 |
 |
By Wayne Rohde
The Oklahoma Legislature will be considering Nick’s Law, introduced by Sen. Gumm-D, Durant, Sen. Anderson-R, Enid, and Sen. Easley-D, Tulsa, 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.
Wayne Rohde (a true Reagan Republican)
OK Legislators’ Blog: Another Chapter in the Struggle – Senator Jay Paul Gumm
Nick’s Law & Autism Legislation in Oklahoma blog: Dr. Jepson Seminar on Financial Impact of Autism
27 Comments
1. Adam replies at 13th January 2009, 9:51 pm :
No, Wayne, this is not “free market” it is more government interference in the market by requiring PRIVATE companies pay for something. This is not free market, and to claim that it is, makes you a liar.
Nick’s law is wrong, and you are wrong for trying to require private companies, using the force and power of the government, to pay for the medical costs of individuals.
Nick’s law is NOT good for Oklahoman’s and it is not the right thing to do. Stop, Wayne, stop trying to drive insurance companies out of Oklahoma, stop trying to penalize private enterprise, and stop trying to use government to push the cost of care for your children onto somebody else.
2. Wayne Rohde replies at 14th January 2009, 4:00 pm :
Adam
Sorry that you feel that way towards others who are not as perfect as you.
Private Insurance will provide coverage or the taxpayers will pay for it. Your choice.
By the way, 30 states will be introducing legislation similar to Nick’s Law this year along with a federal mandate that is gaining bi-partisan support in DC.
Most of the Red states are seeing this as the best way to deal with the exploding epidemic known as autism. Texas, LA, SC, AZ, PA, IL, IN, and FL in the last few years. Insurance companies are still thriving in those states. Where would the insurance companies go? Many states have more mandates that OK.
By the way, TX, AZ, FL, and LA have uninsured rates equal to or greater than OK and the saw what is the “Right Thing to Do.”
3. Seth replies at 14th January 2009, 4:10 pm :
Wayne,
Your legislation is obsolete, Blue Cross and Blue Shield of Oklahoma announced this year that they are launching Autism coverage. That, as Speaker Benge pointed out, is a true free market response to demand.
As the bottom line of BCBS grows because of the unique service that they offer, market incentive will cause other companies to offer similar services.
What you are looking for is a free ride Wayne, you are looking to pass your responsibilities to someone else.
Even if we were to mandate Autism coverage today, tit would not solve any problems. The VAST majority of Oklahomans do not have insurance coverage…and by mandating that companies cover even more, will just raise the cost of premiums putting it even further out of reach.
What is your solution to the uninsured problem? Universal Health Care?
You got one thing right, you are a true ‘Regan Republican’! Regan, whose economic plan of deficit spending known as ‘Reaganomics’ gave us the disaster that we have today.
4. Sheri replies at 14th January 2009, 4:27 pm :
Seth, Seth, Seth
Igorance is Bliss. Right now the taxpayers are fronting the cost. $310 Million in the hole we are but lets add more to the existing state tax bill. Tax payers pay for Sooner start , medicaid , ssi and if your IQ is above 71 or make 1cent more than what is allowed you get nadda.
Check out the Oklahoma State Representative Republican’s solution…..
http://okhouse.gov/OkhouseMedia/pressroom.aspx?NewsID=1726
5. Sheri replies at 14th January 2009, 4:30 pm :
Seth the more state dollars pay into state ran autism care instead of insurance the more you are being fished into Universal Health Care…………..
6. Seth replies at 14th January 2009, 4:54 pm :
Sheri you are ignorant, you cannot create a straw man argument, if you want to argue the merits of other state programs we can do that. But that is not the argument. I am not arguing for universal health care, but that is ultimately where Nicks Law will lead, because not every person with autism is covered by insurance, in fact very few people have insurance. Because if you mandate that insurance companies cover autism, then that will include autistic persons on SoonerStart increasing the bill for SoonerStart!
Never the less, even if they are approved, when did it become the responsibility of the private sector to be forced to take care of people? Is that not a choice? Where do we draw the line? But even that is not the question.
The question is, do we value the principles that this country was founded on, that namely being voluntary association, and the rights of businesses to offer the services that they wish to offer?
7. Seth replies at 14th January 2009, 4:58 pm :
As long as you want to play “Lets-Post-A-Press-Release”
http://okhouse.gov/OkhouseMedia/pressroom.aspx?NewsID=1726
Why should I have to pay YOUR autistic child? MORE that I already am!!
8. Vicki replies at 14th January 2009, 5:31 pm :
Ouch! Seth you are truly a mean spirited man. Why should the rest of us with private have to pay for someone else’s insulin, viagra, chemotherapy or drug rehab? I don’t have diabetes. I don’t do drugs or have cancer, but that’s all rolled into MY insurance policy.
These kids and families can’t help that they have autism. Why are you so angry about them having insurance? If we’re PAYING for it, we’d like it to cover our treatments. It seems fair to me. If we don’t get insurance coverage, they’ll just be pushed onto the rolls of Medicaid, with case management and government oversight, and you’ll REALLY be paying for it them.
The information the legislators are putting out is misleading. I can’t help but wonder how much the insurance companies are paying to prevent this coverage, and if it wouldn’t be cheaper to just adopt the coverage and move on.
9. Wayne Rohde replies at 14th January 2009, 5:51 pm :
Seth
Please read the details of the BCBS announcement. It does not provide coverage for the clinically proven and medically necessary therapies that our children need to recover from autism.
What it does cover is what other insurance companies already cover. Brings them level with their competitors. That is all.
Without private insurance coverage, more and more children and adults will be dependent on state run and paid for health care. That is what is called universial heath care.
Take a deep breath, and think about your inward comments. The market place has not worked and will not respond to this epidemic. They used to cover several years ago, but once the prevelence exploded so did their efforts to slide in exclusionary clauses. Now, who is kidding who here.
By the way, 30 states are introducing legislation similar to Nick’s Law this year. And a federal mandate is gaining bi-partisan support in DC. Let’s get a bill done to fit Oklahoma or someone else will tell us what to do.
10. Seth replies at 14th January 2009, 9:05 pm :
“By the way, 30 states are introducing legislation similar to Nick’s Law this year. And a federal mandate is gaining bi-partisan support in DC. Let’s get a bill done to fit Oklahoma or someone else will tell us what to do.”
Argumentum ad Populum: Meaning, it is right because everyone else is doing it.
Did your father ever use the phrase “If all of your friends jumped off of a cliff would you jump too?”?
“The market place has not worked and will not respond to this epidemic. ”
Then quit billing this as a ‘free market approach’ and call it what it is, Fascism, National Socialism, where the state all but takes control of the private sector.
11. Adam replies at 14th January 2009, 9:11 pm :
Nice try Wayne, you are merely demonstrating that you’re as irrational as you are dishonest. Your red herring about perfection did not go unnoticed by thinking people, and it only confirms that you’re seeking to manipulate the legal process with irrational appeals and insinuations.
Tell ya what, Wayne, why don’t YOU pay for the care of YOUR child, instead of trying to force private companies to do it for you? Last time I checked, voluntary association (thanks Seth)…you know, freedom, responsibility, all that…dictates that it isn’t anybody else’s responsibility to care for you. Taxpayers paying for it is the same thing: pushing the cost of care for yourself or your child onto somebody else. Instead of the entire tax paying population of Oklahoma, you want to penalize a select few.
Just because the majority is doing something doesn’t make it right. Fallacy #2 in this one comment. Who cares if every other state in the Union is doing it? It has no bearing on the subject whatsoever, so quit pulling it out as if it does. The question isn’t, nor ever has been, “what is everybody else doing?” The question is, whether it is the right thing to do. And the answer is clear: it isn’t.
You’re a responsibility-dodging fascist in the strict meaning of the term. You want government to take care of you at the expense of another private group.
I say again: stop Wayne.
12. Wayne Rohde replies at 14th January 2009, 10:47 pm :
Seth and Adam
Good Day to both of you. Too bad that you are consumed with so much hatred towards your fellow man.
13. Adam replies at 14th January 2009, 11:08 pm :
Thank you Wayne. Continue to demonstrate that you’ve no rebuttal, and that ARE in fact trying to get others to pay for your responsibility.
Those of us who aren’t seeking to steal from our fellow man see you for what you are: a sycophantic socialist trying to hide your greed like every other socialist/fascist has done: In the name of “fellow man.” Your interest in “fellow man” extends only insofar as you are able to use government to steal from them for your private benefit.
14. Seth replies at 14th January 2009, 11:24 pm :
As typical of a National Socialist, once cornered with the facts, there is no response. Hide behind your National Socialistic ideals of “the betterment of man kind”.
I encourage the people who read this post to go and read about what exactly a National Socialist and a Fascist are, and then it becomes clear that this legislation is philosophically rooted in Socialism, and that it should not be veiled ‘free market solutions’ when what you are proposing is counter intuitive to every free market principle that has ever been laid out, from Adam Smith to Ayn Rand to Alan Greenspan. This sir, is a slap in the face to free market capitalism, and when confronted with that fact, there is no response.
15. Wayne Rohde replies at 14th January 2009, 11:50 pm :
Adam and Seth
Let’s continue this discussion off list. I can’t decide whether you are high school seniors or first year law students. Hope that you are not the ones that worked at interns at the capitol.
If you dare, email me directly and we will have a civil discussion.
wrohde@cox.net
16. Laurie replies at 14th January 2009, 11:55 pm :
Adam said:
“stop trying to use government to push the cost of care for your children onto somebody else.”
Adam, by not passing Nick’s Law, it is the government who is pushing the cost of caring for our beautiful children onto somebody else. Today a child needing treatment has to depend on state (tax payer) funded programs for these treatments. Nick’s Law would take some of the burden OFF of the taxpayer.
Seth said,
“What you are looking for is a free ride Wayne, you are looking to pass your responsibilities to someone else.”
A free ride? How is paying insurance premiums a free ride? Isn’t what the government is offering now a free ride? State funded programs paid for by YOU.
Seth you also said,
“if you mandate that insurance companies cover autism, then that will include autistic persons on SoonerStart increasing the bill for SoonerStart!”
Sooner Start is a state funded (tax payer funded) program and is FREE of charge to those who participate. If a child is on Sooner Start and his insurance actually covered treatments – Sooner Start costs could actually go DOWN.
One more from Seth:
“when did it become the responsibility of the private sector to be forced to take care of people”
Seth, the way the system works right now, it is the responsibility of the private sector (tax payer) to cover costs related to autism. Because insurance does not cover Autism, the costs are then shifted onto the state funded programs. Funded by you, the tax payer. So actually the government is currently making it the responsibility of the private sector to take care of these children.
Please take a minute to do some research on this issue and you may better understand our point of view.
Seth also said,
“What is your solution to the uninsured problem? Universal Health Care?”
How does paying a premium to the insurance company and expecting them to cover treatments sound like Universal Health Care? Don’t you think that as taxes continue to rise due to all these free state funded services that perhaps THAT will take away from people’s ability to pay insurance premiums?
And on a personal note – I believe it truly does take a village.
17. Harriet replies at 15th January 2009, 12:14 am :
Wayne,
I am confused about something. Can you please articulate what is it that either of these fellows have said that is a problem for your position? I would like to see an intelligent discourse of the issue.
You appear to be an intelligent fellow so why not give them a point by point rebuttal?
I see nothing wrong with continuing the discussion in this public forum. After all, to my knowledge this is not a censored site and we are still (hopefully?!) able to exercise our right (as citizens of this great nation) with regards to freedom of speech.
If one does not wish to hear what they have to say, one simply doesn’t read it. Just as I am not obligated to listen to (or read, in this instance) any opinion that may dissent from my own, you too may ignore anything said by dissenters to your opinion.
Unless you have something to hide, I would like to see a serious rebuttal in the public forum to counter the points that have been made.
What is it that is in error with their points and why are the arguments they have made not valid? Continuing this discussion off list which involves public policy and legislative matters gives the appearance that there are some factors at work here about which the general public should not know. I would hope that is not the case.
Illuminate us, please.
18. Adam replies at 15th January 2009, 12:32 am :
“Let’s continue this discussion off list.” ~ Wayne
No Wayne, you made this post public, any criticism you receive ought to be public. Especially considering that you’re trying to make this a public law…trying to take it out of the public spotlight is absolutely unacceptable. If I am wrong, prove it publicly…and I will admit such. But trying to take it away from public scrutiny where the SERIOUS problems with Nick’s Law ought to be debated, is intolerable.
“Adam, by not passing Nick’s Law, it is the government who is pushing the cost of caring for our beautiful children onto somebody else. Today a child needing treatment has to depend on state (tax payer) funded programs for these treatments. Nick’s Law would take some of the burden OFF of the taxpayer.” ~ Laurie
Is the concept of YOU paying for YOUR child that difficult to comprehend? Furthermore, more wrong legislation isn’t justified by current practices that are wrong.
Insurance companies are in business, they are not charities. Therefore, if you use the force of government to demand that they take care of you, they’re going to pass that cost along to other people. Thus, your excuse that somehow forcing other private entities to pay for your medical costs is going to reduce the cost to other taxpayers is entirely without merit.
“And on a personal note – I believe it truly does take a village.” ~ Laurie
Which is EXACTLY what I’ve been saying: this law is socialist/fascist to the core. It is the avoidance of personal responsibility in the hopes that you can successfully manipulate government to pawn the personal costs off on someone else.
Maybe some people don’t have a problem with socialism, but I do.
19. Seth replies at 15th January 2009, 12:43 am :
“A free ride? How is paying insurance premiums a free ride? Isn’t what the government is offering now a free ride? State funded programs paid for by YOU.”
Wayne has insurance (I do believe, why else would he argue for this law?) he is looking for someone else to pay for what is currently coming out of his pocket. (the cost Nicks Autism treatments) How is this not a free ride.
“Sooner Start is a state funded (tax payer funded) program and is FREE of charge to those who participate. If a child is on Sooner Start and his insurance actually covered treatments – Sooner Start costs could actually go DOWN.”
First, it should be pointed out that it is “FREE” and that there is no such thing as free, we are paying for it already. Secondly, I will continue to pay for SoonerStart through my tax dollars, and then on top of that, I will pay for Autism treatment in my insurance premiums that could increase anywhere from 7.2% to 19% if Nick’s Law is implemented. What is sad about all of this? I will never be able to have children to utilize what is being plundered from me.
“Seth, the way the system works right now, it is the responsibility of the private sector (tax payer) to cover costs related to autism. Because insurance does not cover Autism, the costs are then shifted onto the state funded programs. Funded by you, the tax payer. So actually the government is currently making it the responsibility of the private sector to take care of these children.”
You are not taking responsibility for your own child, you are instead creating a fallacious dichotomy, in that there are more than just the two options that you have provided. 0.002% of the population has Autism (http://autism.emedtv.com/autism/autism-statistics.html). Why can’t churches and other charitable organizations pick up the slack for what the poorer families cannot afford? Not saying that is my solutions, but that is an option, one that you apparently have not considered. Why should the 99.998% of the population be forced to pay for their treatment?
“How does paying a premium to the insurance company and expecting them to cover treatments sound like Universal Health Care? Don’t you think that as taxes continue to rise due to all these free state funded services that perhaps THAT will take away from people’s ability to pay insurance premiums?”
Not everyone can afford insurance, which means we will still have autistic children not being covered by your fantastic plan. How are we to get those children covered by insurance? Maybe your next comment would give us a look at who you are looking at for a solution?
“And on a personal note – I believe it truly does take a village.”
Hmm…Hillary Clinton?
20. Wayne Rohde replies at 15th January 2009, 2:16 pm :
To Seth and Adam.
This is complicated and requires a lot of information so you can understand what the current costs of providing treatments.
1. Children can recover from autism. If left untreated, eventually they will become wards of the state and the taxpayers will pay for their care. A current cost analysis by Harvard Univ in 2006 puts the cost of lifetime care at $ 3.25 million per individual in Oklahoma if that care is provided by the state. With approx 400-450 children each are diagnosed with autism in Oklahoma, start doing the math if those children do not receive therapies and treatments. It could cost the state nearly 1.5 billion each year to provide care. That is why I am advocating for a more cost efficient model knows as Nick’s Law.
2. Vast majority of the parents in Oklahoma who have children with autism have insurance, whether obtained thru their employer or as an individual plan.
3. In Oklahoma, there is no private insurance provider that provides coverage for the clinically proven and medically necessary treatments known as ABA (Applied Behavorial Analysis – behavior therapy). ABA is the most cost effective treatment for autism and has been endorsed by US Dept of Ed, Surgeons General, AAP, US Dept of Defense thru their TriCare program for autism, and the list is longer. Some speech, OT, and PT are covered with extreme limits. Behavioral Therapy is generally 80% of the total cost of treatment, yet no coverage.
4. Currently, most families will spend from $ 2,000 to $ 5,000 out of pocket each month to cover the costs. Those who can not provide these resources seek gov’t paid for programs.
5. These families have liquidated their own life and retirement savings, borrowed from extended family, sold homes, filed bankruptcy, 80% divorce rates, been foreclosed, just so they can provide these treatments for their children. And the kids are improving dramatically. We are wanting our kids back and to become self sufficient members of our society instead of becoming very very expensive burdens.
6. The actuary study by the House that was released last week states insurance costs will increase up to nearly 20% is a fraud. The calculations are misleading and inaccurate. The report contains several grammatical errors as well. Even a couple of insurance actuaries from a state that passed an insurance mandate agreed with our findings. This was nothing more than an attempt to relieve some political pressure.
7. The actuary study and methodology that was prepared and we presented in April 2008 has been endorsed by several other state legislatures. That study showed that the average policy would be effected by 0.473% which is consistent with CAHI, a national organization of insurance providers. There statements show that an autism mandate cost less than 1.0%.
8. I am very concerned about the high % of uninsured in Ok. That itself creates higher medical costs for all. However, it is a faulty argument to state that Nick’s Law will raise rates. Several other states that have passed mandates have uninsured rates equal to or greater than OK. Texas, LA, FL, and AZ.
8. The prevalence for those seeking services is not 1 out of 150. That is the prevalence of autism. Consistent actuary prevalence would dictate that 10% of children with autism would seek the max benefit of Nick’s Law and scale back from there. This is because of the wide range of severity of autism spectrum disorder. This is the big error in the House study that was released.
9. Universal Health Care is a difficult concept since there is a wide range of opinions of what that would look like. It is my belief that if we get a model similar to what Europe or Canada has, then we will be worse off, instead of better, regarding treatment of individuals with any disability or disorder. The specialists are not there. There is extreme rationing of services. So I do not want us moving in that direction. Gov’t paid for health care must exist for a small segment of our population that have no means to provide for themselves. But when that segment becomes the majority of people in society, then we are in serious trouble.
10. Insurance companies continuing to deny coverage, forces families to seek state and federal services. We do not want gov’t handouts. We want to contract with private insurance to help provide coverage. Otherwise, the families are broke and the care of these children will be left on the doorstep of the taxpayers. Insurance riders do not work, we are just self insuring ourselves.
11. 80% of all children with autism are under the age of 16. In a couple of years, the first big wave will start applying for state benefits. What would happen if they received treatments and therapies? They would not require as many expensive benefits and care. We want our children back and to be self sufficient members of society. They can work, pay taxes, and co-exist into society.
12. There are now 8 states that have passed similar legislation to Nick’s Law. There will be no less than 30 states that will be introducing or re-introducing legislation this year. It is because of this great epidemic and the huge financial and emotion burden on the families and children. We must address this. There are many research projects ongoing to help stop this epidemic and hundreds of millions of dollars being spent. At last count 1.5 billion have been approved by legislation but not yet completely funded on the fed level. Our argument in Oklahoma is not about what causes autism, but how we should provide care for these children and adults.
13. Someone mentioned Sooner Starts. That program exists to provide some care up to the age of 3. that is it.
14. For those who say that we are asking for a free ride regarding insurance, let me ask you this? Do you consider people that have vision and dental coverage slackers? What about breast cancer, kidney transplants. They are all mandates place upon insurance by either legislative measures, lawsuits, or medical practitioners.
15. We welcome the House Autism Plan to help create an infrastructure of practitioners. However, it does not go far enough. It is like building a hospital and recruiting doctors. But someone forgot about the support staff, the nurses that work with the patients, and finally HOW TO PAY FOR THEM.
21. Laurie replies at 15th January 2009, 4:04 pm :
*Seth* You said, “You are not taking responsibility for your own child”
Do you know of anyone who pays 100% of their children’s medical costs without utilizing either insurance coverage or state services? Anyone who pays 100 % of their own medical costs?
Are you saying that anyone who uses insurance benefits is not taking responsibility for themselves or their children?
*Seth* 0.002% of the population has Autism (http://autism.emedtv.com/autism/autism-statistics.html).
Well then when Nick’s Law passes it really shouldn’t affect premiums. By the way, those stats are from 2006 and the rate is no longer 1 in 166 children but 1 in 150.
*Seth* “Wayne has insurance (I do believe, why else would he argue for this law?) he is looking for someone else to pay for what is currently coming out of his pocket. (the cost Nicks Autism treatments) How is this not a free ride”.
Yes Wayne has insurance as I do. Just to be clear – are you saying that if our insurance companies (who take our premiums) pay for services – you consider that a free ride?
*Seth* “First, it should be pointed out that it is “FREE” and that there is no such thing as free, we are paying for it already.” ( soonerstart)
I believe I stated that more than once in my post. I said the tax payer was paying for these programs. And as Wayne stated, it only covers children to age three.
*Seth* “Secondly, I will continue to pay for SoonerStart through my tax dollars, and then on top of that, I will pay for Autism treatment in my insurance premiums that could increase anywhere from 7.2% to 19% if Nick’s Law is implemented”
(From Waynes Post)
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. ~~~~
Seth the study numbers showed that the increase would be much less than those stated in the Republican’s study. We could play dueling studies for years while every year in Oklahoma 400 children are diagnosed.
*Seth* What is sad about all of this? I will never be able to have children to utilize what is being plundered from me.
If you had children and they never had to utilize state services or fight for treatments – I would not consider that “sad”. If you are saying you will never recoup monies you’ve contributed through taxes – we all pay for programs and benefits that we never utilize. State Tax, Federal Tax, City Tax, etc.
*Seth* Why can’t churches and other charitable organizations pick up the slack for what the poorer families cannot afford? Not saying that is my solutions, but that is an option, one that you apparently have not considered. Why should the 99.998% of the population be forced to pay for their treatment?
Ok – 99.998% of the population is paying right now through taxes for state funded services. Insurance companies paying for a small percent (only those insured) of these children’s treatments would take some of the burden off of the taxpayer. And wouldn’t taking money from a church or charitable group also be a “free ride”? Some of these families are paying thousands out of pocket every single month. Mortgaging homes, cashing in retirement accounts, all to pay for treatments.
*Seth* Not everyone can afford insurance, which means we will still have autistic children not being covered by your fantastic plan. How are we to get those children covered by insurance? Maybe your next comment would give us a look at who you are looking at for a solution?
What is your solution? Everyone pay 100 % of their own medical bills with no insurance coverage? Yes there are uninsured. Yes it is a problem. Children without insurance will continue to utilize the state services. The numbers continue to grow and insurance coverage would take some of the burden off of the tax payer. I wish every child could be covered. I don’t have “the” solution Seth. But I do see both state funded services and insurance coverage as parts of that solution.
22. Seth replies at 15th January 2009, 4:35 pm :
“Children can recover from autism. If left untreated, eventually they will become wards of the state and the taxpayers will pay for their care. A current cost analysis by Harvard Univ in 2006 puts the cost of lifetime care at $ 3.25 million per individual in Oklahoma if that care is provided by the state. With approx 400-450 children each are diagnosed with autism in Oklahoma, start doing the math if those children do not receive therapies and treatments. It could cost the state nearly 1.5 billion each year to provide care. That is why I am advocating for a more cost efficient model knows as Nick’s Law.”
I just read the study of which you speak, the cost figures that you gave a high end, because if you go with the low end figure that was also provided ($39,000 a year) it would only cost the state $16Million or a maximum cost per year per child of $130,000 which would be $58.5Million . (http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html)
Do you realize that you are talking about burdening the entire state with the costs of not only SoonerCare and other state programs(Because Nick’s Law would not end the programs) but also higher insurance premiums for 450 people? There are 3.6 Million Oklahomans and you want all of them to pay for Autism treatment TWICE!
“Vast majority of the parents in Oklahoma who have children with autism have insurance, whether obtained thru their employer or as an individual plan.”
I would like to see proof, because even if that is so, there will still be that group of autistic children who don’t. Also, what is your plan for when the child reaches the age 18 and is no longer covered by his/her parents insurance. In Illinois for example, once the child reaches 18 they have two more years as a dependent before they are removed from the insurance policy. How then are you to pay for the remainder of their life? Once YOUR (as a parent) insurance no longer covers?
“In Oklahoma, there is no private insurance provider that provides coverage for the clinically proven and medically necessary treatments known as ABA (Applied Behavorial (sic) Analysis – behavior therapy). ABA is the most cost effective treatment for autism and has been endorsed by US Dept of Ed, Surgeons General, AAP, US Dept of Defense thru their TriCare program for autism, and the list is longer. Some speech, OT, and PT are covered with extreme limits. Behavioral Therapy is generally 80% of the total cost of treatment, yet no coverage”
And there for ever person who seeks insurance in Oklahoma should pay for this why? Is it not the right of a private business to offer what ever services that they wish? Is that not why Gay Rights activists get upset when services are denied to them because of their sexual orientation? Because in our society businesses have (for the most part) the right to offer what ever services to whom ever they wish.
“Currently, most families will spend from $ 2,000 to $ 5,000 out of pocket each month to cover the costs. Those who can not provide these resources seek gov’t paid for programs.”
And by pushing those costs to the insurance companies will only make sure that all policy holders pay that, along with the government programs.
“These families have liquidated their own life and retirement savings, borrowed from extended family, sold homes, filed bankruptcy, 80% divorce rates, been foreclosed, just so they can provide these treatments for their children. And the kids are improving dramatically. We are wanting our kids back and to become self sufficient members of our society instead of becoming very very expensive burdens.”
This is completely irrelevant and is merely a case of Argumentum ad Misericordiam. It has no real bearing on the argument at hand.
“The actuary study by the House that was released last week states insurance costs will increase up to nearly 20% is a fraud. The calculations are misleading and inaccurate. The report contains several grammatical errors as well. Even a couple of insurance actuaries from a state that passed an insurance mandate agreed with our findings. This was nothing more than an attempt to relieve some political pressure.”
First and foremost the study that was released said that it could increase anywhere from 7.2% to 19% it didn’t say that it was a guaranteed to increase by 20%. Secondly the grammatical errors are of no consequence, because if we were to begin and hold grammar as a standard, then from the content of some of your posts, you to would fail. And what are your findings, and how many actuaries do you have? Because I am sure that I could find my own number of actuaries who say that the opposite.
“The actuary study and methodology that was prepared and we presented in April 2008 has been endorsed by several other state legislatures. That study showed that the average policy would be effected(sic) by 0.473% which is consistent with CAHI, a national organization of insurance providers. There statements show that an autism mandate cost less than 1.0%.”
Yet another flaw in your logic, this time Argumentum ad Numeram. Just because the proposition has support does not make it right. Please quit appealing to what other states have done as poof that this is right. Massachusetts and Connecticut approved Gay Marriage dose that mean it the right thing to do?
Which Autism mandate? You say ‘an’ which would mean one in specific, which one, and how dose that compare to what you are proposing? Were can we look at a copy of the mandate that is referenced by CAHI?
“I am very concerned about the high % of uninsured in Ok. That itself creates higher medical costs for all. However, it is a faulty argument to state that Nick’s Law will raise rates. Several other states that have passed mandates have uninsured rates equal to or greater than OK. Texas, LA, FL, and AZ.”
Once again, Argumentum ad Numeram, just because other states have done it doesn’t make it right.
I believe that it is clearly obvious that if you make something more expensive, fewer people will be able to afford what ever service is being offered. Basic supply and demand theory.
“The prevalence for those seeking services is not 1 out of 150. That is the prevalence of autism. Consistent actuary prevalence would dictate that 10% of children with autism would seek the max benefit of Nick’s Law and scale back from there. This is because of the wide range of severity of autism spectrum disorder. This is the big error in the House study that was released.”
I will assume with the largest number available. But what you are saying is that an even smaller fraction of society will benefit from Nick’s Law that what I have been operating under? If not clarify, because the statement your statement is not well constructed.
“Gov’t paid for health care must exist for a small segment of our population that have(sic) no means to provide for themselves. But when that segment becomes the majority of people in society, then we are in serious trouble.”
What you have just could also be worded as “Socialism (government financed health care) must exist for a small segment of our population that has (correct word as opposed to have) no means to provide for themselves.”
“Insurance companies continuing to deny coverage, forces families to seek state and federal services. We do not want gov’t handouts. We want to contract with private insurance to help provide coverage. Otherwise, the families are broke and the care of these children will be left on the doorstep of the taxpayers. Insurance riders do not work, we are just self insuring ourselves.”
You do not want to contract with private insurance; you want the state to be forced to provide a service, which is a violation of basic contract law. Once one party has been forced into the agreement it no longer becomes a true contract in a free market system. You have a fallacious logic in your argument, namely Bifrucation, there are more that just the two options that you have provided.
“80% of all children with autism are under the age of 16. In a couple of years, the first big wave will start applying for state benefits. What would happen if they received treatments and therapies? They would not require as many expensive benefits and care. We want our children back and to be self sufficient members of society. They can work, pay taxes, and co-exist into society.”
What is the point of this statement? Please clarify and I will address.
“There are now 8 states that have passed similar legislation to Nick’s Law. There will be no less than 30 states that will be introducing or re-introducing legislation this year. It is because of this great epidemic and the huge financial and emotion burden on the families and children. We must address this. There are many research projects ongoing to help stop this epidemic and hundreds of millions of dollars being spent. At last count 1.5 billion have been approved by legislation but not yet completely funded on the fed level. Our argument in Oklahoma is not about what causes autism, but how we should provide care for these children and adults.”
I am really getting tired of pointing out your fallacy of Argumentum ad Numeram. I have addressed this several times, and this is just one more case of it. I will go back to my Gay Marriage argument, 6 states in the union recognize same sex unions or marriage, dose that make it the right thing to do? You need to give a more compelling argument than “everyone else is doing it”
“Someone mentioned Sooner Starts. That program exists to provide some care up to the age of 3. that is it.”
Fantastic! That really sinks your supporter’s argument!
“For those who say that we are asking for a free ride regarding insurance, let me ask you this? Do you consider people that have vision and dental coverage slackers? What about breast cancer, kidney transplants. They are all mandates place upon insurance by either legislative measures, lawsuits, or medical practitioners.”
Slackers? No. All though I should point out that the word ‘slacker’ never came out of my mouth. Mandates of any type are wrong, if an insurance company should be able to choose which services they cover. And if Autism were to become a large enough problem, the private sector would capitulate to demand. Basic free market principles, but as it stands, only 0.002% of the population has this condition, therefore the demand is not there yet for them to offer this service. Insurance companies must be profitable and maintain competitiveness.
“We welcome the House Autism Plan to help create an infrastructure of practitioners. However, it does not go far enough. It is like building a hospital and recruiting doctors. But someone forgot about the support staff, the nurses that work with the patients, and finally HOW TO PAY FOR THEM.”
With the infrastructure of practitioners will come the basic free market reality, which is; the desire to undercut the competition will ultimately lead to a benefit to the consumer, supply and demand, the more people offering a service the more competitive the price structure.
23. Seth replies at 15th January 2009, 4:54 pm :
Address to Laurie:
“Do you know of anyone who pays 100% of their children’s medical costs without utilizing either insurance coverage or state services? Anyone who pays 100 % of their own medical costs?
Are you saying that anyone who uses insurance benefits is not taking responsibility for themselves or their children?”
I pay for my own health care, in fact all of the services that I use are not covered by insurance. Acupuncture, herbal medicine, homeopathy, nutrition based healing, those are services that I pay for out of my own pocket. You don’t see me asking for the state to mandate that insurance pay for those services.
“Well then when Nick’s Law passes it really shouldn’t affect premiums. By the way, those stats are from 2006 and the rate is no longer 1 in 166 children but 1 in 150.”
That is the point, that rates will increase, but only a tiny fraction of society will gain. I will round down and say that it is 1 out of ever 100 persons that suffers from autism, that is only 1% of the population, and the number smaller that than by your own admission.
“Yes Wayne has insurance as I do. Just to be clear – are you saying that if our insurance companies (who take our premiums) pay for services – you consider that a free ride?”
When your contract didn’t include those services, and then you wish to use the power of the state to modify an agreement after it has been signed, yes I call that a free ride.
“ (From Waynes Post)
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. ~~~~
Seth the study numbers showed that the increase would be much less than those stated in the Republican’s study. We could play dueling studies for years while every year in Oklahoma 400 children are diagnosed.”
Yup we can, and maybe we should really study this and think this completely through before we attempt to set public policy.
“If you had children and they never had to utilize state services or fight for treatments – I would not consider that “sad”. If you are saying you will never recoup monies you’ve contributed through taxes – we all pay for programs and benefits that we never utilize. State Tax, Federal Tax, City Tax, etc.”
No I am saying, that I will never get to have children, and yet I am still being robbed to pay for your treatment for your children. That madam is sad, not only is it sad, it is wrong.
“Ok – 99.998% of the population is paying right now through taxes for state funded services. Insurance companies paying for a small percent (only those insured) of these children’s treatments would take some of the burden off of the taxpayer. And wouldn’t taking money from a church or charitable group also be a “free ride”? Some of these families are paying thousands out of pocket every single month. Mortgaging homes, cashing in retirement accounts, all to pay for treatments.”
But it is a voluntary option, and government intervention is not required. But I merely brought that up to show the fallacious dichotomy that you created. And the latter portion of that has nothing to do with this argument, it is a textbook example of Argumentum ad Misericordiam.
“What is your solution? Everyone pay 100 % of their own medical bills with no insurance coverage? Yes there are uninsured. Yes it is a problem. Children without insurance will continue to utilize the state services. The numbers continue to grow and insurance coverage would take some of the burden off of the tax payer. I wish every child could be covered. I don’t have “the” solution Seth. But I do see both state funded services and insurance coverage as parts of that solution.”
I am not saying that I have a solution, nor am I required by any rules of argument that I come up with one. What I am saying is that your solution reeks of socialistic and fascist thought, and while some people clearly support it, any person who claims to be ‘capitalistic’ or a ‘free market capitalist’ and most certainly a ‘Regan Republican’ (or at least the generally accepted meaning of the term, even though held a lot of national socialist ideas) should not support the ideology brought forth by Nick’s Law.
24. Adam replies at 15th January 2009, 7:26 pm :
Wayne~
Though I see that Seth has already responded, I am compelled to respond to you as well. Your entire outlay of “information so you can understand” doesn’t deal with the question at all. Its like a word problem in school that throws in a bunch of ancillary stuff to throw you off track.
What is the question here? The question is, is it morally right to use government to force someone else to pay for your medical costs? This is the question, and everything that you say that doesn’t deal with the question is avoidance. I’m going to make this clear…
You are trying to use government to force private groups to pay for your costs.
You even confirm this with point #2 that you make. If insurance that people have already cover these particular treatments, then Nick’s Law is pointless; however, the point is that their current insurance DOES NOT cover this. Your proposal: force somebody else, other than those responsible to pay for it.
I commend your rhetorical abilities…you must have studied the classical examples of people parading their children, wives, families, etc in front of the public and jury to try and persuade them that the ROCK HARD FACTS are irrelevant. Right is right. Wrong is wrong. It doesn’t matter if you want to parade every single child with an illness in front of us, it doesn’t justify trying to force somebody else to pay for it. This is the definition of theft: the use of force against the private property of another. This, Wayne, is exactly what you are doing: initiating force against someone else’s private property, and you just hoping that nobody will notice. This is stealing.
You can’t even keep your own story straight…observe:
“The actuary study … we presented in April … showed that the average policy would be effected by 0.473%”
“it is a faulty argument to state that Nick’s Law will raise rates.”
So which is it? Which of these statements is false?
“Insurance companies continuing to deny coverage, forces families to seek state and federal services. We do not want gov’t handouts. We want to contract with private insurance to help provide coverage.”
This is totally false. You ARE looking for a government handout…you’re looking for government to force someone else to take care of you. That is a government hand out. Plundering your neighbor with the arm of government is still plundering your neighbor.
Furthermore, you do NOT want to contract with private companies…otherwise you’d be negotiating with private insurance companies…you want the government to force these private companies to take care of you.
“For those who say that we are asking for a free ride regarding insurance, let me ask you this? Do you consider people that have vision and dental coverage slackers? What about breast cancer, kidney transplants. They are all mandates place upon insurance by either legislative measures, lawsuits, or medical practitioners.”
What do you not understand about this Wayne? Two wrongs, don’t make a right. Three wrongs don’t, and many wrongs piled on top of each other don’t make it right. If government forced a private company to pay for the medical costs of somebody…I don’t care what the ailment is…it is wrong. If insurance companies already provided this care, you wouldn’t be here; if insurance companies complete a cost-benefit analysis and determine that it is a good decision to cover dental matters, and they contract with you to cover dental problems for $x.xx a month, then there is no problem. Same goes for autistic care. But they haven’t. This is not a service that is being offered. (pay attention here) SERVICE. Just like trying to get the government to force your oil and lube company to also put new tires on is wrong; insurance companies are offering a service to people…they are in business…and the services that they offer are limited. You don’t like this, you want a free ride by forcing them to now offer you the service you want.
Let me make this very clear: nobody has a right to insurance, anymore than I have a right to a movie ticket. Both are services that are being offered by private companies. For you to come along and try to force a private insurance company to take care of you is flat WRONG.
It is stealing.
If these points are your argument for Nick’s Law, I pray to God that the legislators this year see through your shenanigans and greed, and tell you no: you do not have the right to force somebody else to take care of you.
25. Wayne Rohde replies at 15th January 2009, 7:54 pm :
To Seth and Adam
I must admit. You both are so damn smart. Probably too smart for 1st year college students.
Need to live in the real world not in your college hypathetic what if.
Here ends the lesson. Welcome to the real world gents.
26. Sybil replies at 15th January 2009, 10:08 pm :
These guys make some great points.
Too bad you are unable or unwilling to actually make rebuttal.
I am glad the point was made that using the force of government on the private sector is the equivalent of stealing.
I, too, hope legislators see through this.
27. The Enforcer replies at 16th January 2009, 9:50 pm :
Great comments Seth and Adam!
Wayne – tired of threatening all of our elected officials yet? Try swimming with dolphins or something like that to relieve stress.
Leave a comment