Tuesday, March 3, 2009

The Impact of HB 1588


How would the government benefit from HB 1588?

"Admittedly, in the near term, mandating this coverage could add slightly to the cost of health insurance in Virginia. But whatever the cost, and no one can say for certain what it will be, it pales by comparison with what it will be if we fail to invest now in early intervention services. Autistic children who receive insufficient treatment can sometimes end up being institutionalized at taxpayer expense, at costs in the millions for each patient,” said Delegate David E. Poisson.

The Autism Society of America estimates that the total lifetime cost of caring for an autistic child ranges from $3.5 to $5 million. The United States is spending almost $90 billion annually in costs for autism (this figure includes research, insurance costs and non-covered expenses, Medicaid waivers for autism, educational spending, housing, transportation, employment, therapeutic services and caregiver costs).

By passing HB 1588, the government would benefit from reduced overall expenses related to caring for people with autism. If insurance companies were required to cover these children, the government would no longer be responsible for paying the incurred costs left unpaid by the insurance companies and families. The families of autistic children do not always have the resources available to obtain care. The families alone might only be able to pay for the most basic essential care and not the extra costs that are associated (transportation, behavioral therapy, etc.). The passing of this bill would not only assist the families directly but would also help tax-paying citizens by re-directing the funds once used to care for these children. These individuals would potentially be higher functioning in society if they received the necessary care early on versus providing care later because the therapies received would allow the individuals to contribute more to society.


Politically: who/what affects this bill?

In the United States, health care insurance companies have a tremendous amount of power on the influence of governmental decisions as it applies to health care. This bill would expand most normal coverage policies for the autistic child, which would result in overall increased costs for insurance companies to care for these individuals throughout a lifetime. The following parties also have an influence on HB 1588: nurses, policy advocates, pharmaceutical companies, bill sponsors and active voters.


What impact would HB 1588 have on nurses, individual clients and families, and the health care system as a whole?

If HB 1588 is passed, nurses would be able to be more efficient in the care they give. The passing of this bill would also require nurses to be more educated on autism spectrum disorders. If autistic clients were receiving behavioral therapy, they would be more compliant. This would make the nurse's job easier (ex. fighting with patient). The patients would probably be more compliant overall if they were provided with medical coverage. They would probably take their medications regularly, attend therapy sessions and obtain help when needed. Children are more likely to be abused when parents are frustrated and stressed out. With HB 1588, Families would be less stressed about obtaining care for their children. This could potentially lead to a better home environment. The health care system would need to create more jobs to facilitate the care for these clients if this bill is passed. The health care system would no longer have to "eat the cost" of the treatments provided to these children because the insurance companies would be required to pay.

7 comments:

  1. I think this bill is a great idea! I babysat for a family a few years ago who was having a hard time paying for treatment for their autistic son. They ended up being unable to afford the treatment, so they did everything that they could afford: dietary changes and having him sleep with his head near a huge magnet (which was supposed to help). A bill like this could help so many families in similar situations and hopefully cut down on costs that are sure to build up once these children become adults.

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  2. To highlight the additional cost that autism carries when compared to other children with diabetes or asthma, a study conducted in 2005 found that “Autistic children exhibited significantly greater median total healthcare costs than children with asthma ($2103.58 vs. $850.27, P < 0.05) or diabetes ($2103.58 vs. $1605.20, P < 0.05) in the 12-month post-diagnosis period. After controlling for confounders, autistic children exhibited significantly greater 12-month post-diagnosis total healthcare costs than asthmatic children (P < 0.0001); the difference in total healthcare cost between autistic and diabetic children was non-significant (P = 0.84) (Flanders et all, 2005).” Even though the total healthcare cost were not found to be significantly different, the awareness that cost are high for any child with a certain problem carries stressors for parents in being able to pay for treatment without additional insurance. Does anyone know how much insurance covers for other children’s diagnosis versus autism?

    Here is the link for the abstract of the article that I found http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=103623413.html

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  3. We were unable to find an exact number for the annual costs for a child with a different chronic illness. However, we acknowledge that any child who has a chronic illness is in need of frequent, or constant, medical support and treatment, which causes medical bills to quickly accumulate. As a group, we feel that the passing of a bill that would financially aid families who have a child with a chronic illness is so imperative. In the case of Autism, children need treatment early because the longer treatment is delayed, the less progress these children have later on. However, without the money to pay for behavior therapy and speech therapy, these children are going without treatment, causing them to potentially regress even further and lessens their chances of progress to a more functional individual.

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  4. That is a very significant fact that autistic individuals have a much higher need of care over their lifetime and thus spend hundreds of thousands to several million dollars over their lifetime. My cousin, Bryce, is autistic, and the onset of his autism was AFTER he was born. Even as an infant, he was considered "high-functioning" and normal, but around 1 year of age after he had already started talking he stopped, and it was discovered that he was having continuous frontal lobe seizures that destroyed his ability to be a normal child again. He is now close to 15, and even his growth is stunted; his younger brother Ryan is taller and bulkier than he is. It is sad to see my cousin going from a happy little baby to the person he is now; action really does need to be taken. I wholly agree that insurance companies should be forced to take on the responsibility of helping support the medical costs of these children; my aunt and uncle were lucky because they got in touch with the Autism Society quickly and received grants for his care. However, I am still concerned about treatment after he turns 21. My aunt and uncle no doubt will still be taking care of him, but how much longer can he decide that he can still run and jump up in their laps as if he were 5? How much longer will he able to go up to strangers and take their hands to say hello without disturbing them enough to make them think he is assaulting them? It is appalling that insurance companies have denied care to these individuals and it is still disturbing that they will not be required to continue care after age 21.

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  5. This sounds like a wonderful bill that will benefit all parties involved, except the insurance companies. It is evident that the treatment for these children is crucial, and you state that paying for these preventive services will ultimately decrease health care costs for the government in the long run. But it will be the insurance companies that get hit hardest with the additional finances that they will be paying for these treatments. Do you know if any of the insurance companies have made a statement on this bill or have responded in some way?

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  6. In an economy that is struggling like ours is, I feel that creating more jobs could only benefit our society. Additionally, I'm sure the economic strain might be felt even more by families that are required to pay for the medical bills of their loved one out of pocket. If private health insurance agencies would cover treatments for autism, then perhaps that could alleviate that growing stress. I'm sorry to have read above that your bill did not pass for the time being considering how dire the need is currently.

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  7. Thanks to everyone who has commented on our blog! It is very disheartening to see these individuals age without progressing developmentally because of lack of treatment given to them.
    Natalie, I feel that insurance companies would take a financial blow if they were held responsible for providing the financial assistance to their clients with autism. However, throughout the nursing program, I feel that we have seen how some insurance companies take advantage of their clients by forgoing payment of services that the clients contracts states that the insurance companies will pay. As seen in "Sicko" and other lectures throughout the semester, many insurance companies work to make their bottom line aka the greatest profit possible. They should be working for the benefit and health of their clients, but this is often not the case!

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