“Bill Passed in Albany to Make Insurers Pay for Autism Care”

by Walter Olson on June 29, 2010

So puzzling and inexplicable that health insurance rates keep rising. [NYT]

{ 11 comments }

1 Ron Miller 06.29.10 at 11:15 am

Really? If medical insurance does not cover this, I’m not sure I understand the point of medical insurance. In fact, I think most insurers do cover this anyway.

2 gitarcarver 06.29.10 at 12:15 pm

The issue may be that they are required to carry this coverage.

Why should people that do not have children, are passed the child bearing age, etc, be forced to pay for this?

There is a difference between offering a coverage, and being forced to cover something and I think that is objection here.

3 bradley13 06.29.10 at 12:54 pm

As I understand the situation, most insurance covers physical birth defects. However, autism covers a whole spectrum, and it is not clear to what extent which parts of the spectrum are due to physical defects. Long term care is hideously expensive, and it is entirely understandable that insurance companies want to be able to exclude this from their standard policies. Otherwise costs – and premiums – will inevitably rise.

Let me digress. I used to have plain vanilla catastrophic health insurance. If I were seriously ill, or in a serious accident, my medical care was covered. No coverage for acupuncture, homeopathy, etc. High deductible, so that I paid for little things myself. The benefit was obvious: my insurance was very inexpensive.

This kind of coverage is no longer available here. Now, all insurers are required to cover “alternative medicine”, whether or not you want it. It’s free and its trendy, so people use it. Guess what, health care costs go up.

Legislative interference in rate setting also means that high deductibles no longer make sense – there is no significant discount over low deductibles. With low deductibles, doctors notice huge increases in “silly” appointments in the second half of the year: the annual deductible is used up, so why shouldn’t people go to the doctor with every little ache and pain. So, again, costs go up.

The result: my total health care costs (medical + insurance) are around three times what they used to be, even though I am just as healthy as I was a few years ago.

Which brings us back to coverage for long-term care: let people decide if they want it. If they do, fine, then they won’t mind paying a higher premium. If they don’t, their premiums will be less expensive.

Get the government to stop micromanaging health insurance. Ensure truth in advertising and let the free market work. Watch health care costs plummet.

4 Doug 06.29.10 at 4:00 pm

Oh Bradley13, you spew truth. Dead on right. Adding more and more mandates to your insurance takes away choice and control of your health and pocketbook. My little daughter has autism spectrum disorder or mild CP, or whatever that particular doctor decides. Our insurance has paid for some therapy, like speech and OT and PT, but for the most part, we are on our own. But, I think we have more control of who we see and on what terms. Yes, I would like insurance to pay for it. It would seem cheaper, but I know that is NOT what insurance is for. I think that the more govt interferes with rules and regulations, the more difficult it will be to find help and to tailor a program that will help my daughter.

5 wfjag 06.29.10 at 4:40 pm

The problem with your argument, Bradley, is that you’ll pay one way or another. One of the main effects of bills like this is that med insurers cannot deny coverage because of an ASD diagnosis. When that is allowed, the result is that such persons end up on government programs, like Medicaid, and, not infrequently, efforts are made to make that person’s description look as bad as possible, so that they qualify for all possible government services, which normally also means that they qualify for SSD payments. At least with med insurance, they or their guardians are paying for part of the costs and it isn’t all tax dollars for all of their medical and hospital care (including treatment that has nothing to do with ASD — standard things like fevers, broken arms, etc.).

Further, insurers are much better than gov’t programs at questioning costs and treatments. For gov’t programs, the more you spend each year, the easier it is to justify a larger budget and adding employees in the future. Also, decisions on what a gov’t program will cover are much more likely to be political. As a result, gov’t programs increasingly cover complementary and alternative medicine, chiropractic (and, “Yes” there is now something called “Neurological Chiropractic”, and in some states DCs are allowed to “treat” autism), homeopathy, etc.

However, it looks like that the NY Legislature didn’t bother including even the minimum controls in its legislation. About 20 states now require that med insurers offer this coverage. Generally, the premium increases have been small — less than .5%. But, that’s accomplished by sharply limiting what is allowed as a covered treatment. If (as appears to be the case with the NY law) bio-med, complementary and alternative medicine, chiropractic “treatments, “etc., are covered, then the premium increases could be significant (over 2%).

6 Todd Rogers 06.29.10 at 6:28 pm

Quote: “It would be unconscionable to force New Yorkers to pay out-of-pocket for this common, chronic condition.” Now, let’s substitute the notion of hunger pangs for autism. By this clown’s reasoning, the state should be paying my grocery bill.

7 SPQR 06.29.10 at 8:34 pm

Certainly, the biggest deception is calling such programs “insurance” …

8 Richard Nieporent 06.29.10 at 11:10 pm

Good point SPQR. What we have is not health insurance but prepaid medical care. Just the paperwork alone adds significantly to the cost. Every primary care physician must hire a number of workers in order to process the insurance forms.

9 No Name Guy 06.30.10 at 10:53 am

SPQR / Richard:

Yes and yes.

Immagine how expensive an oil change would be if one needed to file an insurance claim. Add to that the lack of competition / price to effectiveness calculation of the consumer.

Insurance is, by definition, a means of guarding against events that have predicitable average frequency, yet are unpredictable as to exactly who and when they’ll strike. Think car crash vs. oil change. One knows that that a driver has a 1 in XX,XXX chance of getting in a wreck in any given year. No one can predict EXACTLY which driver(s) or exactly when they’ll crash. An oil change, on the other hand, is needed every 3,000 to 7,500 miles (in other words, it “strikes” EVERY driver at some point).

10 Bob Lipton 06.30.10 at 4:43 pm

There is no doubt that autism is a medical condition. There is no doubt that it is not currently covered by every health care insurance. There is, therefore, the inevitable result that requiring that it be covered will increase costs. I am sure this will win a lot of snaps for the legislator, since it requires no tax revenue and will cover people for whom everyone feels sympathy. But as it is a de novo expense on me at a time of life when I am unlikely to father children — and have none myself — it is, in effect, a tax. It will also raise the costs of state and local employees as they must be covered under it.

While I might very well be in favor of such an assessment, I object to the sneaky way it has been added to my public burden in a way that legislators won’t have to answer for. Instead they will doubtless rail against the health insurance corporations for their higher premiums for New York State residents, as if the two events — the legislation and the insurance rate increases — were unconnected.

Bob

11 William Nuesslein 07.04.10 at 7:01 am

How does one get into the deep pockets of vaccines manufacturers? You buy a corrupt doctor and have him claim that a vaccine causes something. Pick a problem with only subjective elements in its diagnosis. Use activist to overstate the burden of problem. Supposedly an autistic child has a permanent problem.

Dr. Wakefield has been completely repudiated and vaccines exonerated. But Autism carries on. My friend’s child has a high functioning autistic child. Why should the community pay for that through health insurance? I think Autism is mainly a racket, like whiplash in auto accidents.

By the way the 1 in 150 rate that is advertised highly is about the rate of schizophrenia. Schizophrenia is absolutely horrible for the patient and his love ones. I am very angry that health care dollars are used so irrationally.

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