Parents of autistic children vow to pursue insuran

[tim huntzinger]

Autism is a medical condition of the brain and should be afforded parity for appropriate treatments.  We need to stop the anti-brain bigotry and get on board this.  Insurance companies are able to have it both ways: they get to soak us on the premiums and pass on costs for therapies for neurological illnesses on to the taxpayer.

HST [having said that] I am unsure what medical treatments are available for autism outside of psychotropics, whose costs would pale compared to psychosocial approaches.  Far cheaper to prevent the condition if possible, but as a matter of fairness and justice autism should be covered by insurance companies.  This will help develop the most cost-effective approach that achieves results.

[zstyles]

Jack Kanjian loves dinosaurs. He's writing a book about his favorites on colored construction paper, illustrated with crayons. When he grows up, Jack wants to run a prehistoric zoo — with real dinosaurs, not just replicas — and start a TV station dedicated to the creatures.

He plays the piano, pee-wee basketball and rides horses competitively. A few weeks ago he went skiing in Aspen.

Jack has autism.

You'd never know it meeting him. He seems like any precocious 9-year-old, an honor student in the third-grade gifted program.

The reason for Jack's success: his parents, Palm Beach County Commissioner Bob Kanjian and his wife, Anne, who had the money to put him through rigorous therapy sessions called applied behavioral analysis during the crucial early years, after Jack was diagnosed with autism at 2 years old.

The treatments ran about $45,000 a year, Kanjian said, and weren't covered by insurance.

Kanjian is using his clout as a county commissioner to advocate that the same coverage be available to everyone with insurance. He wants Florida legislators to mandate that private insurance companies cover autism, a battle that's being waged in a growing number of states across the country.

When his son was diagnosed with the brain disorder, Kanjian recalled meeting a school custodian whose child also had autism. Their incomes determined the level of care each child got, he said.

"The difference between his job and my job shouldn't be the difference between whether his kids make it or not," said Kanjian, a Republican appointed to his commission seat in August by Gov. Charlie Crist. "We're a society that's better than that."

Kanjian added autism insurance to Palm Beach County's legislative priority list, which means the county's legislative staff and $370,000 private lobbying team will push the issue in the spring session.

It's an uphill battle. Insurance companies across the country have opposed such efforts, arguing that as additional coverages are mandated, premiums for all policyholders rise.

But in Tallahassee, the effort has a powerful ally in Senate Democrat Steve Geller of Cooper City. Geller has been trying get autism insurance mandated for years, but he sees more opportunity this spring. It's his final session in a long legislative career.

"I feel really, really strongly about this issue," he said. "I'm going to see if I can persuade some people who might not otherwise vote for it. This is my going-away present."

Geller said he'll likely go for a $10,000 or $12,000 yearly coverage limit for autism treatments — less than what advocates want, but "a lot better than nothing," he said.

Autism is a brain-development disorder that impedes normal social and communication skills. There's a broad spectrum of autism patients. In severe cases or without early treatment, autistic children spend their adult lives institutionalized.

There is no cure, and researchers are unsure what causes autism, although it is believed to be an inherited disorder.

Jack has a moderate case. Like many kids with autism, he didn't respond to his name as a toddler, struggled to communicate and fixated on inanimate objects. He'd stare at ceiling fans and roll his toy trucks back and forth for hours, watching the wheels.

Once his parents got the autism diagnosis, the Kanjians took immediate action. They put him in the exhaustive one-on-one therapy sessions, running about 40 hours a week. He started achieving real breakthroughs when his 7-year-old sister, Hannah, started to talk. Suddenly, he had a model for how to communicate and to interact.

Jack's made such progress, his parents don't even tell his sports team coaches that he has autism.

But such treatments are out of reach even for most upper-middle class families. Many take out second mortgages to pay for the treatments and end up in debt and divorce, according to autism advocates.

Seventeen states mandate some level of autism coverage, although New York-based Autism Speaks, an advocacy organization, says only four states offer adequate benefits. South Carolina has the most comprehensive plan with a yearly coverage limit of $50,000 for autism treatment, said Elizabeth Emken, the group's vice president of government relations.

"It's an issue that's time has come, frankly," she said. "Nobody's really debating that these kids need this. The argument is who should pay for it?"

Kanjian, a former Palm Beach county School Board member, said he views autism insurance as a good business decision. Kids with autism in special-needs schools cost the school district about $23,000 a year, triple an average student. And having autism patients institutionalized as adults can cost the state millions later in life, he said.

"You're going to save their lives," he said. "But second, what a great investment."

Anne Kanjian, watching her son flip through his dinosaur book, added: "He's going to grow up and go to college and maybe find the cure for autism."

[guido911]

^ Good story zstyles. I have a history with a previously undiagnosed autistic 2 year old that my family was providing care to several years back. I like to think that thanks to our efforts, which included in large measure getting this child the treatment/therapy he needed, we made a huge difference in his life. I would like to think that this child, who is probably in elementary school, has a real chance at a "normal" life. Treatment and therapy works, I witnessed it first hand.

[cannon_fodder]

I understand their are severe problems and costs associated with autism.  I understand that with help autistic children can adjust.

But at a 1/150 rate occurrence, and 75,000,000 million children in the United States; that is 500,000 kids that need treatment.  At $15,000 mandated coverage for each - the government is dictating private companies spend $7,500,000,000.00 to cover them on a national level.  

If it is more economical for the State to have children that have undergone treatment and better for our society as a whole, then why aren't we the taxpayers doing more?  Why force those of us who have to pay for our insurance to pay MORE so the State can save money and 1% of the population can have their child's condition covered?

I don't mean to sound selfish here, it's mandates like this that make health insurance so expensive.  In Oklahoma it is already expensive, a dictation for extending coverage that is not very rare while being expensive will only increase that cost more.  If the State thinks this is something that should be done, then the State should facilitate the duty - not dictate it upon someone else.

[guido911]

quote:Originally posted by cannon_fodder

I understand their are severe problems and costs associated with autism.  I understand that with help autistic children can adjust.

But at a 1/150 rate occurrence, and 75,000,000 million children in the United States; that is 500,000 kids that need treatment.  At $15,000 mandated coverage for each - the government is dictating private companies spend $7,500,000,000.00 to cover them on a national level.  

If it is more economical for the State to have children that have undergone treatment and better for our society as a whole, then why aren't we the taxpayers doing more?  Why force those of us who have to pay for our insurance to pay MORE so the State can save money and 1% of the population can have their child's condition covered?

I don't mean to sound selfish here, it's mandates like this that make health insurance so expensive.  In Oklahoma it is already expensive, a dictation for extending coverage that is not very rare while being expensive will only increase that cost more.  If the State thinks this is something that should be done, then the State should facilitate the duty - not dictate it upon someone else.

When it comes to children, who cannot work to pay for treatment, who by themselves cannot get health insurance, and who by themselves cannot even get medical treatment, solutions must be found despite the economic realities. To this extent, I agree with the principles of those pushing Nick's law and Huntzinger's point.
As for selfishness CF, I have no problem confessing that when it comes to health of our children, I am VERY selfish for the very reasons I just stated. I am also, gulp, very liberal when it comes to the health of our children and government's role, if not responsibility, in this issue.

[cannon_fodder]

As I said Guido, if it is a proper roll that society should adhere to and, as indicated, we would all come out ahead... then so be it.  But government should do it, not pass the buck.

[guido911]

quote:Originally posted by cannon_fodder

As I said Guido, if it is a proper roll that society should adhere to and, as indicated, we would all come out ahead... then so be it.  But government should do it, not pass the buck.

All I want is consistency. Just a few weeks ago our legislature passed a law mandating that day cares carry minimun amounts of liability insurance and efforts (I think are still underway) to mandate that nursing homes carry minimum liability insurance. I see no difference between that exercise of government power on the private sector and requiring health care insurers, if they want to do business in this state, to provide insurance to cover the costs for autism treatment. In any case, I thought the real beef was that the GOP was blocking a hearing on the matter. Has this matter been heard yet?

[cannon_fodder]

Requiring someone to have liability insurance protects the population from potential harm CAUSED BY that individual.  It ensures that company (or driver) can pay for harm they are likely to cause.  It passes the cost of the potential harm proportionally on to the individuals or companies that are likely to cause it.  Essentially dictating that the company has the ability to pay (there are self insurance provisions available) for likely potential harm.

Conversely, requiring a company to provide health insurance coverage passes the potential cost of the individual for a risk to that individual on to the masses (others in the insurance pool).  There is no third party involved that we are protecting... we are dictating that an insurance company assume the risk for an individual.

Essentially, with liability insurance the government is dictating the availability of compensation for a third party, in this instance there is no third party we are protecting.  

Did I make that clear?  I worded it carefully because it's kind of an abstract concept, but an important one to me.  Our system of responsibility fails if the person who caused you harm can not pay for it - which is very likely in an auto accident (or nursing home med mal).  It's liability insurance vs. individual expense.

That, of course, says nothing about the merit of your desire to see coverage, just my view on the role of government.
- - -

And, as I understand it a hearing was held.  The issue was an Autism group was not allowed to speak.  Again, as I understand it.

[guido911]

quote:Originally posted by cannon_fodder

Requiring someone to have liability insurance protects the population from potential harm CAUSED BY that individual.  It ensures that company (or driver) can pay for harm they are likely to cause.  It passes the cost of the potential harm proportionally on to the individuals or companies that are likely to cause it.  Essentially dictating that the company has the ability to pay (there are self insurance provisions available) for likely potential harm.

Conversely, requiring a company to provide health insurance coverage passes the potential cost of the individual for a risk to that individual on to the masses (others in the insurance pool).  There is no third party involved that we are protecting... we are dictating that an insurance company assume the risk for an individual.

Essentially, with liability insurance the government is dictating the availability of compensation for a third party, in this instance there is no third party we are protecting.  

Did I make that clear?  I worded it carefully because it's kind of an abstract concept, but an important one to me.  Our system of responsibility fails if the person who caused you harm can not pay for it - which is very likely in an auto accident (or nursing home med mal).  It's liability insurance vs. individual expense.

That, of course, says nothing about the merit of your desire to see coverage, just my view on the role of government.
- - -

And, as I understand it a hearing was held.  The issue was an Autism group was not allowed to speak.  Again, as I understand it.

I see a distinction without a difference. I see under both your and I views, the goverment acting to protect the interests of a class of persons who are blameless. But we can disagree.  Incidentally, how does your analysis work when you consider that Oklahoma's legislature mandates that insurers offer UM/UIM insurance to its insureds.

[cannon_fodder]

It is unaffected.  They are forced to offer insurance at whatever rates they deem fair.  It is more a law requiring companies to let everyone know that such a thing exists and is reflective of the State policy on liability insurance.  If insurance companies were required to offer coverage for Autism to individuals and were free to charge what their actuaries deemed necessary I would have no problem.

Anyway, I see a huge distinction between making sure you can cover your potential debts and requiring other's to pay for an unfortunate circumstance.  In one, the actor is required to do something - in the other nothing is required of the actor.  In on the one causing the risk pays for it, in the other the risk mandate is spread to everyone.  Spreading risk to everyone should imply the State assuming the duty... not passing the buck.

But, if you see no difference between covering your own liabilities and being forced to cover someone else's.  I can not sway your opinion.

And again, this analysis is not a statement on the merits of your claim nor the propriety of state sponsored treatment of Autism.

[guido911]

quote:Originally posted by cannon_fodder

if you see no difference between covering your own liabilities and being forced to cover someone else's.  I can not sway your opinion.

Umm, that's what UM/UIM coverage is CF. Wanna try again?

[cannon_fodder]

You are not forced to get UM coverage.  No one else is forced to pay for your UM coverage.  If YOU chose to pay for YOUR UM coverage it benefits YOU.  

The Autism coverage would be forced.  Everyone would be forced to pay for it.  If the State forces everyone to get Autism coverage everyone would pay for it to bennefit a few.

There are huge difference there.  Most notably personal choice to either pay for the service or not.  Insurance are only required to offer it - I would be on board with a proposal to require insurers to offer Autism coverage in their medical policies, for an added fee.   Just like UM.

[guido911]

quote:Originally posted by cannon_fodder

You are not forced to get UM coverage.  No one else is forced to pay for your UM coverage.  If YOU chose to pay for YOUR UM coverage it benefits YOU.  

The Autism coverage would be forced.  Everyone would be forced to pay for it.  If the State forces everyone to get Autism coverage everyone would pay for it to bennefit a few.

There are huge difference there.  Most notably personal choice to either pay for the service or not.  Insurance are only required to offer it - I would be on board with a proposal to require insurers to offer Autism coverage in their medical policies, for an added fee.   Just like UM.

You are lost in your argument. The issue was whether government should force insurance companies to provide coverage. Look at a sentence from one of your previous
posts:

"I understand people with autistic children need more help, but I'm not sure it is the proper place for the government to dictate what companies have to render that help."

Oklahoma's UM/UIM statute, 36 O.S. § 3636(A) states:

A. No policy insuring against loss resulting from liability imposed by law for bodily injury or death suffered by any person arising out of the ownership, maintenance or use of a motor vehicle shall be issued, delivered, renewed, or extended in this state with respect to a motor vehicle registered or principally garaged in this state unless the policy includes the coverage described in subsection B of this section.

From the above, Oklahoma's legislature forces insurance companies to offer UM/UIM insurance, Nick's law ostensibly forces insurance companies to offer coverage for autism.

We clearly are not communicating or are at an impasse. Moving on.

[cannon_fodder]

That's a problem, because in my head it is perfectly clear and a radically difference.

I think you are misled by the law you cited below, you have to keep reading the entire statute- you are NOT required to get UM coverage.  I say again, you, nor anyone else, is required to have UM coverage.  You can sign a waiver specifically excusing yourself from UM coverage.  

No one is forced to get UM coverage.  However, you are proposing essentially forces everyone to get Autism coverage.  That is as simply as I can state it.

quote:You may make one of four choices about Uninsured Motorist Coverage:

    1. You may buy Uninsured Motorist coverage equal to your bodily injury liability coverage for $_____ for ____ months.

    2. You may buy Uninsured Motorist coverage in the amount of $10,000.00 for each person injured, not to exceed $20,000.00 for two or more persons injured in one occurrence (the smallest coverage which Oklahoma law allows) for $______ for ____ months.

    3. You may buy Uninsured Motorist coverage in an amount less than your bodily injury liability coverage but more than the minimum levels.

    4. You may reject Uninsured Motorist coverage.

http://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=87144

If you understand what I'm trying to say, or I am wrong - please explain. I get very frustrated when I am unable to communicate my point.

[zstyles]

Autism Votes... It's time for lawmakers to listen.

Dear Oklahoma Autism Advocate,
Speaker of the House Chris Benge wants to know how much it will cost to end healthcare discrimination against kids with autism.  

We checked our pockets. Literally....

It's only SEVEN QUARTERS.  To provide children with autism with the coverage specified in Nick's law, individual monthly insurance premiums will increase by less than seven quarters, or $1.66 to be exact.

There are TWO WEEKS left in the session!  Just TWO WEEKS but we can do it!

Speaker Benge MUST hear from you TODAY to learn how $1.66 can not only help your child, but save Oklahoma taxpayers millions of dollars!  

How Can You Help?

1.  CALLYOUR OWN MEMBER of the Oklahoma House and ASK THEM to ASK THE SPEAKER TO LET NICK'S LAW GO TO THE HOUSE FLOOR FOR A VOTE!  Find out who represents YOU and their phone number by going to the Autism Votes Resources Page.

2.  CALL SPEAKER BENGE'S OFFICE!  Let the Speaker know how much Nick's Law is needed by families in Oklahoma.  Urge the Speaker to bring Nick's Law up for an immediate vote in the House.

Call Speaker Benge at (405) 557-7340!

3.  Follow up your calls by SENDING AN EMAILto Speaker Benge and YOUR OWN House Representative with the same message: Schedule a House Vote!

4.  FORWARD THIS EMAIL to everyone you know!!  SEND TO ANYONE WHO LIVES IN OKLAHOMA. Friends, family members, neighbors, church members, teachers, therapists and your co-workers. Tell them to CALL the Speaker and send Emails TODAY!!!

Once you hang up...DIAL AGAIN.  Let's help Oklahoma become the next state to provide kids with autism the health care coverage they need and deserve.  

Sign up now at www.autismvotes.org/oklahoma for breaking news and action alerts in Oklahoma.

Thank you!

Shelley Hendrix
Director of State Advocacy Relations
Autism Speaks