Saturday, January 10, 2009

It's the Right Thing to Do - Editorial

The Oklahoma Legislature will be considering Nick's Law, introduced by Sen. Gumm-D, Durant, Sen. Anderson-R, Enid, Sen. Easley-D, Tulsa, Rep. Mike Brown-D Tahlequah, and Rep. Wallace Collins-D Norman, which would allow parents to obtain a timely diagnosis and seek clinically proven and effective treatments for their children with autism.

Nick’s Law is the cornerstone for providing a wholesale and systemic change in the way families in Oklahoma care for their autistic children. Private insurance companies would be required to cover the diagnosis, treatment and medically necessary therapies these children must have to become independent adults and to escape from the iron claws of autism.

Autism is the fastest-growing disease in the country; according to the Centers for Disease Control and Prevention, autism is more prevalent than all pediatric cancers, AIDS, Down syndrome and diabetes combined. Autism affects 1 in 150 children nationwide.

Costs to diagnose and effectively treat this disability can range from $2,000 to $5,000 per month or more, depending on the severity. About 400 to 500 children will be diagnosed with autism each year.

In 2008, Arizona passed similar legislation, along with Pennsylvania, Louisiana, Illinois, and Florida. South Carolina and Texas passed their autism legislation in 2007. There will be no less than 26 states in 2009 that will introduce or re-introduce similar legislation, including Oklahoma.

This past year was a challenge, and also a real eye opener for typical citizens to understand the workings of the state capitol. Last session, we went to the capitol and talked with our legislators about the merits of Nick’s Law; we showed them pictures of our children, told them our stories, and explained the struggles in our daily lives. We sent letters, emails, faxes, and pictures.

In the Senate we were able to get Nick’s Law passed as an amendment to a few bills, but then the problems began.

In the House, politics became more important than the business of the people. Instead of being able to be heard in a committee, partisan maneuvering was the name of the game. We were denied the opportunity to be heard, yet others in the committee room were given that very same opportunity. We were called a mob, yet all we did was stand quietly in the committee room with pictures of our children.

There are many reasons FOR why Nick’s Law is the right thing to do. There were many excuses given to stop this bill from becoming law.

We were told that autism needed to be studied further. Now that the interim studies have been conducted, how are the results going to be used to stop this growing epidemic?

We have been offered tax credits, insurance policy riders, increased state services, and other suggestions have also been given as possible solutions. We have also been informed, that because of the problem of the uninsured in our state, adding a mandate will cause more people to become uninsured. These are all excuses, and they are all BULL, plain and simple.

A recent Oklahoman editorial suggested that all mandate proposals should have a cost-benefit analysis. We offered Nick’s Law with an actuarial study last session. The study was transparent and the methodology was accepted by four other state legislatures. Yet it was purposely misinterpreted to defend the notion that Nick’s Law would have a dramatic effect on insurance costs.

Offering tax credits is not an effective or efficient way to handle the problem. Most parents are struggling to pay for the therapies now; we cannot wait several months to have tax credits offset our state income tax. By the way, can we obtain a $ 30,000 or even a $ 60,000 tax credit each year?

Medical Insurance Riders do not exist for the simple reason that the people purchasing them are the same that will be filing the claims; in other words, A insures B insures C insures A.

Proposing increases to state services is a non-starter. The state currently has a 4 to 5 year wait on the Medicaid waiver. Medicaid does not even cover the most effective treatments. In addition, to suggest we fund state services more means tax increases to all of us. There is not enough state money to fund services to all of the families affected by autism.

A recent announcement from a large insurer that there will be coverage for autism without any significant cost to their members, provided some hope and a wonderful start to the new year. However, once details were released, all the excitement was met with disappointment. No new solutions and a denial of clinically proven and medically necessary behavioral therapy known as ABA (Applied Behavioral Analysis).

Now we are hearing that Oklahoma is not ready for another mandate because of the lack of practitioners. Let me address that by using free market principals and empirical evidence from other states that have passed legislation similar to Nick’s Law. The reason for the lack of practitioners is because there is no method of payment for these services, other than out of pocket reimbursements from parents or very limited Medicaid payments.

Do you think that orthopedic doctors would practice in areas where the only method of payment for services is out of pocket payments? No!, and neither should qualified therapists who will treat children with autism. Once other states passed legislation, practitioners and specialists started to open clinics and provide services. They are flocking to these states.

By defending the anti-insurance mandate mantra, our Legislature is driving Oklahoma to state-run and paid for health care. Eighty percent of these children are younger than 16; without effective treatment, the first big wave of these children will be applying for state and federal services in less than three years. This coincides with the first big wave of retiring baby boomers.

It’s time to seriously discuss why Nick’s Law is good for the children and adults with autism, it’s good for the taxpayers of Oklahoma, and it’s the right thing to do.

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