Friday, May 16, 2008

autism speaks; just another entitlement trap ??

While traveling around OK I've heard this commercial for a bill known as Nick's Law which according to autism speaks is bottled up in committee in the state legislature. The commercial leads everyone to believe that without the passage of this bill the EVIL, rich insurance companies will NOT cover any expenses related to autism. Insurance companies just like any other corporation has government mandates which REQUIRE certain things be covered as part of their contract, just like you have state minimums with auto insurance.

I happen to have a very close dear person that I'm acquainted with that works for one of the largest insurance companies so I asked about this piece of legislation and why it is that the insurance companies won't cover associated cost with autism. Many of these *drugs* are still considered experimental by the insurance companies and based on the track record of the FDA I can't blame them a bit.

You can CHOSE to purchase upgraded insurance which will cover you in case of accident, theft, fire and just about anything you can think of, of course it is going to cost you more money. Health insurance is much the same there is a basic plan with upgrades that are available for more money.

Of course what Nick's law requires is that autism be included in EVERY policy which limits the cost for those that actually need that type of coverage and increases the cost for those that don't require that type of coverage. The argument is that the rates won't be raised by that much so therefore we MUST do it immediately. Like a friend of mine likes to point out, when exactly is "not that much" going to be too much. A penny here and a penny there eventually adds up to REAL money.

The problem isn't always what it appears to be and in this instance I hope the state makes the CORRECT decision which is not more government involvement. Absolutely nothing prevents these people from paying and receiving services based upon the contracts they sign. Finding a company that is going to place themselves into the proposition of losing much money is another story all together.

Just a thought, I wonder if the insurance companies might be willing to provide autism coverage if it wasn't listed in the mental illness category.


Jason said...

Oh, I know you can't blame them a bit. Who cares if these families can't afford the treatment for their children? It's their fault for having a disabled child, right, Tom?

tom said...

Not what I said nor what I meant but you just keep living in your dream world. With the very lawsuit happy Americans and those abroad I completely understand why companies aren't exactly willing to open themselves up to lawsuits, and besides NONE of these drugs which are being prescribed have been shown to lessen the symptoms of autism.

Nothing prevents these parents from taking out insurance that covers autism, most just want government to mandate so with the increased cost we ALL pay for it instead of those that REQUIRE. I guess that would be your definition of "general welfare of the people".

Since we don't understand the conditions which leads to autism I'm not going to blame anyone for such problems yet, unless it is determined somehow that an environmental condition causes it and the pregnant woman has at her disposal the means which can prevent this.

I do have a HUGE problem with women that are pregnant that continue to smoke, drink, do drugs, have multiple sex partners and the like, but those conditions haven't been proven to cause autism.

Our oldest was very mentally challenged during his childhood and we spent thousands of dollars trying to get to the cause of his issues. Speech therapist, and numerous other experts all trying to get us to put him on one med or the other. So YES I can relate my life nor my families life has been the proverbial bowl of cherries.

Jason you aren't the only one on the planet to have issues, get over yourself and live in the real world where not everything is solved by a government mandate.

Jason said...

That's laughable, Tom. You really are out there if you want to try and pretend I want everything solved by a government mandate.

DRUGS don't less it. However, enzyme treatments and other things that are not manufactured by major drug companies have proven to be effective. All this bill is doing is making the insurance companies quit hiding behind the claim it's "experimental" so they don't have to pay for it. If the insurance companies won't acknowledge it then the government should step in and make them be fair to their customers.

You may want to blindly believe everything you hear from the insurance companies but most of us know they're only out for profit and will ignore any legitimate treatment for a disease until they have no other alternative but to admit to the truth.

Oh, and don't forget this "autism insurance" you claim is out there. You wouldn't think to buy it until you get the diagnosis...and that point they won't cover it because it's a pre-existing condition.

Come on, Tom. Families of children with autism are being shafted by the insurance companies. If you went through it then you should have compassion for the families going through it and not rubber stamp what you hear from the insurance companies.

tom said...

If these treatments are available over the counter then why should insurance companies pick up the cost? I can't have cough syrup covered under my insurance nor will my insurance company pay for all the herbal supplements we take. So somehow people with autistic children should get some sort of preferential treatment.

If you want government to step in and dictate to the insurance companies HOW they MUST operate then YES you are looking for a government solution. I don't blindly follow what the insurance companies tell me after all I've had to purchase insurance for my family and now my employees for over two decades. I'm quite aware of the ins and outs of the insurance companies and their sales reps.
Apparently you haven't seen many of the new insurance policies that have been out since the mid 90's which only carry a pre existing condition for a year.

Of course you wouldn't want to admit to those people who do see a doctor for a condition, then once they have something they go get insurance with the assumption that the insurance is going to start paying for it immediately.

I don't have on rose colored glasses thinking everybody is just so holy and Christian like. There is MUCH fraud within the insurance industry from the clientèle so I can throughly understand the need for the insurance company not only to protect themselves but of their trustworthy clients as well.

When companies stop making profit they go out of business which is why the insurance companies must make some to be able to afford to continue to operate.

Perhaps these people who can't afford the cost of the treatments should seek out sponsorship or contact local organizations which can help them.