Talley: Coverage Cheaper Than The Alternative
By Shaun Kenney | Tuesday, February 1st, 2011 | PolicyLee Talley, a longtime Republican activist and a key supporter of HB 2467, writes on the importance of coverage for children with autism and the reasons why coverage is a better alternative than the current system. His guest post for Bearing Drift is below:
On the eve of the third reading and I hope the passage of Tag Greason’s Autism Insurance Reform Bill (HB2467), I am happy to see the cause of families with children and loved ones with Autism being a hot topic of debate on the blogs and Facebook pages of Virginians everywhere.
However I am deeply disappointed in our oppositions continued disrespect and prejudice when they attempt to argue against such needed legislation.
Yes folks, I will tell you up front this will cause your insurance to go up. It will go up LESS THAN 40 CENTS A MONTH. It will not bankrupt the taxpayers and it will not cause 8 million more mandates to be passed.
It is in no way similar to Obamacare. In fact even Obamacare does nothing to cover medically necessary treatment for autism. In fact the word autism is not even in the Obamacare bill.
The people who are paid to advocate against this bill like saying it’s a educational problem. They are wrong and insulting every person who has autism. Autism is a neuro-biological dysfunction of the brain. The brain is not working correctly! They say it’s a educational problem it should be treated in the school system. If that is so then why don’t we send kids that have heart defects to school and not to a hospital? Maybe we could educate their heart to work better. If that sounds crazy to you then why do they continue to deny our children affordable access to treatment for a brain injury?
Here is an explanation I gave earlier about the difference between medically based verses education based treatment.
What people confuse about the educationally verses medically based treatments is they tie the setting of the therapy to the therapy performed.
The treatments are to force the brain to develop stronger neural pathways to route around the damaged autistic brain so that the child can achieve as normal a life as possible. These treatments though are no different than you or I going to physical therapist for a hurt leg or physical injury. Those treatments are considered medical and so are the therapies needed for children and adults with Autism.
If you or I have a stroke we aren’t sent to school to get speech, occupational, or physical therapy. We get our medical needs serviced by healthcare professionals. Speech, occupational, or physical therapy is no different for Harry than for a stroke victim yet the stroke victims therapy is covered under the insurance.
ABA therapy goes to the core of the matter. It is provided by trained psychologists who are working with the physical brain as much as a orthopedic doctor would work with the physical structure your body to heal it. The activities are more than academic but all are structured to stimulate growth of neural connections in the brain to heal and work around brains damaged by the autism.
At the end of the day making the education system the primary care givers for autism is the same as sending your child to kindergarten to get brain surgery.
Let us talk about costs too at the beginning I said that this would cause a premium increase, less than 40 cents per month. Here are notes from the 2009 JLARC Study on Autism Services in Virginia:
“A study published in a national journal found that Pennsylvania could save an average of $187,000 to $203,000 on each child who received three years of EIBI relative to one who received special education services until age 22. The Pennsylvania study also suggested that cost savings would likely continue to accrue after children exit the school system. The study found that the state could save from $656,000 to $1.1 million per child if expenditures up to age 55 are included.
Another study published in a national journal found that Texas could save an average of $208,500 in education costs for each student who received three years of EIBI relative to a student who received 18 years of special education from ages four to 22. Applied to the estimated 10,000 children with ASDs in Texas, it was estimated that the state could save almost $2.1 billion by implementing intensive treatment programs.”
Source: 2009 Report of the Joint Legislative Audit and Review Commission to the Governor and General Assembly of Virginia (JLARC Report)
These two studies show the lifetime societal cost of having a child with Autism.
Harvard School of Public Health (Ganz, 2006) $3.2 million per person over lifetime
Includes direct and indirect costs, such as lost productivity
Pennsylvania (Green, Jacobson & Mulick, 1998)
Over $1 million per person
I could add to these statements but I’d rather let the studies speak in their own words.
At the end of this all folks all I ask is give families who fight this your respect. Don’t deny the fact that this is a real and honest disability just like MS, Cerebral Palsy, Childhood Cancer, Diabetes, etc. after unfortunate etc.
If you think its too expensive to treat now imagine what it will cost later when all these kids are in group home settings and are wards of the states. Who cares for these children when they are adults and their parents have passed on? That would be each and every taxpayer in Virginia. That’s who.
1 in 70 boys and 1 in 110 children born today have autism. I know lots of you our there are starting your families. I pray every night each one of you do not have to lay your head on the pillow wondering what will be of your child when he or she is grown and you are not there to understand them or to love them or to show them the attention they need when something is just beyond their abilities.
God Bless and thanks to Bearing Drift for allowing me to speak to you on such an important issue.
P.S. – Call your Delegate tomorrow and ask them to support HB2467 as it comes up for vote on the floor of the House of Delegates.
Click here for the full Autism Speaks PDF.
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About the author
Shaun Kenney is the Chairman of the Fluvanna County Board of Supervisors, former Communications Director for the Republican Party of Virginia, and an active blogger since 2002. Shaun lives in Thomas Jefferson's backyard with his wife, six children, and a modest attempt at a farm in Kents Store, Virginia.
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10 Responses to "Talley: Coverage Cheaper Than The Alternative"
I apologize profoundly for reposting this again but it seems to fit here too.
Reposted from the DJ post I didn’t see anything about how to define autism. This is not cancer or diabetes. Are you all aware there has been an exponential rise in “autism” cases over the last 20 years? Is this due to an increase in “real” autism? How are you defining Real autism? If the increase is real as opposed to definitional we have a public health crisis. Autistic people at least in the past were typically considered as having major dysfunctionality. If it is definitional then we are simply reclassifying people from one category to another or including large numbers of marginally affected individuals who can function well enough in society. If it is real then urgent action is needed to identify the cause. Health Insurance would be the LEAST of our problems. If it is definitional then we need to calm down and carefully reanalyze the data. Otherwise we will encourage people to game the system. But that would fly in the face of our desire for hysteria.
http://www.firstsigns.org/screening/DSM4.htm
There is your definition of Autism according to the DSM IV. Again everything in the bill is medical and science based!
Great post Lee.
I’m sorry that I wasn’t clearer. The diagnosis of a neurologic condition such as autism or even Alzheimers is rarely as conclusive as the diagnosis of diabetes or cancer since there isn’t some simple blood test or biopsy which can be performed, at least with our current state of knowledge. The question is why over the past 20 years is there an exponential rise in the numbers of people classified with this serious condition? Is it due to changes in the way practitioners apply the definition now compared to 20 years ago or is it a “real” increase. As far as I’m aware there is a division of opinion in the scientific community as to whether the increase is real or definitional. Since ‘true’ autism is a serious condition requiring extensive care and support for many years and sometimes for life (something I would be in favor of providing in some way) we really need to know why there is an exponential rise and who truly has the condition. Otherwise resources will be poorly distributed and the numbers may continue to rise.
valentinus,
I encourage you to check out the great scientific work being done by Autism Speaks and the Autism Science Foundation.
[...] of this bill and how it forces private insurers to provide and specified type of coverage, but as Shaun Kenney highlights over on Bearing Drift it is the right thing to [...]
I wouldn’t argue against autism being a medical condition. I am concerned that any mandates from the government as to what insurance must cover interfere in the free market, and I am concerned that “less than 40 cents a month” could build up as the government forces coverage for one problem after another. If the free market were allowed to work naturally for health insurance, I would think it would be easier to find coverage for what autistic people need. Doesn’t the “no buying across state borders” thing particularly interfere in niche markets?
Since it is a chronic illness it should be covered for the life of the patient just like other chronic illnesses. Also, we need to stop treating all brain injuries like it’s mental illness. Hang in there Lee, we are rooting for you and your son.
I am a Democrat and believe in both Obama’s Health Care Plan, Tag Greason’s Autism Insurance Reform Bill, and proper insurance coverage for all children with disabilities. We also need more medicaid waiver coverage. The cost of health care for children with disabilities is outrageous and unfair. We need to do what’s right for individual health needs and support families who work hard every day to do the right thing with limited support.
Sorry. I’m late to this party, but there is no explanation of this EIBI treatment or its rate of effectiveness. The quotes say that hundreds of thousands of dollars are saved through this treatment versus special education. How much is EIBI? How much is special education? What is the cure rate using EIBI? Is it 100% effective? 75% effective? Can someone with autism receive the EIBI treatment with no effect and then proceed to go on to the additional expense of special education?
You make it sound like an either or. I’m not convinced.
Not enough information to make an informed decision from this piece.
I am against mandates in general and this is just another government mandate.
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