From the 1980s up until the early 2000s, it was nearly impossible for someone living with HIV to access insurance products, and they often struggled to access products linked to insurance, such as mortgages. For many gay and bisexual men (regardless of their HIV status), invasive “lifestyle” questionnaires, mandatory HIV testing, heavily-loaded premiums and a refusal to accept the validity of long-term relationships, were a common experience when seeking life and protection insurance.
Happily, thanks to persistent campaigning by LGBT+ and HIV activists and the introduction of strict guidelines on what can be asked in application processes, many of these practices have now been eradicated and access has been improved.
People living with HIV can now access banking services, general insurance products such as motor, buildings, and home contents, and pensions and savings products without any need to mention their status.
Where health information is required, there have also been improvements to access. Recent reforms in travel insurance mean that someone with a CD4 count of 400 or above and an undetectable viral load who is otherwise healthy should be able to get cover at no extra cost.[1] Life insurance for people living with HIV has been available since 2009, and the quality of cover is rapidly improving.[2]
Evidently, access has improved considerably for people living with HIV and this should be celebrated. However, the research NAT took in the report HIV and Finance highlights that there is still room for improvement.
NAT found that one in four (25%) people living with HIV have been refused a financial product or quoted an unaffordable insurance premium in the last five years. Some insurance products, such as income protection insurance and critical illness cover, still remain completely unavailable to people living with HIV. Given the significant improvements in mortality and morbidity of people living with HIV since the introduction of effective treatment, NAT question whether this treatment is proportionate to the reality of living with HIV today.
People living with HIV often struggle to navigate a marketplace which caters for the mainstream – with only three in ten (28%) saying they knew where to look for HIV-inclusive financial products.
NAT also identified persistent remnants of the discriminatory past. Critical illness cover policies will only pay claims for HIV when acquired through an occupational injury or assault. By singling out HIV as the only condition where mode of transmission is relevant to the success of a claim, insurance providers are continuing to engage in stigmatising and discriminatory practice.
Bad practice past and present, as well as current levels of societal stigma, has led to three in five (60%) people living with HIV avoiding applying for financial products because of their HIV status. This self-exclusion is largely due to fears of refusal, higher costs and stigma.
Financial products protect against financial shocks and help promote financial resilience, which can support adherence to treatment and the long-term financial security of an ageing population of people living with HIV. It is therefore crucial that HIV organisations and financial service providers work together to more widely disseminate information to improve understanding of the availability of financial products to people living with HIV.
People living with HIV aren’t alone in facing these barriers to access. They are part of the 15 million people living with a long-term condition in the UK today, and we know that many in this group struggle with the same barriers to access as those living with HIV.
The report highlights that these issues require strategic action from a range of stakeholders, including the financial services industry, the financial services regulator (the Financial Conduct Authority), and the government. NAT have outlined a range of policy and practice recommendations that should be implemented, whilst recognising that further work is needed to resolve some of the more complex issues of access. NAT is determined to continue championing the financial inclusion of people living with HIV, ensuring our recommendations become a reality.
The report states improving access is a win-win situation for all involved. It presents a significant market opportunity for businesses who adapt their approach to better meet the needs of people with HIV and other long-term conditions. It ensures that regulators and governments are protecting consumers and citizens from harm. Finally, and most importantly from NAT’s perspective, it enables people living with HIV and other long-term conditions to better protect themselves financially.
The full details of our research and recommendations are outlined in the report HIV and Finance: Exploring access to financial services for people living with HIV in the UK.
If you are living with HIV and need further information on the availability of financial products, you can visit NAM Aidsmap’s resource on Personal Finance.
[1] Viral load tests measure the amount of HIV’s genetic material in a blood sample, whilst CD4 count tests indicate the strength of the immune system. A viral load below 50 is classed as undetectable – meaning the virus is at a very low level and cannot be passed on. CD4 count. People living with HIV who have a CD4 count over 500 are usually in good health. For further information see http://www.aidsmap.com/CD4-viral-load-amp-other-tests/page/1327442/
[2] For example, life insurance terms were usually capped at 10 years when policies were first introduced in 2009. Recent research by specialist broker Unusual Risks showed that the average length term insured is now 19 years, with the longest term at 25 years.
Blog post shared from NAT.org.uk
The new analysis shows the impact of tax, benefit and public service changes at the intersection of income, gender and ethnicity for the first time. It covers fiscal policy from 2010 up to and including the 2016 Autumn Financial Statement which projected to 2020.
The analysis shows that by 2020:
- Individuals in the poorest households will lose most from tax and benefit changes, but in every income group BME women will lose the greatest proportion of their individual income.
- Low income black and Asian women will lose around twice as much money as low income white men as a result of tax and benefit changes.
The analysis also shows that lone mothers are hardest hit:
- Out of all household types, lone mothers are hardest hit by cuts to services and tax and benefits changes followed by lone fathers and single female pensioners.
- Among lone mothers, it is again BME women that lose the most.
Keep an eye on the Women’s Budget Group website for its comprehensive response to the 2016 Autumn Financial Statement (to be published 15 December).
The RSA launches the Citizens’ Economics Council, supported by Barrow Cadbury Trust and Friends Provident Foundation, on Wednesday 29 June. In this blog, which was first published on the RSA website, Anthony Painter, Director of the Action and Research Centre at the RSA, discusses the implications of the referendum result for democracy and refers to the predictions of the 2013 Policy Network publication ‘Democratic stress, the populist signal and extremist threat’ which was also supported by Barrow Cadbury Trust. Sign up to attend the launch event.
The EU referendum is now done and the UK has voted to leave the EU. It was anything but a glorious advert for British democracy.
On one hand, we had a campaign that was willing and determined to set people against one another by their ethnicity, their class, and whether they were ‘experts’ or ‘elites’. The other campaign, when it wasn’t in melodrama mode, deployed the modern organisational technology of political narrowcasting. In so doing, it ignored a huge part of the country, on the basis of its probability of supporting its campaign. As a consequence, whole areas – including many traditional Labour areas in the north crucial to the outcome – heard only the discordant voice of Faragism.
Much has been made about the fact that this referendum was a choice about the types of values that our country epitomises. The referendum was indeed that but more besides. It was also a choice about the type of democracy we want to be. There are deeper democratic and social forces at play – how they are resolved will be one of the critical decisions we as a society make in the coming years.
For many decades now trust in representative democracy has been in decline. Interestingly, many of the advocates of leave framed their argument in terms of defending parliamentary democracy. But it was no such thing. Representative liberal democracy relies not only on the consent of people but on a set of institutional arrangements that can meet their needs and protect their rights – from independent legal institutions to international cooperation. ‘Take back control’ ultimately rejects this web of relationships in favour of some general ‘will of the people’. But how is this ‘will’ formed?
The answer is by substituting individual instincts and emotion for expertise, representation and institutional structures that put a break on populist impulses – if only to force us to pause for thought. Not only in politics but in education, health, business, local governance, and policing too, we are ever more willing to put our personal judgement ahead of ‘experts’ or ‘so-called experts’ as they have come to be known. The experts failed to convince their fellow countrymen and if their post-Brexit prophecies do not come to pass then the schism will become deeper.
Scrutiny and a degree of scepticism is not in itself a bad thing of course – the high-trust society had major drawbacks as Hillsborough, the increasing share of national wealth taken by the top, figures of trust preying on children, and the scandal of Mid-Staffordshire NHS Trust all show. Healthy scepticism is just that – healthy. Too often, however, we are replacing scrutiny and scepticism with a trust in our own instinct and cynicism. It is ‘me the people’ rather than ‘we the people’.
So the legitimacy of hierarchy is threatened but then replaced with a notion of democracy centred around populist individualism – whether it’s ‘take back control’ or ‘make America great again’. The foolish aspect of the decision to hold this referendum was the notion that it would resolve anything. Instead, it has released the forces of populist individualism. Far from being a political alternative, populism is actually an alternative form of democracy. The aim is not simply to replace parties and powers within representative democracy, it seeks to replace representative democracy itself. These forces may be difficult to contain now. Labour is seen to have deserted whole swathes of its traditional support; Conservatives are seen as vacillating and untrustworthy. The mainstream is brittle.
This was all predictable. In a paper on populism, extremism and democracy back in 2013, I wrote of the referendum pledge:
“As a strategy to minimise the space for the UK’s populist radical right party (UKIP), David Cameron’s EU referendum pledge is likely to be a misguided one. It may split away a portion of his party, threaten his own leadership, give profile to a populist party that he cannot or will not match, boost the brand image of UKIP in the eurosceptic media, and fail to address the real underlying anxieties of voters who are attracted to UKIP. It is a considerable opportunity for UKIP as they are given the spotlight in a way they have not been able to secure in their entire history.”
This feels like a scenario that is closer to the current reality than a ‘lancing of the boil’ that the Prime Minister was hoping for. The same paper recommended a process of ‘contact democracy’ where the political mainstream engaged in a process of democratic engagement in a discursive rather than campaigning fashion. A discursive democracy is a very different approach to individualist populism and tired, narrowcasting, hierarchical representative democracy. Discursive democracy breaks down the barriers between experts and the people, the governing and the governed, policy and politics. In other words, it flattens democratic engagement and eschews false divides, opening out and making democracy more solidaristic as a consequence.
Next week, the RSA will launch the Citizens’ Economic Council which is in an experiment in discursive, solidaristic, contact democracy. Essentially, a demographically diverse group of 50 – 60 citizens selected using stratified random sampling methodology will, over the course of a year, deliberate on the big economic questions of the time and make their own recommendations for future economic priorities – including the fundamental objectives on which economic policy is based. Economists have had a tough ride of late – justifiably some might argue – but this opens up the black box of economic thinking to the laity. We are intrigued to see the outcome.
This is but one experiment and others have been successfully run previously as tracked by Claudia Chwalisz in The Populist Signal. An unstated conviction at the heart of this experiment has to be that if representative democracy is to face continuing pressures then there has to be an alternative that is not akin to the referendum campaign we have just endured.
Democracy is hard; it requires work. Representative democracy was a hard won battle. The historian E.P.Thompson has described the two centuries-long making of the English working class. World War II contributed an accelerated politicisation. An exclusively class-centric politics doesn’t feel right for these more plural times. Class is important but just one component of political consciousness. However, we can’t just allow democracy to be a battle between an untrusted ‘elite’ and an impulsive political discourse. Democracy works best when it challenges all of us to think, discuss, and reflect. That’s where models such as the Citizens’ Economic Council come in.
There’s lots of unfinished business post-referendum: the presence in our midst of far-right violent extremism, how we can find the right relationship with the post-Eurozone/post-crash EU from which we intend to depart, and the future of political parties that are split in quite fundamental ways. But we desperately need to take time to understand the democratic mess that we have created. In reality, democratic forms co-exist. We might want to reflect on how we can bring people into the process of making better informed decisions about the national future. That means a bigger role for people in our democracy.
Sign up here for the launch of the RSA Citizens Economic Council
