Insuring America's New Epidemic: Autism

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published December 24, 2007

In light of such a dramatic increase, experts have tried to explain not only the reason behind the rise in diagnoses but also the very cause of autism itself, which remains largely unknown. Unlike most physical and mental health issues directly related to children's health, autism is still viewed as a little-understood anomaly, frequently leaving parents and caregivers of diagnosed children little recourse to either medical or emotional support.

The cost of treating autism is extraordinarily expensive: average estimates for treating a child with autism (who may require 30 to 40 hours a week of medical treatment, including occupational, speech, and physical therapy) start at $70,000 and easily climb into the hundreds of thousands of dollars before the child has reached the age of 16. A 2003 U.S. study put the average lifetime cost of autism treatment at a staggering $3.2 million, while a British study estimated the lifetime cost at almost $5 million. The current economic impact of autism stands at $90 billion, a figure expected to more than double over the next decade.

Clearly, treatments are not cheap, and in families where financial resources are limited, children living with autism are often left to fend on their own, creating a multitude of additional negative outcomes — commonly long-term stress, physical deterioration, social isolation, and divorce.

Astonishingly, healthcare providers and insurance companies currently offer little to no coverage for autism treatments. This may be due in large part to the fact that the disease is so little understood. With many pediatricians missing early warning signs or misdiagnosing autistic children as simply "developmentally delayed," few treatments are recognized as being sufficiently able to combat common effects of the disorder.

Thankfully, parents have taken the lead where insurance companies and medical officials have failed to do so. An 'autism culture,' replete with various interpretations of the disease and its most effective treatments, has risen nationally and become entrenched in areas where autism rates have skyrocketed, forcing lawmakers to deal directly with the issue of autism healthcare. As private insurers may elect not to cover autism-related health expenses, a bipartisan effort among lawmakers in several states has been formulated to change the current voluntary standard.
United States

Detroit Senator Tupac Hunter affirms, "If treated early, people with this ailment can go on to become productive citizens, but what happens is, because the treatment is so expensive, because insurance companies don't cover it, gone untreated it gets worse and worse and worse."

The fact is that for a large number of individuals, autism is treatable. A small percentage of diagnosed children have even been known to recover fully and adopt normal social and behavioral skills. The debate as to how and why is just beginning, but it cannot be successfully resolved without the proper intervention of federal and private insurance coverage, without which the epidemic remains a major threat to the next generation of American children.


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