Monday, March 23, 2009

Autism Treatment and Government Insurance Mandates

In a March 1, 2009, essay published on the blog of the campus newspaper The Undercurrent, Rituparna Basu argues persuasively against a proposed Virginia law (House Bill 83) “that would require insurance companies to cover the medical costs of treating children with autism”. Rituparna writes:

This bill will make it illegal for insurance companies to offer coverage that does not include treatment for autism, even if they can offer a more affordable insurance package without such coverage. This means that everyone will be forced to buy coverage for autism treatment, even if their children don’t need it or if they don’t have children at all. (In fact, spiraling insurance costs are in part due to more and more benefits being mandated by law.)

Parents of autistic children in support of this bill argue that “they should be able to give their children any treatment they feel works and not be socked with astronomical medical bills.” Whatever their intent, in practice this means others are socked with these bills.

If it is unfair for parents of autistic children to have to pay their children’s medical bills, how much more unfair is it for other parents to have to pay the same bills?

Insurance mandates like the Virginia proposal are in fact not insurance at all, but wealth redistribution schemes masquerading as insurance. They are one of the many government intrusions into the medical field that is crippling American healthcare. But if insurance companies are not forced to cover autism treatment, commenter asks:

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…

Rituparna responds that:

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.

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.

The issue is clear-cut. The guiding moral principle of individual rights as well as the government’s proper role as protector of those rights unequivocally call for the defeat of that legislation in Virginia.

But also exposed here is the inherent injustice and contradictions of our current health care system, which I brought out in this comment on the site:

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. 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.

My comments were well received by Elisheva Levin, a parent of an autistic child, who is in just the financial situation fretted about:

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!

The proliferation of insurance benefit mandates (over 2000 nationwide) is one of the key reasons for the soaring cost of health insurance. Once we started down this road, the inevitable result had to be rising demands from special interests demanding that “their” ailment be forced down other peoples’ throats. The end result is a steady de facto socialization of medicine masquerading as “insurance”, with a pseudo-private, government protected big insurance company cartel providing the conduit for state power.

Abolishing all benefit mandates is one of the key reforms needed to restore contractual freedom to the health insurance market. Derived from the fundamental rights of the individual, the right to freedom of contract between voluntarily consenting adults is both the moral and the practical thing to do.

No comments: