Should health insurance cover autism treatment?

If universal health coverage comes to fruition, there will be intense lobbying to influence what will be covered.

Doug Farrago talks about behavioral therapy for autism as being one controversial issue. It’s expensive, hasn’t been proven to work, and addresses a disease where there is no definitive diagnostic test.

Politicians will have to make difficult decisions, or the cost of coverage will spiral wildly out of control.

Will they have the balls to stand up to impassioned lobbying when push comes to shove?

It’s doubtful:

Lawmakers . . . are afraid of looking bad by not supporting these bills. Who wants to say no to children? . . . If we go to socialized healthcare system then the government pays the cost and they just pass it on to the rest of us as well. The bottom line is that someone has to pay for this questionable therapy for a medical problem that isn’t so easy to diagnose.

Comments

Supremacy.claus
I would appreciate data to support any form of unified syndrome of autism, outside of a totally non-specific, final common pathway for 1000 causes of a deficit in relatedness. One clear association is with a mood disorder in mothers. These parents who will not let go may have a high rate of serious mental illness, and their obsessiveness may be a symptom. We may be spending $billions catering to the severe mental illnesses of the clients of bullying lawyers.
Most of the overdiagnosed kids are immature, in their language, in their social skills. Wait a couple of years, they miraculously improve. This happens with or without the $100K in bogus treatment outside of ordinary education and enriching life experience, such as team sports, family outings, invitations to normal kids activities.
I find these rich, entitled bullies to be pernicious, especially with their lawyers. These blood sucking lawyer predators are stealing every penny from the public. Worst of all? They are depriving superior poor kids who would blossom and zoom ahead with the slightest opportunity. These deprived but superior kids do not have vicious lawyers to intimidate schools. They rot in rotten local schools that crush all striving and intellectual enrichment, surrounded by future criminals and drug addicts having no need for any education.
Hillary Clinton promised $700 million in additional autism funding. That is a huge bribe to her teacher constituency for worthless make work. Such corruption dwarfs the biggest organized crime enterprise. Clinton is a lawyer. Obama is a lawyer. They will control government for the foreseeable future, and repay their constituencies.
Anonymous
When they can no longer put off the tough economic choices on medical costs, they’ll probably pass the buck eventually to something like the military base closure commission. That may allow our government to start saying “No”.
Dr. John Grohol
Wow, it's scary to see physicians believing the rubbish published by a mainstream newspaper, rather than actually looking at the primary literature themselves before jumping to misinformed conclusions.
Depression doesn't have a blood test either, does that mean it doesn't exist? Gee, it's no wonder the stigma and discrimination around these disorders continues to exist when supposedly-bright docs talk like this. Autism, like depression, is in the DSM-IV, meaning it exists and although you're welcomed to disagree with its diagnostic criteria, is very much a real condition.
I pulled up over 800 studies in PsycINFO on behavior therapy and autism. So while it's nice of USA Today to look at 2 of those studies, I think that's a far cry from an objective literature review of the effectiveness of behavioral therapy for autism. Here's a few that tell the other side of the story:
Cohen, H. et al. (2006). Early Intensive Behavioral Treatment: Replication of the UCLA Model in a Community Setting.Journal of Developmental & Behavioral Pediatrics, 27(Suppl2), S145-S155.
Diggle T, McConachie HR, Randle VRL. (2004). Parent-mediated early intervention for young children with autism spectrum disorder (Cochrane review). In: The Cochrane Library, Issue 3. Wiley, Chichester, UK.
Eikeseth, S. et al. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: A comparison controlled study. Behavior Modification, 31(3), 264-278.
Eikeseth S, Smith T, Jahr E, et al. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism. A 1-year comparison controlled study. Behavavioral Modification, 26, 49–68.
Really, I think your readers expect more from you than links to garbage such as this.
Michael Rack, MD
Dr. Grohol, I agree with you that autism exists; I don’t know enough about beavioral therapy for autism to comment about that. However, your arguement that a disease is real because it is in DSM is weak. Homosexuality was once in the DSM, but it was taken out by a vote of the APA.
Dr. John Grohol
Yes, that’s old history — it happened 35 years ago and a number of DSM revisions ago. Should we also go back and look at the medical texts of the 1800s to make similar facetious comparisons?

Should health insurance cover autism treatment?

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