Insurance Denials for Genetic Testing: Testing the Durable Relationship of Socioeconomic Status and Health

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  In Refereed Roundtable 60min: Table 4. Cultural Authority of Medicine

Abstract

Drawing from a case study of insurance denials for genetic testing, this paper considers how the integration of Bourdieausian concepts into fundamental cause theory can increase the theory’s utility in health disparities research. In the past 10 years significant advancements have been made in developing precision medicine technology that aims to improve population health by providing tools that will better predict, diagnose, treat, and monitor disease on an individual basis. Most patients in the U.S. who might benefit from this new medically technology depend on their health insurance, but health insurance payers have been slow in revising their coverage policies to permit insurance coverage. As a result, many individuals seeking health insurance coverage genetic testing, may instead receive an insurance denial for their claim. Fortunately for some, an insurance claims denial is not always mean a dead-end for patients seeking financial assistance to cover the high price tag of new medical technology. By drawing interviews with women diagnosed with breast cancer (N=24), this paper illustrates how, despite a health insurance denial for genetic testing, individuals may rely on non-material forms of capital to successfully overcome insurance constraints to this diagnostic technology. This analysis uses Bourdieu’s capital theory to consider how an individual’s social, cultural, and economic capital dynamically interacts with the structures of the healthcare system to grant access to new medical technology. In doing so, we gain a novel perspective on the multidimensionality of socioeconomic status (SES) and advance our appreciation for the fundamental and durable relationship between SES and health.

Author

• Emily Allia Hammad Mrig, Yale University