Who Should Pay for Autism Treatment?

Karen, you're conflating two different things. The first is a case where the government forces certain medical treatments to be included in an insurance policy. The second is a case where individuals voluntarily choose which policy they want to buy--knowing which medical treatments will be covered. The former involves coercion, and the latter does not. Thus, the former is fair, and the latter is not fair--not fair because it forces people to pay for coverage that they don't want. It's also not fair to the insurance companies that are no longer free to conduct THEIR businesses as they see fit.

Yes it is unfair that people without autistic kids have to help pay for the treatment through higher insurance costs. It's equally unfair that people without brain tumours or leukaemia or spinal injuries have to pay for treatment of others through higher insurances costs, and so on and so forth. But that's what insurance is all about.

[...] coverage to pay for such a situation, mandating coverage is not right.  As Rituparna Basu writes in the Undercurrent: …Insurance companies’ costs will obviously increase if they are [...]

Thanks for the enlightening post.

I am the parent of a child with an autism spectrum disorder and we have incurred a great deal of personal expense to cover treatment that our insurance does not cover. Although there is a special developmental disability waiver (which comes from federal money) that might cover some of this treatment in my state, it is unlikely that my son would qualify for it as he is very high functioning, and even if he did, he would go without treatment for the seven to ten years it takes to come to the top of the waiting list. And if he did finally qualify and come to the top of the list, the treatment provided would likely not be what we believed would be best for him. When you take government funding, you lose the freedom to decide.

MIke Zemack is right: the best solution is to let all of the people of the United States keep as much of their money as possible, and let them then decide how to spend it for the benefit of their own family in their own situation. If I could have the money back from the 90 cents of each of my health-care dollar expenses that go towards government programs that do not help my child, it would cover most of those expenses incurred that my insurance does not pay.
And I would be the final arbiter of what to spend those dollars on for my son's benefit.

Finally, even as they are taxxed* to death, Americans are amazingly generous people--this is part of the self-sufficiency that were the social norm for America's frontier communities--and there is quite a lot of private charity available for parents who could use a leg-up.

*if any word should be a four letter word, taxx should be!

Rituparna is right here. The same arguments used against autism insurance mandates points to a genuine injustice suffered by parents of autistic children, though. While they struggle to pay the cost of their own children's treatment, they themselves are victims of a myriad of other government mandates, programs, and policies.

For example, they are forced to pay the cost of similar insurance mandates such as New Jersey’s soon to be (or already) enacted Senate bill S1940, which requires insurance companies to cover mental healthcare expenses relating to eating disorders. In addition, that same unfortunate couple that is unable to afford treatment for their own autistic child is paying, through their taxes, the healthcare expenditures of: the elderly (Medicare), the poor (Medicaid), other peoples’ children (SCHIP), other uninsured people ("charitable" government aid to hospitals to cover "free" emergency room care, including for illegal aliens, imposed under the federal law EMTALA), etc., etc., etc. In addition, there are medical research grants to universities and colleges. And don’t forget foreign aid healthcare spending, including President Bush's $50 billion Aids relief package to Africa. Undoubtedly, there is more.

Dead.letter.office asks; "What would you have families do when unable to afford treatment for an autistic child?". Rather than perpetuate the injustice with more of the same, it's time to begin to dismantle the network of government intrusions into the medical field. All of these government-imposed wealth redistribution schemes should be phased out and abolished in favor of a free market.

That long-term solution to fixing our government-crippled healthcare system with its soaring costs is admittedly of little help to the autism parents struggling to pay bills today. So here's a short-term, simple interim step to advocate for those "unable to afford treatment for an autistic child"...tax credits. America currently spends about $8000 per capita on healthcare annually, almost 90% of which represent people spending other peoples' money. That money comes out of someone's pocket. The amount of money that most of us pay toward other people’s healthcare undoubtedly runs to many thousands of dollars annually. Simply allow the costs of uninsured ailments like autism to be offset by direct tax credits up to the amount the parents pay toward the litany of forced payments cited above. This would allow them to spend their own money on their own children as they see fit.

It's simple, just, and violates no one's rights. Just as these parents have no right to force others to pay for their medical expenses, so the myriad of recipients of government largess have no right to their healthcare dollars.

Thanks for sending this to the carnival this week!

Like I stated in my blog post, the families who endure these hardships certainly deserve our sympathy. I think that many individuals and organizations would choose to personally contribute to these families because they feel for the plight of these children. If voluntary charity is not enough to sustain these individuals, that would be a tragic situation. It’s always tragic when good, honest people suffer due to circumstances beyond their control.

Such circumstances, however, no matter how dire they may be, do not justify forcing others to sacrifice their own lives. As Americans, we have no claim to the lives or property of others. We do not have the right to expect others to give up that which they use to sustain their lives in order to sustain our own. If we get sick or have our house torn down by a tornado or lose our job, we can ask others for their voluntary help, but it’s wrong for us to have the government expropriate their money for our sake. This would be unjust and the consequences devastating, as illustrated in my blog post.

The underlying premise behind your concern is that everyone has a right to values such as health care, even at the expense of others. No such right, however, exists. Rights are freedoms to act in your own interest without interference from others, not entitlements to values that others have produced.

Yes, medical care is expensive. Yes, it’s horrible when someone cannot save their child because they cannot afford it. This is the price, however, of living in a country that allows people to work to afford such expenses and mitigate such risks. Either we guarantee that people have a right to pursue their own happiness, or we force them to serve the happiness of others. That’s our choice.

It must be noted, however, that it is highly unlikely that charity would truly be unavailable in America. Americans are already the most charitable nation in the world today. If we weren’t forced to turn over so much of our wealth to support endeavors we did not value, we’d be far more generous in cases where people truly suffered misfortune.

If charity is truly unavailable (which is once again unlikely since Americans are very benevolent), then that means the individual cannot purchase that treatment, just like an individual who wants to purchase a car but cannot afford one. Medical services are goods like any other. Some can afford them, others cannot. While the physical cost of not being able to afford insurance or the proper medical treatment might be devastating to an individual, it still does not justify forcing others to pay your medical bills.

Consider the alternative. Every time someone has a life-threatening need, we abandon our own values for them. The world is full of people in need- should our hard-earned wealth continuously be taken away from us and given to them? And who is to decide whose needs prevail?

The only solution to driving down the cost of health care and making it accessible to more people is to remove all government regulations in the health care and insurance industries and to allow the free market to deliver the most efficient and cost-effective services. In every private industry, costs decrease as time goes on. The cost of computers is much cheaper today than ten years ago. This is exactly what will happen if medical research and treatment are liberated.

dead.letter.office,

"What should happen to those people who did plan for life’s inherent dangers, to the best of their abilities. There are some eventualities too unlikely to be planned against by any individual, and there are some inherent dangers or accidents of fate for which no amount of planning is adequate preparation."

Sans private charity, they should be left to die. There's a difference between planning for an eventuality and ignoring one exists. If one is not willing to risk it occuring, he should "plan" for it by avoiding the activity entirely.

I don't see how you can not mean to imply that the author's position is vicious, evil, and immoral. Simply raising such a question, when the answer can be so easily derived from the principles laid out in the article, makes me suspect that that was exactly what you intended to do.

Hi Grant. Thanks for the response. My goal is not to get the author to blurt out something she (I assume from the name this is a woman) would regret. I'm not a fully educated Objectivist (in fact I doubt you would consider me an Objectivist at all) and my question is an honest one.

You say, "I am fully aware that by standing opposed to government-mandated insurance coverage for autism I am condemning those who have not planned against life’s inherent dangers to have to life with the consequences." My question is what should happen to those people who did plan for life's inherent dangers, to the best of their abilities. There are some eventualities too unlikely to be planned against by any individual, and there are some inherent dangers or accidents of fate for which no amount of planning is adequate preparation.

I don't accuse anyone here of being vicious, evil, or immoral.

dead.letter.office,

I cannot speak for the author, but since I agree with him completely, I will respond to your question. No, I am not afraid to do so. I know what you are implying and I know that you are trying to induce your opponent into blurting out something he would regret.

Your mistake is in assuming that he would regret it. I am fully aware that by standing opposed to government-mandated insurance coverage for autism I am condemning those who have not planned against life's inherent dangers to have to life with the consequences. I do not regard that as vicious nor evil nor immoral.

You're going to have to try harder than that if you want to make your advocacy for involuntary servitude seem like a rational and moral state of affairs.

What would you have families do when unable to afford treatment for an autistic child? You suggest voluntary charity, but there is no evidence that charity would be forthcoming in an amount sufficient to meet the needs of the families (in fact the implication of your piece is that you and others would be unwilling personally to contribute even the relatively small amount mandated by an increase in all insurance premiums). So what happens when by an "act of God" (or a random occurrence beyond their control for which they bear no responsibility, if you like) people find themselves unable to afford the treatment they need, for autism or anything else?

Regarding the comment by Tanner's dad, who refers to cases asserting a link between vaccines and autism: in fact, there is no evidence that the pharmaceutical industry (which develops said vaccines) is "causing the problem."

According to the recent decision in Cedillo vs. Secretary of Health and Human Services, "the medical and scientific communities ... have found no association between vaccines and autism."

And this is under the lesser standards required by the vaccine court; in other words, they did not have to show cause and effect, only "biological plausibility." They were not able to satisfy this for the court.

On the other hand, countless lives have been saved by the development of MMR vaccines and other drugs. Now, due to the recent decline in immunization rates, the occurrence of these diseases is on the rise. That is a clear and objective fact. We don't know what causes autism, but we do know that vaccines save lives.

One must be careful not to be swayed by assertions of blame that are not supported by the scientific research. Finally, anyone who utilizes the medicines developed by the pharmaceutical industry should be grateful for the life-changing and life-saving benefits he obtains from their products.

RB,
Your point about insurance companies is dead right.

I about and linked to a great piece that deals very comprehensively with this matter:

http://priceofsin.wordpress.com/2009/01/02/insurance-think/

Nice article, well written!

TD, I would refer you to Atlas Shrugged (pages 950-951).

Regards,
Flash

Who should pay? Well we have now two conceded cases that slipped into the sunlight. Poling vs HHS and Banks vs HHS. The insurance companies have an easy out. One day they will wake up and pass the bill over to the pharmaceutical industry where it belongs. They are making the money. I feel they are causing the problem. I believe they should pay the bill.