About Me 0117: About Making Money

A lot has been made in the debate about Autism and healthcare, because of the potential burden it will place on insurance companies, who will most likely trickle that cost down to everyone. I'm not going to get into the debate as to whether or not insurance coverage for Autism is right or justified, but rather I want to talk about the costs of Autism. Or, more specifically, the overall toll Autism plays on families.

Applied Behavior Analysis (ABA) therapy is the only therapy or "treatment" that seems to work with children with Autism. It uses the Behavioralist method of teaching by encouraging correct behaviors with rewards. It also uses the Environmentalist teaching method, in that practitioners eliminate distractions from the classroom environment, making it easier for the children to learn. It's great, when done correctly, and it can be expensive.

In order for it to work, you need to have a psychologist on staff, your therapist, an occupational therapist (manages sensory needs as well as motor skills), and a teacher. Most often your staff to student ratio comes very close to 1:1, and that's expensive. These are all highly trained individuals that have worked hard, studied hard, and spent a lot of money to get their education customized to work with these children.

Now, many good school districts, much like the one we are currently in, have great programs that provide all this as part of the Public school system. Most do not, from what I understand. Therefore parents need to go to special private schools, often costing them between $28,000 to $50,000 a year per student. If they have two children, it's doubled, and so on for each child on the Spectrum. It's not the most encouraging sign.

And, of course, these schools and supportive school districts are few and far between. That means either driving long distances, or moving to locations that have support for children on the Spectrum. This limits job mobility, housing opportunities, and a feeling of control that many people have naturally. That goes to piece of mind, and is a hidden stress point on families with children on the Spectrum.

But therapy isn't the only thing that is expensive! When the child goes home, they need to continue the same routines that they are being taught at school. Therefore parents need to modify the home environment to match, as much as possible, the school environment. For some families, that means providing a "sensory room", where children can pull out of their fog by being provided the sensory stimulation or deprivation they need, depending on their sensory needs. So dark rooms, soft music, indoor swings, trampolines, full body massagers, and a ball pit are just some of the things that can help children. Some of those things are pretty cheap, but others can be expensive.

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Many Americans are soon going to find prescription medications making less of a dent in their wallets, with 19 brand-name drugs losing patent protection this year or next, and more than two dozen others by 2015.

Before long, "eight out of 10 prescriptions can be filled with a generic," notes Steve Miller, chief medical officer for Express Scripts, a pharmacy benefit management company in St. Louis.

Among the bestselling drugs, cholesterol reducer Lipitor lost its patent protection last week, while the blood thinner Plavix loses exclusivity in the spring of 2012. As other firms manufacture generic equivalents, prices should drop "by 60 percent to 80 percent," Miller says.

For example, before the cholesterol drug Zocor went off patent in 2006, it sold for about $150 for a 30-day supply. Six months later, as more generic manufacturers entered the market, the price dropped to less than $20, according to Express Scripts.

Obviously, consumers would be wise to pay attention to which of their medications are moving to generic, but there other steps they can take to save on prescriptions.

Talk to your healthcare provider. If drug costs are an issue, "tell your doctor," says Ira Wilson, chairman of Brown University's Department of Health Services, Policy, and Practice. Too often physicians prescribe the newest drug, even though an established medicine may work better and cost less. A published study of 17,000 seniors by Wilson showed that patients are about five times more likely to be switched to a lower-cost medicine if they discuss costs with their doctors. Even when generics aren't available, doctors have other lower-cost options, such as prescribing another drug in the same therapeutic class or even within a different class.

Get a medication review. Ask your doctor or pharmacist to review your medications, suggests Nicole Brandt, associate professor at the University of Maryland's pharmacy school. "The first question is whether a medication is still indicated," she notes. "Clearly, you'll save a lot of money if you can stop a medication."

Some medicines intended for short-term use, such as sleeping pills or drugs that many hospital patients get to relieve stomach distress, unwittingly become long-term habits. Drug reviews also can lead to dose reductions for certain medicines—common among older adults, as the aging body metabolizes drugs differently—or reveal that patients are taking similar medicines prescribed by different doctors. Under Medicare, certain beneficiaries may qualify for a free annual medication review, Brandt says.

Look for 3-for-1 deals. Mail-ordering drugs can save you money on medications that you tolerate and take for a chronic condition, but not for one-time prescriptions. You also can get a 90-day supply for a single copay, rather than three monthly ones. Some local pharmacies do this, too.

Check your health plan's formulary. You'll pay more for brand-name medications that are excluded. However, if a particular drug is necessary for you and not covered under the formulary, then "appealing is a good thing to do," says Cheryl Fish-Parcham of the advocacy group Families USA.

Check with your health plan about how to pursue the appeals process or consult your state's Consumer Assistance Program. These resources can also hook you up with pharmaceutical assistance programs if you are having problems affording your medicines.

Now read how biking to work is saving one writer's life >

About Me 0117

Monday, December 26, 2011

About Making Money

Now read how biking to work is saving one writer's life >

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