Mandating Insurance Coverage for Autistic Children

The Center for Disease control estimates that 1 in 110 children in America have an autism spectrum disorder, or ASD, and the number of children diagnosed has increased 57% in just four years (Rice 1-20). Almost everyone has had some experience with a child diagnosed with autism. These children reside in our communities, attend our schools, and may even be in our own family. Some states, such as Oklahoma, have individuals that are dedicated to passing mandated insurance coverage for children on the autism spectrum. They have been met with fierce opposition and have yet to succeed in getting any mandate passed in legislation. Only six states have specific laws that mandate insurance coverage for autism while 10 others have coverage for autistic individuals through mandates for the mentally ill (Kaminski). The lack of adequate health care for children with autism is a real problem in the United States and the number of families affected by this deficiency in coverage is only growing. States should mandate private insurers to provide coverage to children under 21 diagnosed with an autism spectrum disorder because the expense on the individual family is too great which results in a lack of treatment, left untreated the effect on autistic children as well as society is detrimental, and this is the only way to insure that autistic children receive adequate health insurance coverage.
Many opponents of laws mandating that private insurers cover autism treatments for children argue that the cost of individual premiums will rise and would result in more families not being able to afford health insurance. These opponents often include the health insurance companies, which have an interest in retaining a high profit margin, state Chamber of Commerce’s, as well as many in the Republican Party. Also, some individuals believe that they shouldn’t be forced to pay the high cost of coverage for a child with autism even though their particular family is not affected. The increase in health insurance premiums due to mandated autism coverage varies from state to state. While the state of Virginia, that recently passed these type of mandates, has forecasted a $4.88 rise in standard monthly premiums, other estimates have been much more conservative predicting a premium increase of only one dollar ("Evaluation of Proposed Mandated Health Insurance Benefits" 1-60). The average cost of covering an autistic child for one year is $36,000, which is about three to ten times the amount spent on health care for their neurobiological typical counterparts (Bouder, Spielman, and Mandell 953-957). This type of financial burden on a family can be insurmountable. Often times when parents cannot afford the treatments that their children need they are left with no options. Some low-income families can receive assistance through state insurance such as Medicaid, although many services such as applied behavior analysis, or ABA, may not be covered. Some opponents also argue that many therapies are offered through the school for free and are not based on a family’s income. Unfortunately, many autistic children rely on services that cannot be obtained at school. Early intervention is absolutely crucial to the development of children with autism. According to a report by Michael Guralnick, proper early intervention, before age 5, can reduce, and in some cases even prevent cognitive delay in children with disabilities (345-319). The increase in premiums that may result in these types of mandates would be minimal compared to the bankruptcies, stress, and lack of treatment for individual families.
I believe that autistic children who receive proper early intervention tend to be more productive members of society later on in their life. By passing mandates to cover these individuals we will be ensuring that they receive adequate and proper treatment. When autistic children receive proper treatment they have improved cognitive and behavioral skills that allow them not only to work, but also to be successful. The American Academy of Pediatrics recommends that as soon as an autism diagnosis is suspected in a child, treatment should begin immediately ("Evaluation of Proposed Mandated Health Insurance Benefits" 1-60). There is a small window of time in which treatment is found to be the most effective. Many children are missing this window of opportunity due to a lack in health insurance coverage. According to a study published in the American Journal on Mental Retardation, “when young children receive early intervention, we found that 48% of all children showed rapid learning, achieved average post treatment scores, and at age 7, were succeeding in regular education classrooms” (Sallows, and Graupner 438-417). With laws that mandate private insurers to cover these types of services, autistic children will be guaranteed to receive these treatments that evidence has shown to greatly improve functioning. With the cases of autism only rising in the United States, more and more families will find themselves struggling to afford care for their disabled children. It is also important to discuss what happens when children who do not receive adequate treatment grow up and no longer have parents to care for them. These autistic children could grow up reliant on the federal government for their care. By ensuring health insurance for them now we can give these individuals, as well as society, more hope for the future.
Some insurance companies do in fact cover autism treatments; although the caps on coverage are set so low autistic children are still left with gaps in treatment. Some families aren’t waiting for legislation to be passed. In the case of, Johns v. Blue Cross Blue Shield of Michigan, a family sued Blue Cross for denying their autistic child applied behavior analysis and were successful (Baldas). Blue Cross went on to include coverage of ABA to patients ages 2-5 (Baldas). In this particular case, the outcome was positive, but these types of lawsuits take time and may only impact a small segment of the country. In the meantime, these children are losing crucial time that could be spent in treatment. Opponents argue that instead of mandates legislators should be focusing on expanding existing laws such as the Individuals with Disabilities Education Act and coming up with more effective programs to help treat autistic children. While this is a great idea, it is only one small step in the right direction. Opponents also argue that by allowing insurance companies to sell policies across state lines more competition would be created and that may result in more coverage for things like autism. However, selling insurance across state lines would allow an insurer to choose their regulator resulting in coverage for only the healthiest Americans ("National Association of Insurance Commissioners"). Those with illnesses would find it even more difficult to obtain insurance. Insurance companies that chose to continue serving customers with more severe illnesses would be taking on the most risk and would eventually become too costly or die out all together. Interstate policies would also guarantee that insurers would be able to sell policies without obtaining a license from the particular state that the consumer resides in and would prevent state regulators from protecting consumers ("National Association of Insurance Commissioners"). The cost of health care premiums is determined by how healthy the members are. Selling insurance across state lines would allow these insurers to exclude anyone that isn’t healthy.
Children are innocent and rely on their parents and society to care for them. If we fail to provide them with proper health care and treatment the effect will not only be on the individual and their families, but the result will have consequences to us all. If appealing to your better nature is not an adequate reason for mandates then I appeal to your common sense. Many mandates are already in place and do not necessarily increase health insurance premiums. The cost of the possible rise in monthly premiums is diminutive compared to the ability to ensure that children who have these types of disabilities are given the opportunity not only to be healthy, but also to flourish. In the spirit of full disclosure I must admit that I have a personal interest in these types of mandates being passed. My oldest son was diagnosed at 5 years old with Aspergers syndrome, which is on the autism spectrum. Due to a gap in his insurance coverage he has been unable to receive applied behavior analysis. I may be emotionally biased on this subject but I also have the ability to realize the complexities in getting treatment and understanding what it is going to take to make it happen. The benefits of mandating health insurance coverage for autistic children far outweigh the risks. While insurance premiums may rise by a few extra dollars a month, this is a small price to pay to ensure that autistic children receive adequate health care coverage. If these children receive proper early intervention they will be able to contribute to our society. Without these types of mandates autistic children will lack the ability to reach their full potential. I believe that these types of mandates will eventually be passed and insurance companies will begin to cover the treatments that autistic children so desperately need, but it is up to us as a society to determine how long these children and families will have to wait.















Works Cited

Baldas, T. "Michigan Class Action Settlement on Autism Treatment Hailed as Landmark Case." National Law Journal (2009): n. pag. Web. 24 Feb 2010. .

Bouder, J., S. Spielman, and D. Mandell. "Quantifying the Impact of Autism Coverage on Private Insurance Premiums ." Journal of Autism and Developmental Disorders 39.6 (2009): 953-957. Web. 23 Feb 2010. .

Guralnick, M. "Effectiveness of Early Intervention for Vulnerable Children: A Developmental Perspective." American Association on Intellectual and Developmental Disabilities 102.4 (1998): 345-319. Web. 23 Feb 2010. .

"Interstate Health Insurance: Myth vs. Reality." National Association of Insurance Commissioners. The Center for Insurance Policy Research, Web. 24 Feb 2010. .

Kaminski, J. "OLR Research Report." Insurance Coverage For Autism. 27 Dec 2006. OLR Research Report, Web. 23 Feb 2010. .

Rice, C. United States. Prevalence of Autism Spectrum Disorders --- Autism and Developmental Disabilities Monitoring Network. Atlanta: Center for Disease Control and Prevention, 2009. Web. 23 Feb 2010. .

Sallows, G., and T. Graupner. "Intensive Behavioral Treatment for Children With Autism: Four-Year Outcome and Predictors." American Journal on Mental Retardation 110.6 (2005): 438-417. Web. 24 Feb 2010. .

Virginia. Evaluation of Proposed Mandated Health Insurance Benefits. Richmond: Joint Legislative Audit and Review Commission, 2008. Web. 23 Feb 2010. .

Unit 2 blog: A Vindication of the Rights of Woman

In one section of A Vindication of the Rights of Woman, Mary Wollstonecraft addresses Rousseau’s ideas of a woman’s beauty and education. Wollstonecraft effectively persuades her audience by pointing out the fallacies of Rousseau’s arguments. She does this with her use of colorful and alluring vocabulary. Even if you are unfamiliar with this particular work she makes her premise very clear and lets the reader know her intentions and beliefs from the start. She begins by stating that even though you may know her opinion she feels that she must defend her position and in her own words explains that she must, “attack it in a more circumstantial manner, and make the application myself” (Wollstonecraft chap. 5 par. 2). Throughout the chapter Wollstonecraft includes direct quotes from Rousseau in an attempt to show the audience that she is not misquoting or deviating from his message. She follows by giving an explanation of why she disagrees. This is an excellent use of evidence and lends her argument ample credibility. At one point she quotes Rousseau as saying, “The education of women should always be relative to men” (Wollstonecraft chap. 5 par. 10). He is further quoted and explains that he believes that because young girls like to play dress up and that this must be the way nature has intended women to be and that as a society we should only nurture those qualities in regards to a woman’s education(Wollstonecraft chap. 5 par. 11). Wollstonecraft responds in a very direct manner, using powerful language, saying that Rousseau is not going back to nature but he is in fact appealing to his own “disturbed” and “crude” appetite (Wollstonecraft chap. 5 par. 16). Wollstonecraft uses the warrant or enthymeme that adultery could be a consequence of following Rousseau’s logic. She further backs her argument by explaining that if a woman is able to caress her husband while she should be angry, then why wouldn’t she be able to do the same when parting with a lover (Wollstonecraft chap. 5 par. 31). She continues to directly quote Rousseau and also persists that she wants to be consistent and give the reader an objective view. I love the way she concludes her argument by explaining that she does not hate Rousseau, but rather she explains, “I war not with his ashes, but his opinions” (Wollstonecraft chap. 5 par. 60). She also warns of the suffering and degradation of women if certain prejudices are not overcome. Wollstonecraft perfectly employs all points on the rhetoric triangle and is very persuasive by accommodating her audience and giving great reasons behind her claims. It is hard for me to imagine the attitude and behaviorism of her era but I can only imagine the courage it must have taken for her to state her opinions and beliefs. Even in today’s society women are often scorned for strongly expressing their views and are ridiculed publicly. I look forward to studying her works further.

Works Cited

Wollstonecraft, Mary. A Vindication of the Rights of Woman. Boston: Peter Edes

for Thomas and Andrews, 1792. Bartelby.com. Web. 23 February 2010.

Unit 2 blog: Responding to Writing Arguments

When presenting an argument I never considered using different techniques to try and win over my audience. After reading Writing arguments I have discovered many different tools that will enable me to be more persuasive to my particular audience. The rhetorical triangle helps make an argument more effective by considering three different points. You must consider the message, writer/speaker, and the audience when arguing (Ramage, John, and Johnson 75). This allows you to create a more persuasive argument that will be more productive and credible. One important point that the text explains is to understand the difference between an issue question and an information question (Ramage, John, and Johnson 77). In an argument the question is more likely going to be an issue question that offers different viewpoints and may be controversial. Another point that I found extremely useful is that you have to be careful about making certain assumptions when you are arguing. For example, if you say abortion is wrong because it kills a life, then you must understand that the opposition may not agree that a fetus is in fact a life. These kinds of unstated assumptions have been labeled enthymeme by the famous Greek philosopher Aristotle (Ramage, John, and Johnson 88). Stephen Toulmin took the idea of the enthymeme further by coming up with the term warrant, which changes the enthymeme into a whole logical form (Ramage, John, and Johnson 91). I have noticed in political arguments especially, the mistake of beginning an appeal with an unstated assumption that the opposition may not necessarily agree with, therefore the argument fails immediately. Another very important part of arguing effectively is verifying the source of the evidence you use to back up your claim. Your use of evidence lends your argument credibility. Using outdated or badly sourced evidence can destroy your message. Appealing to the ethos, pathos, and logos of your audience is important but it is also essential to consider its kairos. According to the text, the kairos of an argument is, “its timing, and its appropriateness for the occasion” (Ramage, John, and Johnson 129). For example, when writing a response to an argument like a newspaper article, you only have a short time to respond in order for your appeal to have the greatest persuasiveness. Using imagery, metaphors and similes, as well as short narratives, can make an argument more compelling. It is also very useful to accommodate your audience when you are arguing. It is very easy to have a one-sided argument and not consider the objections of those who would disagree with you. If you wish to be persuasive it is essential that be willing to concede to certain opposition and to summarize and address opposing viewpoints (Ramage, John, and Johnson 149). The text goes into further detail about how to make your argument more convincing. A resemblance argument is when you compare something to another hoping that you can relocate your audience’s feeling or understanding from one thing to another (Ramage, John, and Johnson 271). I have noticed that I often use resemblance when arguing about a complex situation. My oldest son has Asperger’s syndrome and in my arguments for mandated health insurance I often use him as an example of the type of people that would be affected by the new law that I am advocating. Lastly, the text talks about the importance of understanding critical differences in sources. When doing research it is important that you look at the source with rhetorical awareness. In order to read your source rhetorically you should ask yourself two questions: “What was the source author’s purpose in writing this piece? And what might be my purpose in using this piece?” (Ramage, John, and Johnson376). It is so easy to get caught up in your argument that you start to use sources that are only convincing to those that are already convinced. Not only are understanding your source rhetorically important, but the citing and documentation of the sources you choose to use is crucial. You can use attributive tags to help shape your reader’s response to a particular source (Ramage, John, and Johnson 390). For example, if you are using a source that you agree with you can use positive words to help shape your audience’s attitude toward the source. The last chapter of the assigned reading also goes into detail about how to cite sources using MLA and APA style. I hope to incorporate many of the tools and techniques discussed in these chapters to make my writing more persuasive and confident.

Works Cited
Ramage, J., B. John, and J. Johnson. Writing Arguments A Rhetoric with Readings. 7th ed. United States: Pearson Education, Inc., 2007. 75-387. Print.