http://throughtheeyesofautism.wordpress.com/2009/02/15/its-not-ok-to-kill/
Posted on February 15, 2009 by Adonya Wong
Some Oklahomans won’t ever get it.
I can understand some of their concerns, but it would have been really nice if these “lawmakers” had actually taken the time to hear the bill.
It would have been nice if they had taken the time to review the laws of the states that have already passed similar laws.
It would have been nice, but I guess nice isn’t part of their vocabulary.
I do not know what the next steps will be as I am certain the “fight” is not over. It’s just very unfortunate that the Oklahoma children with autism will have to wait more months or years before the “lawmakers” decide in their favor.
Unfortunately, this decision will prove too late for most.
“You’re doing fine, Oklahoma!” {sigh}
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7 comments:
The legislature seems to have entered the twilight zone on this issue. The comments that members of the house committee made during the hearings were just bizarre.
The mantra from the Republicans at the capitol is this. We need to build an infrastructure of therapists before a mandate can be passed. One, now the Republicans want government to hire, train, recruit therapists into the state. No more against big government.
Second, they totally forgot any economic education. Without an income stream, therapists will not provide services in this state.
Third, when pressed about the timeframe for building this infrastructure, they are saying 4 to 5 years. They do not understand economics and fail to protect the most vulnerable members of our society, the children with special needs.
What is stopping children in Oklahoma from getting treatment? My son suffers from far worse than Autism (although many of his issues are within the spectrum)and has always been treated, albeit out of pocket. Is the government mandating that children without insurance coverage can't get the necessary treatment? Will a therapist in Oklahoma not see a child if payment is made up front?
Mike
Most of the medically necessary treatments and therapies are not covered by insurance. Therefore it is out of pocket.
When you add up the cost of OT/PT or Speech at $ 100+ per visit (insurance will cover some with extreme office vists-usually 20 per year), behavior therapy is not covered and will cost any where from $1K to $5K per month.
Also, the diagnosis, testing, and screening for autism is very expensive. $ 2K to $ 12K. Most insurance will not cover this except of a 10% to 20%.
Parents who do not have the resources to pay for these services $ 20K to $ 100K per year, simply give up and the child will never have the opportunity to live a fruitful life.
Since there is no method for income for therapists, there is an accute shortage in the state. Most of us go out of state.
In the states that have passed a mandate, medical docs and therapists flock to that state, thus providing greater medical access for all.
I guess what bothers me is many believe that because insurance covers it that there is a reduced cost. Once the government mandates coverage for the special needs within the spectrum then the cost for the rest of goes flying through the roof.
My son has many of the symptomatic traits of the Autism Spectrum. In places like Florida where similar legislation or additional educational funds are allocated for Autism, they do everything they can to "diagnose" a child with Autism. Had we fallen into that trap we never would have determined the root cause of the problem, a rare seizure disorder.
The legislation you are proposing will drive the cost of insurance and associated services like OT and SLP through the roof for those of us that do not fall under the Autism umbrella.
Mike
I am trying to understand your argument.
The cause of Autism will take a long time due to the varied uniqueness of each child on the spectrum. Our Fed Gov't has now allocated over 400 million and with unfunded allocations of another 1.8 billion.
What you and I have to concern ourselves is how to recover these children and that takes a lot of effort on the part of parents, the schools, medical community, and the participation of the insurance industry to finance the medical care.
Without insurance coverage now, you have just a few providers. Of the states that have implemented the mandate, the insurance industry recruits practitioners to handle the case load and they also determine the reimbursement costs to the providers. That is a better free market than we have now.
I do not know how you can conclude that with a mandate, then the cost for the rest goes flying thru the roof. You need to supply some evidence because I have not seen anything to justify that for the 8 states that have passed similar legislation to Nick's Law.
You mentioned in your last paragraph that the costs of OT and SLP services will increase. Actually it is the reverse. Since each insurance company will set the prices for reimbursements to the practitioner, it is the insurance industry that will bring the prices down once more practitioners are available.
Supply and demand. The more suppliers to meet the demand, the less cost to the seeker of the supply. This has been the case in the 8 states as well.
You kind of touched on a topic with Sen Gumm about the schools. Let me explain what needs to be done here.
The schools need to play an active part with the therapies that these children receive. Therefore, they will shoulder a lot of the expense of treatment and the insurance industry is not the sole provider.
But the schools are actually pushing back as well even under Federal Law to comply. That is why you see a huge jump in due process hearings or very contentious IEP meetings over the last couple of years.
We are advocating in Nick's Law to provide coverage for diagnosis, testing and screening of autism so every children can receive early intervention services. We all know that the sooner the better. Studies show that if we can provide those services, we can reverse the symptoms of Autism from nearly 35-45% of the kids before they reach 1st grade.
We all need to work together to help these children.
Wayne,
I have fought long and hard to prove that my child was not Autistic. Not because of some stigma, but because he is not. He has many of the symptoms that lie within the list of so called spectrum disorders but he is not Autistic. Many times in Florida I had doctors and teachers tell me that if I would agree he were Autistic, then they could provide far more services than if he were classified "disabled, other".
When the government throws money at something (which is what the mandate does, indirectly) there will be a push to get a piece of the pie. Children that suffer from other disorders, potentially treatable via other methods if properly diagnosed, will be pushed into the Autism Box. Schools will, in order to gain more funds, create more Autistic kids. Who cares if they really aren't Autistic?(FYI, my son has expressive and receptive delays, social issues due to them and odd behaviors all caused by a rare seizure disorder most recently he lost his eyesight).
There is no free market with a government mandate. Bringing in more providers who all accept the insurance rate means that only those with Autism and insurance will get that rate, the rest of us will make up the difference (ask your hospital if they have two rates for procedures, they do and the lower one is that provided by insurance). There is no competition when insurance companies set the rate. The cost that is set by the insurance companies will apply ONLY to those children with Autism. Specialists will make up the difference on those of us who don't have insurance or don't have Autism.
Instead of mandating that insurance companies cover Autism, why not, at the same time mandate cost controls for the people providing the service.
I don't want to turn this into a battle. I pray daily for all parents of special needs children, that they might be able to offer them the support they need but involving the government is not the way to go, nor is forcing a private company to do the governments bidding (look at why state farm will no longer insure homes in florida).
Mike
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