| News
& Views
- Oct, 1992 Issue |
A Response To Dr. Eugene Thorne
By: Saul Rudman, M.S.Ed., Director of Adms.
CEDU Middle School * CEDU High School
Running Springs, California
(714) 867-2722
In issue #17 (August 1992), Dr. D. Eugene
Thorne ponders “Does it seem to others that it is paradoxical for insurance
carriers to demand compliance with standards (such as those of JCAH)
which appear only to increase costs without any demonstrable increase
in outcome effectiveness; and, then to refuse to reimburse parents who
utilize these more cost-effective and outcome-effective, licensed, residential
treatment facilities?”
Thank you, Lon, for facilitating a dialogue
on this subject. I, too, am frequently frustrated by the tendency of
insurance companies to focus on accreditation as opposed to cost effectiveness
and outcome effectiveness. Few would argue that accountability, quality
assurance, and standards of safety are crucial in residential schools
and residential treatment centers. Schools such as CEDU do achieve these
high standards as well as tremendous outcome-effectiveness. Nevertheless,
most insurance companies seem to be completely resistant to researching
the world beyond “JCAH.’; a world that would provide cost-effective,
long-term help under the direction of highly competent licensed mental
health workers.
I am slowly learning (from the CEDU students)
to focus on the solutions versus the problems. In the current economic
and insurance industry environments, creative solutions seem to be extremely
rare. In the spirit of brainstorming, here’s one unresearched fantasy
to be pursued by an enterprising reader.
Many universities offer alumni an investment
option which pools alumni contributions, prudently manages and invests
the pool, and uses the principal plus dividends and interest to provide
tuition for the alumni’s children. In essence, this scheme resembles
a “mom and pop” college tuition insurance; contributing to a pool over
several years insures tuition when or if it’s needed. Should the student
opt to not attend that given institution, their principal plus some
minimal interest is withdrawn from the pool with no penalties.
Parents of new-born children face the reality
that there is a statistically significant chance that their child may,
at some time, need special attention in the educational setting. Their
“special attention in the educational setting. Their “special needs”
may be emotional, cognitive, or a combination of the two and may require
costly remediation and/or residential placement. Surely (tax laws permitting)
many insurance minded parents would gladly contribute to an “education
insurance” pool modeled after the university scheme discussed above.
Small annual contributions could ensure that, if needed, their child
could receive special tutoring, equipment, or placement. If not needed,
principal and some interest could ultimately convert into college tuition.
Since the “need for special services” would have to be verified in order
to protect the pool, a panel of peers (parents who are in the pool and
have loyalty to the pool as well as the special needs of children) could
substitute for the cost conscious, detached “case reviewers” traditionally
existing in the insurance industry.
I believe that my colleagues and I have
some obligation to continue to seek ways to open our doors to those
who have been “boxed-in” by their insurance carriers. Let’s keep talking!
Copyright
© 1992, Woodbury Reports, Inc. (This article may be reproduced without
prior approval if the copyright notice and proper publication and author
attribution accompanies the copy.) |
