RT Journal A1 Brandt J, Quaid KA, Folstein SE T1 INsurance and the presymptomatic diagnosis of delayed-onset disease-reply JF JAMA JO JAMA YR 1989 FD November 3 VO 262 IS 17 SP 2385 OP 2385 DO 10.1001/jama.1989.03430170044018 UL http://dx.doi.org/10.1001/jama.1989.03430170044018 AB In Reply. —  We thank Quarrell et al for highlighting some of the social issues raised by presymptomatic diagnosis of disease with molecular genetic tests. As clinicians and researchers testing for Huntington's disease, we are concerned that those found to be at increased risk for this illness not be subject to unreasonable discrimination. While Quarrell et al admonish us to be realistic about the needs of the insurance industry, our central concern will always be for the health and well-being of those who seek our counsel, technical expertise, and care.We are very aware that the insurance industry is based on the concept of differential risk. Those who have poor driving records pay higher premiums for automobile insurance, and tobacco smokers often pay higher life insurance premiums. This discrimination, most would agree, is fair and just. However, we as a society have decided that some risk variables should not be