 draw a distinction between the “rights” of the “non- infected” versus the “infected” is misleading and=20 counterproductive. This issue requires the co-ordinated=20 efforts of government, labour and business if we are to=20 emerge from apartheid without recreating a new regime=20 of discrimination.
The current policy of insurance companies threatens to=20 undo efforts towards understanding and resolving the=20 impact of Aids, both on the lives of individuals and on=20 the nation as a whole. Carolus and her husband wanted=20 to secure a home loan — not to obtain life assurance.=20 An HIV bar would not only brand her permanently=20 uninsurable, but also ban her from home ownership.
This has significant implications for racial matters.=20 As African and coloured South Africans are now finally=20 able to become home owners, these new requirements=20 frustrate their access. Conversely, current home owners=20 (who are disproportionately white) are not forced to=20 undergo testing, forgo their rights of privacy, risk=20 the inevitable threat to confidentiality of test=20 results, nor face direct and unfair discrimination.
In addition, the preponderance of black persons with=20 HIV among the rising national levels renders any policy=20 of HIV exclusion inherently suspect. This criticism=20 focuses on the effect, not necessarily the intent, of=20 such a policy.
It is critical to the nation’s economy that HIV status=20 becomes de-linked from financial services such as=20 housing bonds, education insurance, and basic loans.=20 Many economic forecasts already predict financially=20 deleterious effects because of the premature loss of=20 highly productive lives in the Aids epidemic. This=20 factor is made significantly worse by insurance=20 companies closing off all persons with HIV from access=20 to financial security.
It is medically established that a person with HIV may=20 lead a healthy, asymptomatic, fully productive life for=20 more than 15 years after acquiring the virus. Denying=20 people with HIV from access to economic opportunities=20 and services is thus not only ethically unjustifiable=20 but financially irrational. There are currently an=20 estimated 1,2-million cases of HIV in South Africa,=20 with a projected rise to 10-25 percent of our total=20 population. Denying financial viability to a=20 significant portion of our domestic labour force is an=20 exercise in economic injustice.
If persons with HIV are uniformly excluded, Truyens’=20 “current policy holders” (who largely resemble the=20 white home owners) will still have to pay — through=20 the taxes and trade-offs incurred by shifting the=20 burden to public assistance. Further, if Truyens’=20 calculations regarding the impact of Aids on the life=20 assurance industry are correct, continued=20 discrimination is pointless. Since HIV exclusions=20 primarily apply to individual policyholders and not the=20 vast body of group-based insurance, the system will be=20 overwhelmed anyhow. Moreover, since nothing prevents an=20 individual from contracting HIV the day after becoming=20 insured, the industry’s approach can only safeguard=20 against those already diagnosed.
If the insurance industry is interested in safeguarding=20 itself from the Aids epidemic, it should cease=20 discrimination. The National Academy of Science in the=20 United States has warned that “(t)he general threat of=20 discrimination in employment or insurance … may deter=20 individuals in high-risk groups from being tested to=20 ascertain their antibody status. Since knowledge of=20 antibody status may prompt some individuals to adopt=20 healthier behaviour, social disincentives to testing=20 should be minimised.”
The National Convention on Aids in South Africa=20 (Nacosa) holds a similar view, which is also endorsed=20 by the Department of Health. The Nacosa National Aids=20 Plan recognises that discrimination encourages denial=20 and failure to seek education or change behaviour:=20 “Combating all forms of discrimination is therefore=20 crucial to preventing or limiting the spread of Aids.”
Goodman works for the Aids Law Project at Wits=20 University’s Centre for Applied Legal Studies
In any event, one of the few reliable studies on the=20 economic impact of Aids in South Africa states that=20 “current evidence suggests that the degree of exposure=20 will not be sufficient to constitute a threat to the=20 viability of insurance companies, especially in view of=20 their substantial reserves”. (Jonathan Broomberg et al,=20 The Economic Impact of Aids in South Africa, September=20
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