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| Yes | 58% | 32 votes | Total: 55 votes | |
| No | 42% | 23 votes |
Yes
by Myca Belknap
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Add to FavoritesThere is currently in the House of Representative a bill which would require Blue Cross Blue Shield (of Michigan) to cover Autism Spectrum Disorder therapy and treatments. Some people are afraid that forcing insurance companies to cover therapy for autism spectrum disorder (ASD) will take away funds from much needed critical care. Such insurance bills have been passed in other states with wonderful results for individuals, families, schools and health providers as well as other professionals rendering services and therapies for ASD patients. The passing of such bills in other states has enabled investors to start private schools (with insurance funding) and thereby offer parents more options as to their child's education. The opening of these schools has also provided employment opportunities to a variety of educational personnel. Running such a school requires Occupational Therapists, Psychologists, Physical Therapist, Teachers, Counselors, Secretarial and Office Staff, Janitorial Services, ect.
It seems to me that the condition of "autism" is a valid disease and it should be considered "critical care". One in 150 children is being diagnosed on the spectrum and that number is predicted to rise even more. Autism is just as debilitating as and more prevalent than diabetes, heart disease, and cancer combined and more long term than some other "covered" diagnosis. Some argue that there is no cure for autism and since it is not life threatening it should be up to insurance companies whether or not it is covered. There is no cure for diabetes, heart disease, and many cancers. But these are life threatening and they claim ASD's are not. Perhaps it is really all about profits. What am I saying? It is always about money. These statements imply that these children do not "need" care as much as any other policy holder and that their condition is not say "life threatening". However, as in my son's case, autism is a "life threatening" condition which if gone untreated puts them in jeopardy of losing their lives, for some everyday. Many, like my son, put themselves at risk and may come close to dying on more than one occasion. The right therapy could decrease the chances of them running out in front of a car or drowning in a lakemy son IS in "imminent" danger. Autism IS a critical and "life threatening" disease. A large number of individuals on the spectrum die because of the symptoms of ASD. Other children on the spectrum will have their own (some different) areas where their life could be threatened. For some, like my son, it is a threat of their physical life, others it is a threat of their quality of life. For some it may be the difference between living on their own or burdening the state in a foster or assisted living environment. The cost of therapy, psychologists and in home tutors is more than the average person can afford. Many cash in their life insurance policies and retirement nest eggs in order to get the treatment their children need. Some take out second mortgages on their homes and put liens on their vehicles. This, however, causes another problem down the road so to speak. When parents die, or are no longer able to work, their ASD children will most likely not be able to support them, let alone themselves. So, the state is burdened and the individual with ASD is taken from their familiar environment and put in a home or other state funded facility. As the numbers rise all of these things may feasibly play a role in the nation's economy. I am personally insulted by the insinuation that autism is any less "critical" than other covered conditions simply because it does not consume the body from the inside out. If we do not pay attention now to the reality of Autism Spectrum Disorders we may be facing much larger problems as a nation in the future when more than one out of every 150 citizens are "on the spectrum". For more information on the rise of autism go to www.autismresourcene twork.org.
Learn more about this author, Myca Belknap.
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No
by David Guzman
Insurance companies do not need more regulation, they need better
regulation.
Ins urance regulation today is a crazy quilt of state insurance
departments , industry ratemaking organizations, assigned risk pools,
and quasi-governmental regulatory bodies. State insurance laws vary
significantly, sometimes even contradicting each other so that
compliance with one state's laws violates another's. Variations in
state rate regulation has the effect of forcing insureds in one state
to pay significantly more than identical insureds in a neighboring
state.
A multi-state insurance company typically deals simultaneously with
more than 51 different regulatory authorities and a number of industry
groups with rate-setting authority. This reporting burden is
significant. Each state requires its own set of annual, quarterly and
ad-hoc reports. All multi-state insurance companies therefore must
dedicate staff to regulatory reporting and complying with each state's
unique requirements.
The cost of complying with and supporting this regulatory nightmare is
a part of the premiums we all pay. Insurance company expenses are
higher than necessary because of this excessive reporting. More
premium tax revenue is dedicated to insurance regulation than is
necessary. The lack of communication between jurisdictions makes
insurance fraud easier to commit because criminals in one state can
simply move to another if things get too hot. Innovation is stifled
because of the difficulty of introducing new products. It is
difficult to standardize forms across states, and the process of
getting new forms approved can take months, even years. The quality of
regulation varies significantly from state to state. In some cases
insurers choose states where they will write business because of the
regulatory environment. They even leave a state altogether in some
cases, leaving insureds high and dry.
If insurance laws and regulations were standardized, reporting and
reserving practices could be standardized, oversight would become more
efficient, regulatory and compliance costs would be reduced, and
benefits would be standardized. More effort could be spent on
innovation, attacking fraud and otherwise reducing costs.
What would be my ideal scenario? I believe that insurance companies
must be regulated just as any financial business must be regulated.
The most important regulatory areas relate to insurer solvency,
conduct, coverage availability, benefits, and pricing. Solvency
regulation and law enforcement should be Federal responsibilities
beca use of their national scope. Consumer protection and insurer
conduct should be a state responsibility. Coverage requirements and
definitions should be divided between state and Federal regulators.
This would allow for some standardization, for example with health
insurance, while also allowing product innovation.
The situation is not likely to improve, however. The regulatory quagmire will
continue to grow and deepen because the states would have to cede some
of their regulatory power to the Federal Government. State insurance
departments are large employers, and any standardization or
centralization would reduce the number of employees. Reduced costs
and reduced premiums will reduce premium tax income as well.
Insurance innovation is difficult, in part because of the regulatory
hodge-podg e, a desirable situation from the insurance department perspective
because new products are often difficult to understand initially.
The status quo is desirable from a governmental point of view.
Legislatures can mandate benefits while the insurance departments
limit the rate increases required to pay for the benefits. This
creates a dynamic that benefits only the regulators. They have no
incentive to give this up. Most of the insurance industry withdrew
altogether from Maine during the late 1980s due to exactly that type
of situation.
This is clearly a situation that will not change without courageous
action on the part of every legislative body in the Country. In the
meantime, we all pay more for insurance than is necessary. Get out
your wallets, folks!
Learn more about this author, David Guzman.
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