Sen Gumm: Mandate Myths From “The Daily Oklahoman” Opinion Page
By Senator Jay Paul Gumm, D-Durant
President Kennedy said, “The great enemy of the truth is very often not the lie – deliberate, contrived and dishonest – but the myth, persistent, persuasive, and unrealistic. Belief in myths allows the comfort of opinion without the discomfort of thought.”
As we fought for health insurance coverage of children with autism, we fought a “persistent, persuasive and unrealistic” myth. The constant refrain from those who oppose helping these families is their opinion insurance mandates like “Nick’s Law” raise premiums and increase the number of people who are uninsured.
The insurance situation in other states unravels the arguments on which the opponents of “Nick’s Law” depend. First, compare the number of legislative mandates among several states. Then, in those states with more legislative mandates, one should look at the percentage of uninsured. Finally, one should examine premium costs in those states compared to Oklahoma. Read more…
This is a smokescreen on a number of fronts. In the first place, government has no business telling any insurance company what they must or must not cover. Regardless of who needs what, it’s tyranny of the first order. You want that, move to England with the rest of the pooves and poms.
Secondly, 2+2=4. You can’t make 2=2=2.5 or 3 by puting part of it into another bucket. Liberals don’t understand scarcity, but we shouldn’t be surprised — they don’t live in the real world.
Third, no matter how much people talk about saving taxpayers money, again, it’s bad math. Medicaid currently covers autism treatment. We can argue about the constitutionality of Medicaid another time, but it covers autism. What percentage of my income goes to Medicaid didn’t go down with any of the previous 36 mandates, so it won’t go down with this one.
People who are forced to take Medicaid due to their situation need to swallow their pride and get in line with the unwed mother with 14 kids and the smelly homeless guy who fried his brain with drugs and alcohol. Those people shouldn’t pimp out their conservatism just because this particular step toward socialized medicine would benefit them. That’s just shameful and disgraceful.
Comment by Butchey Weinstein — September 13, 2008 @ 6:12 pm
“Socialized medicine.” Talk about a smokescreen. That is what the opponents of Nick’s Law want – they say time and again government should take care of these children.
The notion of “insurance” is predicated on a wide risk pool with the risk shared among everyone. If you shear off the “undesirables,” as those who say “government has no business telling any insurance company what they must or must not cover” would have you do, insurance would only be for the healthy and strong. That’s a lovely notion, but what about those who are not.
There is a special responsibility beyond just profit that goes with any company that chooses to go into insurance. You have to be willing to help people. If profit is your only driver, then go sell shoes or oil.
Mandates serve a purpose: ensuring that insurance means insurance. Shearing off the undesirables may mean you don’t have to share risk with them, but you will still pay for them. And to suggest anything else is simply untrue.
Comment by Jay Paul Gumm — September 13, 2008 @ 6:23 pm
With all do respect, Senator, this is a smokescreen. So you’re saying that socialized medicine, (that’s what this is, regardless of any attempts to poo-pooh the notion), will make my taxes go down? Give me a break. Changing the mechanism by which that money is robbed from me doesn’t make it any less a robbery, doesn’t make it any less tyrannical, and so far, it hasn’t made the amount stolen from me any less.
Comment by Butchey Weinstein — September 13, 2008 @ 6:41 pm
Due respect, no do. i rily aint that dum
Comment by Butchey Weinstein — September 13, 2008 @ 6:42 pm
So what is your solution? Just toss these kids aside? They have to be taken care of and from my perspective it makes much more sense to use an institution – insurance – designed to meet health challenges.
These families are paying their premiums, doing the right thing by their children. Shouldn’t insurance cover a bio-neural disorder?
You talk about money robbed from you. Aren’t you in some way being robbed by insurance every day you don’t file a claim and someone else does?
Who is going to pay for the damage in Houston? Ratepayers all across the nation – again, the idea of shared risk. The idea is one day when you need help, the ratepayers who are having claims paid today will have their premiums go to help you when your turn comes.
Again, shearing off the so-called “undesirables” is social Darwinism. It won’t work, and what is left is feeble government programs to deal less effectively with the disorder than what Nick’s Law would have ensured health insurance covers.
We can do it smart or do it stupid. Turning our backs on these kids may be penny wise, but it is dollar dumb – and plain cruel as well. And I will fight for these kids until I have no breath left.
One other thing, you raised the “liberal” tag. Please. I’ll put my gun-totin’, pro-life, tax-cutting credentials against any so-called “conservative” who opposes Nick’s Law. By the way, being pro-life doesn’t end with birth; it should be renewed.
This isn’t conservative vs. liberal – it is far more complex than that. Especially given the statements by Sen. McCain and Gov. Palin in their speeches. They see the value in special needs kids; it is regrettable a small group of Republican leaders in the Oklahoma House of Representatives do not.
Comment by Jay Paul Gumm — September 13, 2008 @ 8:56 pm
No one has more compassion for special needs kids than I do. However, that’s the difference between liberals and conservatives — the conservative sees a need and says, “I need to help”; the liberal sees a need and says, “I need to use the force of government to make everyone help”. It’s not complicated.
The parents aren’t being defrauded unless the insurance carrier told them they’d pay for a condition, then reneged on it. My health insurance doesn’t pay for athletic shoes, even though there are obvious benefits to me wearing a pair of these shoes and actually using them the way they were intended to be used. Tough break, but my policy never said it would cover athletic shoes, so I deal. The insurance companies are doing right by people, so long as they pay for what they say they’ll pay for, and at the correct benefit level. As long as they’re up front about it, no one should whine. If they don’t like it, find a job with a better policy, or pay the extra to have it covered.
The mindset that because there is a need, we should use government to force everyone to kick in for that need is unamerican, it’s socialist, and it robs us of more of our rights and freedoms. Start a private sector fund for autism, like the JDA, MDA or American Heart Association — you’d get my support, and the support of many others. That’s the American way, and the Oklahoma way.
I appreciate the spirited debate, though.
Comment by Butchey Weinstein — September 14, 2008 @ 7:36 am
Butchey Winstein aka Insurance Lobbyist
I need to correct some of your misstatements during your debate with Sen Gumm.
First, standard medicaid does not pay for autism related treatments and therapies. PERIOD!!!
Second, there is a currently waiting list of nearly 5 1/2 to 6 years for a medicaid waiver for services.
Third, the only existing program that the state administers for direct services to families with autism will be terminated in November because of budget cuts in DHS. That program only served 30 families, but is gone.
Setting up a fund like MDA and others tells me that you really do not know about those funds as well. Those funds are national fundraising programs for RESEARCH. Not for direct services.
You keep mentioning conservatism versus liberalism. I am a conservative, love my hunting and guns, strive for lower taxes for all, and to protect the sancity of life, not just until they are born.
It is with that spirit that I challenge you to drop your old tired rhetoric about C vs L or R vs D.
This is a world wide epidemic and getting worse. We can take your road and just let everyone fend for themselves. Then what are your plans to deal with these children?
80% are under the age of 16. Hear somes a financial tidal wave in a few years that will pile on to the upcoming train wreck know as SS and other gov’t services.
Our future workforce is at risk since boys are diagnosed 4 times greater than girls. Currently 1 in 150 kids, that places 1 out of 94 boys.
Autism is a medical condition. We can recover many of the symptoms of autism if we can provide early, consistent, and agressive interventions, treatments, and therapies.
Let me walk you thru the math of your plan for care by forcing all to medicaid. You are telling everyone to go to gov’t paid for services. So much for your conservative label. It’s more like push things down the road and let someone else deal with them.
400 children are diagnosed each year in OK per CDC. The cost of care for gov’t services for the lifetime is approx $ 3.25 million per child. That is an annual cost each year of $ 1.3 billion dollars. That is 20% of the state budget. To pay for that increase according to your plan would mean that every taxpayer, not citizen, but taxpayer would have to pay an additional $600 to $800 per year. That is huge tax increase that you are advocating. PERIOD!
I have a real hard time believing your statement “that no one is more compassionate for special needs kids that I do”. It sounds like you are having the angel and devil on your shoulder argument. Join with us and help us correct this problem of insurance shedding less desirable risk onto the taxpayers.
Comment by Wayne Rohde — September 14, 2008 @ 9:55 am
Okay, after this I am coming down off the soap box for today. Butchey, you said, “However, that’s the difference between liberals and conservatives — the conservative sees a need and says, “I need to help”; the liberal sees a need and says, “I need to use the force of government to make everyone help”. It’s not complicated.”
Conservative or liberal, the premise of government is that together there are things we can and should do that we could not do separately. This is what government was instituted to do, “promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity.” Not possible if you are wracked with autism and the challenges it creates.
If the free market fails, government has a duty to step in. That is the case with Nick’s Law, and I will never turn my back on these kids and their parents.
Comment by Jay Paul Gumm — September 14, 2008 @ 10:13 am
Gentlemen, gentlemen…. Let’s cut to the chase about some misrepresentations here.
1) MDA doesn’t just do research — they provide summer camp, wheelchairs, breathing treatments, you name it, in addition to research. Oughta check your facts before making such statements.
2) There is only going to be an epidemic because autism is the diagnosis du jour. A few years back, it was Bruxism; before that, ADHD. From your assertion, the doctors are planning to start diagnosing any kid who’s the least bit lacking in social skills as autistic. They’ve even invented a new strain, in the past few years; Ausperger’s Syndrome, or highly functioning autism. So a person who’s able to function in society but is prone to hissy-fits or occasional space-outs is now autistic.
3) True conservatism isn’t just about being pro-gun or pro-life. It’s not a one- or even two- or three-issue mindset. It’s a political idealogy that espouses the belief that government is nothing more than individuals banding together to defend their individual, God-given rights. Those rights only number three: Life, liberty and property; or as paraphrased in our Constitution, Life, liberty and the pursuit of happiness. So any assertions that government “has to step in sometimes”; while they might work on the uninformed; are recognized as being pure crap by anyone with any political savvy. The whole, “the free market has failed” mindset has been used by everyone from Cal Hobson to Gene Stipe to David Dank to Kris Steele to Karl Marx. The free market works fine, even when you or I sometimes come up on the short end of the stick.
4) Medicaid, Sooner Care, call it what you want, it’s all people reaping where someone else has sown, it’s all unconstitutional and it’s all theft. Stealing the operation of private and/or self-funded plans from their rightful owners is just yet another unconstitutional avenue to take. There is a program that provides treatment for autism. My tax dollars pay for it, so you’re welcome. Regardless of how the plan is written, Medicaid generally pays for anything and everything, provided the recipient is prepared to grovel, whine, and holler about their rights enough.
Comment by Butchey Weinstein — September 14, 2008 @ 1:46 pm
Is not an autistic child’s life at risk? Is not his pursuit of happiness at risk? What about these parents’ property? All this is at risk.
True conservatism should not be “I got mine, now you get yours any way you can. And, oh, by the way, if you encounter any difficulties along the way – tough, you should have planned better.” Hogwash. We are better than that, or at least I hope we are.
And Butchy, I cannot wait to see a receipt for your contribution to Easter Seals new autism pre-school. Talk, as they say, is cheap about conservative principles. Let’s see the cancelled check.
Comment by Jay Paul Gumm — September 14, 2008 @ 3:09 pm
Hey Butchey-It is amazing to me how much MORE you know about something we have lived with for over 6 years. We pay $1000/month to Aetna for the best medical program offered by my company. Aetna doesn’t pay for the speech/language pathologists (our son is considered non-verbal), occupational therapists, physical therapists, nutritionists, gastroenterologists that specialize in treating autistic children (our son has enterolcolitis as a result of his autism diagnosis), supplements (because of autism, our son’s immune system is highly compromised), or the home therapists that work with our son 45 hours/week.
So I guess if I needed a wheelchair or if my son needed breathing treatments (as long as the diagnosis wasn’t associated with autism), Aetna would pay for these. THERE ARE NO PRIVATE PAY INSURANCE COMPANIES IN OKLAHOMA THAT COVER AUTISM…..but you knew that, didn’t you?
But let’s get down to what you are really trying to accomplish. You are trying to convince those who read this blog that Senator Gumm’s logic is flawed. This is impossible. You can throw out all of the du jour comments you like, but in reality you and whoever else is using your pseudo name are insurance lobbyists without the courage to use your real name(s).
As a parent who lives with autism day in and day out, who has tried every imaginable way to obtain services to help with the $5000/month bill we must pay for our son so that he doesn’t grow up and live off the taxpayers, I say this: People like Senator Gumm looks at a problem and says, “Is this the best way to do this?”, Cowards, on the other hand, say “It can’t be done”.
You Butchey are a coward. Oh, and yes I do like to call it like it is….I’ve never been accused of being as tactful as my husband.
By the way, do you know the difference between a pit bull and the mother of a child with autism? NOTHING!
Robyne Rohde, Mommy to Austin and Nicholas (Nick’s Law)
Comment by Robyne Rohde — September 14, 2008 @ 3:14 pm
Senator Gumm,
Only a socialist uses constitutional, God-given rights as an excuse for redistributionist scams like Nick’s Law. I’m sure George Sore-ass would love your logic.
Mrs. Rohde,
I’m not without sympathy for the plight of your son or your family. I simply refuse to sacrifice my belief in the Constitution. Sounds like your family has the wherewithall to deal with this responsibility/gift God has given you. Others should be so fortunate. My arguments are based on logic, yours on emotion. Government is supposed to be logical, charity emotional. When we start muddying the water, we get garbage like this.
Comment by Rhythm Guy — September 14, 2008 @ 7:50 pm
To Rhythm Guy
Thanks for the comments. Just wanting to get to know you better. Continuing down the current path, I just want to know the people that will asked to pay more in income taxes to cover the state administered health care system that you are creating.
We want none of that. Autism was covered several years ago, now it is not. We do not want government run health care, but you seem not to care if we get there fast.
We are asking for our state government to address a wrong and a fraud that is being placed onto the taxpayers of OK and also the most vulmerable members of society, the children of special needs.
You might be interested in the 6 class action suits across the country that have been filed in several states to address this issue.
The district courts have already ruled against an insurance company in Colorado. It has been upheld by appeals courts as well.
Seveal states are going about this problem by accepting that it is in the best interests of the taxpayers to address this problem with private insurance rather than raising taxes dramatically. 6 states in the last 2 years including Texas, Arizona, Louisiana, Florida, and South Carolina. All with republican legislatures and most of them with republican governors. Oops.
Comment by Wayne Rohde — September 14, 2008 @ 8:17 pm
To Rhythm Guy:
Appreciate the concern but please don’t try to minimize this crisis by calling it emotional. This was one of tactics that Peterson used and ….well..you can see how popular it made him.
Everything I said about my son is factual not emotional. And no, we can’t afford it. We don’t own our house; don’t take vacations, drive old cars, sold our wedding rings, golf clubs, and put off getting dental work done on my husband because we pay for our son’s care before we pay for anything else. This isn’t emotional; this is the reality of thousands of parents in our state. Oh, did I mention, we have used up and/or borrowed against our retirements? Again, this is our reality.
I find it disappointing that when our opponents can’t respond to the realities that thousands of families face every day in Oklahoma….they like to call it ‘emotional’.
Read Senator Gumm’s facts, then reread my husband’s response. These are the realities of what will happen if we don’t pass Nick’s Law.
Comment by Robyne Rohde — September 14, 2008 @ 8:33 pm
Dont throw mccain’s naming autism to mean he supports mandates – read the party platform – States shouldnt pass mandates. it rasises premiums. period. you cant debate that fact. To help you you do so at the expense of others – those that are underinsured or uninsured. I hope that makes you sleep well at night. And for the love of god stop saying its about the insurance companies – IT ISNT. they dont give a damn if a legislature passes a premium or not – they pass that cost along to the consumer. just like with every other product. the end user pays, not the distributor of the product. Finally, autism, as bad as it is, isnt the only problem facing our country, nor the only sickness. Get in line with everyone else that has a problem. Cancer, downs, AIDS, blindness, SIDS, epilepsy, etc. etc. Its an overdiagnosed problem that causes the costs to spiral because its misdiagnosed too often. I know that isnt your fault – but its as much the root of the problem for how expensive your treatments are as anything else.
Comment by Mike — September 14, 2008 @ 8:42 pm
Well, the facts do not support the “mandates raises rates” arguments. Everyone is entitled to their opinion; they are not entitled to their own facts. Enough said.
Comment by Jay Paul Gumm — September 14, 2008 @ 8:54 pm
Mike: Unbelievable!
By the way, wonder how cancer, aids, blindness, epilepsy….gets ‘over-diagnosed’.
Tell me…how does that work exactly?
I bet people are just pretending they can’t see or pretending to have epileptic fits….oh and I bet lots of people ‘claim’ to have AIDS and it just find a way to fool those doctors and insurance companies….
Unbelievable!
Comment by Robyne Rohde — September 14, 2008 @ 8:57 pm
Well, the facts do not support the “mandates raises rates” arguments. All one has to do is look at other states’ mandates, costs and percentage of uninsured – but that’s probably too hard. It’s easier to believe the myth – that way one can avoid the discomfort of thought. Everyone is entitled to their opinion; they are not entitled to their own facts. Enough said.
Comment by Jay Paul Gumm — September 14, 2008 @ 9:04 pm
Any arguments I could make have already been made, far more eloquently than I could replicate. However, I will say this… The senator seems to be laboring under the assumption that no one should mind this bit of government intrusion due to the fact that it won’t cost them anything. Not only is that bull hockey, it’s like saying no one should mind the Patriot Act if they have nothing to hide. Time to get back to just, legitimate and proper governing, people.
Comment by Rhythm Guy — September 15, 2008 @ 7:01 am