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—Dr Tyson is correct in identifying that medical costs associated with family violence, which includes domestic violence, child abuse, and elder abuse, represent a staggering and impressive part of the total health bill of the United States. It is important that such costs be identified and that all participants, including insurance companies, assist in preventive and educational efforts to minimize this cost. The program described by Tyson appears to be this kind of program, and he and the Pennsylvania Blue Shield Institute need to be congratulated.I am further heartened that Tyson agreed with the need to eliminate discrimination in the insurance industry for victims of family violence. Certainly, those instances in which an attempt either not to insure or to increase substantially the rate for individuals identified as victims of family violence seem inappropriate and even actuarially questionable. In July 1995, Timothy Flaherty, MD, an AMA trustee,
McAfee RE. Family Violence and the Insurance Industry: Education, Not Discrimination-Reply. JAMA. 1995;274(18):1428. doi:10.1001/jama.1995.03530180022023