The Money Question
Why are DAN! doctors so expensive? is a question on the website for Talking About Curing Autism (TACA): Have you ever not been able to continue or even start a therapy for your child due to the costs? Today’s Columbus Dispatch reports on the costs of autism and how families and advocacy groups in several states are seeking to get insurance and Medicaid coverage for treatments and therapies.
“I just feel like taxpayers shouldn’t have to pick up the tab,” said Tamara Heydt, the boys’ mother. [Heydt’s sons are both autistic.] “My insurance should have to pay for it. Insurance companies pay for other neurological disorders. I feel like it’s discrimination.”
A bill in the Ohio House would make this happen. It’s modeled after the 2-month-old mental-health parity law, which requires that health insurance cover certain psychological conditions.
The measure has bipartisan sponsorship from Reps. Jon M. Peterson, a Delaware Republican, and Ted Celeste, a Grandview Heights Democrat.
Like the mental-health parity law, this bill would apply to fully insured plans, not self-insured policies. Larger companies and governments tend to have self-insured plans that are governed by federal rules.
Joseph Gibbons, director of government relations for Medical Mutual, said his company doesn’t cover autism treatment and, to his knowledge, no employer has ever asked for such coverage.
Insurance-industry officials want more details about the House bill and are concerned it would open the door to more mandates based on a disease or health condition.
Some 17 states, including Connecticut, Georgia, Indiana, Kentucky, Maryland, New York and Tennessee, require health plans to provide some treatment; Ohio is one among several considering such measures.
TACA mentions the following to help pay for treatments (from DAN! doctors): asking foundations and family to help; getting a loan; and asking if practitioners offer pro-bono work or special payment terms.
15 opinions for The Money Question
Patrick
Nov 8, 2007 at 3:42 pm
I feel like it’s discrimination too.
There are times when I feel like we have been done an injustice by the mainstream medical and research communities by their lack of observance and action in the past.
Some 31 years ago, yes 1976, I attempted to report my difficulties to doctors who at that time had no name for my condition. They thought I needed psychiatric or psychological help. But now 31 years later we at least know that this is a neurological disorder.
At this time I would be happy seeing more freely available support services for Autistic people, of all ages, instead all we have are expensive experimental attempts at cure by folks who don’t even follow mainstream science or medicines principles, and virtually no government support for United States adult citizens, even taxpaying ones.
I also think that instead of the vague recomendation that was listed by TACA, they should get off their butt and list specific Foundations or Providers for pro bono work, and not expect families and individuals who might already be financially distraught to become more indebted, or ask them to get money from other family members.
In the end, my answer is probably that these doctors are soo expensive as they have to pay for travel and hotels at their overblown conferences, that so far have left us with dubious return value on any previous investments.
Markus
Nov 8, 2007 at 5:01 pm
And if you’re in California, you have to dig like a gopher to find this, but the law is actually on your side when extracting coverage from insurance coverage: http://www.insurancehelpforautism.com/index.html
You may need to have a heart to heart with the medical provider or the HR department of your company to aid your efforts. A lot depends on the HR department too and whether they have any leverage. It’s not easy, but it can help.
VAB
Nov 8, 2007 at 5:13 pm
Patric, keep in mind that “treatment” from DAN! doctors is not actual treatment, but basically just smoke and mirrors (some of which is actually harmful). I would not want to see anyone paying for that kind of nonsense.
Regan
Nov 8, 2007 at 5:25 pm
Patrick said,
“…At this time I would be happy seeing more freely available support services for Autistic people, of all ages, instead all we have are expensive experimental attempts at cure by folks who don’t even follow mainstream science or medicines principles, and virtually no government support for United States adult citizens, even taxpaying ones…”
That’s the key point for me. I don’t want my insurance company or my tax dollars paying for homeopathy or similar.
passionlessDrone
Nov 8, 2007 at 5:55 pm
Hello friends -
It reminds me of a bumper sticker I saw once, ‘If you think education is expensive, try ignorance’.
Take care!
-pD
Kristina Chew, PhD
Nov 8, 2007 at 6:08 pm
I was surprised to find the TACA page about the costs of DAN! doctors, though not entirely surprised by the recommendations. I’d like to know how the practitioners themselves address these issues of expenses—what do they say to families?
peony
Nov 8, 2007 at 7:03 pm
Kristina,
Columbus dispatch does not mention anything about DAN therapy coverage. What the parents in the article would like to get coverage are mainstream therapies such as speech, OT, PT and behavioral therapy. These are therapies that most pediatrician recommend. There is still not enough evidence that show any of the DAN! therapy works. Even if the bill passed, I doubt that DAN therapies will be covered.
Autismville
Nov 8, 2007 at 7:27 pm
Hopefully the new recommendations by the AAP for treatment will provide some leverage to those attempting to obtain insurance coverage.
In Texas where we used to live, there was absolutely zero provision of ABA/ST or OT in the public school. So we paid out of pocket since our ERISA governed plan refused to cover autism related treatment … “Experimental” they called it.
Regan
Nov 8, 2007 at 9:35 pm
Just FYI, since it drives me nuts when news stories do not give the bill numbers of legislation–the Ohio bill–HB 170. No mention of specific treatment modalities, which I am guessing will be hammered out in committee or in rule-making in the insurance division if it passes.
http://www.legislature.state.oh.us/BillText127/127_HB_170_I_Y.html
Our state recently included some mental health parity for autism if under the treatment of a licensed psych, or speech and OT under a developmental disabilities bill. Unfortunately we do not have Medicaid waiver, which still makes the whole thing an expensive enterprise, and ABA still gets the hit as “experimental”.
Sarah
Nov 8, 2007 at 10:42 pm
I feel like it’s somewhat dishonest to compare Autism to other (so-called) “neurological disorders.” It’s clearly not like Alzheimer’s or Parkinson’s or something. It’s a developmental difference, but the “treatment” is completely different. It’s educational, not medical.
As for DAN! doctors, is there any evidence at all that they actually “treat” autism successfully? And why should the government (or insurance companies, for that matter) pay for unproven “alternative” medicine?
IMHO, kids with autism don’t need medical treatment *for autism.* They just need access to education, like any other kid.
Amalthea
Nov 9, 2007 at 8:41 am
For me, the most important part isn’t even about insurance covering autism “treatments”, regardless of whether they’re in the form of snake oil or educational accommodations… it’s whether or not this will prevent the insurance companies from continuing to cite a diagnosis of autism, Asperger’s, or PDD-NOS as a “pre-existing condition” and proceeding to refuse coverage of adult autistics entirely.
I can’t quite parse the language in the above-linked bill well enough to determine exactly what they’re trying to do. Could someone more fluent in legalese please tell me if this bill would do anything to remedy that issue?
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Deana
Feb 5, 2008 at 11:29 pm
I’m ALL for DAN! doc’s! Wish it were easy to afford one! I have 2 autistic kids myself and have a wonderful family doctor, my own autism company, and access to many things. Unfortunately, the heavy metal toxicity they have(recorded at family doctors with PROVEN tests) can only be treated with someone who has an extensive biochemistry background(DAN!) We have been doing the diets, and supplements, natural detoxing for 3 years, plus all of my clients do too, and what a HUGE difference it makes! Do the research people, type in heavy metals and autism and how it affects the immune system to detoxing, and how the metals strip out IMPORTANT nutrients that “feed” the brain. All of the kids have enviornmental sensitivities, and only the DAN! docs will treat it nutritionally. For example…All the “meds” to mellow out your kid covers a problem, but supplements like A,C,E,ZINC and MANY others boost the immune sysytem to feel better naturally……no thanks to meds, it’s all natural for us…….and BTW, both of my kids are NOW HFA, and Aspergers, 3 years ago LFA
Kristina Chew, PhD
Feb 5, 2008 at 11:35 pm
I hope things continue to go as well for your kids—sounds ike you have done a lot. We did a number of biomedical remedies until my son was 6 and I have the earliest version of the DAN! protocol; it’s education that has always been our main priority. Best wishes —-
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Mar 1, 2008 at 3:16 pm
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