Saturday, January 31, 2009

A Well Written Argument for Insurance

Utah is considering similar coverage that is under consideration in HB1588. I had to post this because this mom just puts the arguments for insurance coverage so well.


Insurance coverage for autism an investment in the future
The Salt Lake Tribune
By Kim Kowanko

Why do you have insurance? I have it for peace of mind. If some medical problem emerges and the cost of treatment is too great, then my insurance will "insure" that my family and I can still get the needed treatment.

What if a new childhood disease develops? Would we assume that it would be covered by our heath insurance? Or do we expect to have to fight for coverage for every new disease? A new cancer would not be covered automatically; we would have to fight to have the cost of the treatments covered while fighting the disease ourselves or for our children.

Tragically, this is the situation faced by families with children who have autism. They are told that early intervention is key and that there are proven therapies that will drastically improve their child's outcome and thus their future. Once they start trying to initiate these proven treatments, they discover that their insurance doesn't pay for it. They are faced with the realization that they either have to liquidate their assets (if they are lucky enough to have assets) or not give their child a chance to have a full life.

Ten years ago, autism was a rare disease. It affected 1 in 10,000. Now, it's 1 in 150 nationwide. In Utah it's 1 in 133. We have the third highest rate of autism in the nation. It's an epidemic of disastrous proportions and it's getting worse, not better.

If this doesn't scare you, it should. What will society look like if 1 out of 133 people (1 out of 79 men) can't take care of themselves or interact appropriately with the community? What will we do with them? How much money will it cost? A Harvard study in 2007 estimated the cost to care for an individual with autism over a lifetime at $3 million!

At the rate autism is growing, odds are that you will eventually have a very personal reason for supporting early intervention and treatment. It might be your child, grandchild, niece or nephew or neighbor. We can't stick our heads in the sand and hope it will go away. It won't. We have to make good decisions that make sense economically and, most important, morally and ethically.

Senate Bill 43, Clay's Law, would require insurance companies to cover proven and medically necessary therapies for children with autism. If treated early, many children will enter mainstream kindergarten without the need for any kind of aid or special services.

Last time I checked, insurance companies were doing very well. They are not struggling financially to stay afloat like our schools are. So why do we allow insurance companies to discriminate against autistic kids and pass the buck to our schools?

A research and advocacy association of insurance carriers looked at 10 states that have passed similar laws. They found that the incremental cost of the benefits was less than 1 percent. Compare that to $3 million over a lifetime and even if you're the most cold-hearted bean counter on the planet you would have to agree that Clay's Law makes sense. And you would be right.

Let's hope that Utah's lawmakers are taking the time to learn about this devastating epidemic and analyzing the studies that show the cost effectiveness of early treatment and intervention. But most important, let's hope that they have a heart and care about all of Utah's children. After all, how much is a child's life worth?

Kim Kowanko is a full-time mom in Heber City. Her middle son has asperger's disorder.

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